Arbiraterone and / or Chemo

Hi , my understanding is early chemo is given within 3 months of diagnosis if the cancer has escaped the capsule I'd advanced. I also understand that now it should be widely available and is successful for 80% of men and should extend life by average 2 years for the 80%.
Abiriterone is given once the cancer becomes resistant to just zoladex and biclutamide alone ie it's the 2nd line of defence.
At this stage from what I have read of your hubbys situation, I would expect early chemo, zoladex and biclutamide at this time and see how they reduce PSA and cancer size.
Hope that helps

Hi , the chemo and abiriterone do different things so I don't think use of one excludes the other.
Chemo kills the cancer (and anything else fast growing). If it does not work it's usually because the man can not cope with the "poison" I've has a reaction or it damages too much else along the way, that is rare but does happen, 80% of men do well on early chemo.
The abiriterone I believe stops the cancer cells increasing in size by blocking the "food" source for a while.
So the chemo shrinks the cancer( my tumors went from 3.5cm to 0.5 cm on chemo, zoladex and biclutamide). Then in my case the cancer got clever and started using biclutamide as food so they stopped that, then as the PSA kept rising they started me on abiriterone. So for now I would imagine they don't reach for the abiriterone for your hubby as they will want to see if the PSA falls with zoladex and biclutamide first, then I would guess chemo soon and then wait. From what I understand you want to save the abiriterone until as late as possible if the other stuff can bash the cancer without it. Abiriterone does not work for everyone, you will know shortly after it starts if it does, my onco said average success is 18 months, some not at all some 4 years. Every mans cancer is different so like you when we look for answers we could be at the top or bottom of the spectrum or where the majority sit, in the middle!
As ever caveat that the above is what I have gleaned or been told by my onco , I am no doc.

There is a similar drug to arberiterone called enzalutimite which is likely to be my next drug. I will have it prior to chemo as the protocol when I was diagnosed was not to have early chemo that is a recently changed protocol following research. I also had bicultimide for the first 28 days to avoid tumour flare but then three years on I had it as a treatment and it was effective for about a year. I am nearly five years on with bone met spread.

So practices do vary according to what they find. Keep us in touch anyway.

sallyyy,

Regarding your hubby's high PSA. I started with a relatively low PSA, see my profile. I recall asking my Onco "what's better, a PSA of 6 or 600". Her answer was "it's irrelevant, it's the doubling time that matters". I persisted "so a PSA of 6 that doubles to 12 in 3 months is no better or worse than a PSA of 600 that doubles to 1200 in 3 months". Her answer was "yes".

You need to check this out with your Onco but if he/she says the same then maybe you don't need to be too stressed out by the high starting PSA. Fingers crossed for you.

David