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Zytiga/Xtandi post Cabazitaxel

Posted 24 Sep 2017 at 21:10


Could anyone point me to the rules on whether Zytiga or Xtandi are available on the NHS in England after Cabazitaxel?

My brother unfortunately is stage 4 with multiple spinal mets. Up until a few weeks ago he was undergoing a course of Cabazitaxel but crashed off that after 6 treatments and is now being treated in hospital for low blood counts and pneumonia. 

Prior to Cabazitaxel my brother had only 2 mets identified in his spine. He seemed to be doing well on the treatment as his PSA and PAP levels were going down but then he fainted at home and was brought to A&E.  Due his falling, he was X-rayed there as a precaution and this has led to a total of 10 new mets being identified on his spine, femur and skull.

After A&E he was transferred to the local oncology department and his mets were all irradiated. His mets have all been described as treatable by radiation but the oncologist has stated that no further scans will be carried out to determine how effective the radiation has been. The oncologist also told my brother that he now undergone all the treatments permitted by the NHS and that Zytiga or Xtandi (he previously has received neither drug) would not be available as they are still only under consideration by the NHS. The consultant added that in his opinion, even if Zytiga or Xtandi were available, my brother would be too weak to take them.   

Any advice is much appreciated.





Posted 26 Sep 2017 at 01:09

Sounds like a bit of confusion - both are approved for NHS use if the consultant believes that either would actually be beneficial. Sometimes, I suppose the man becomes so weakened that no treatment is going to have the result everyone is hoping for. It might help to understand the oncologist's position if you can clarify why his blood count is so low - have you asked?

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

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