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Break from enzalutamide?

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User
Posted 10 Feb 2021 at 13:53

My partner has been on enzalutamide for about 8 months. He had a spinal cord compression in October 2020 and has been unable to walk since - he was progressing in hospital, can move his legs but has little muscle strength. They discharged him in November because of a covid outbreak, since when his physiotherapy has gone from daily to once a week (if he's lucky). |He has some exercises to do, and is recommended to at least stand every day with the transfer aid, but a lot of the time he is too tired to even attempt it. His calcium has been reduced to a normal level after treatment. The oncology registrar today suggested they may recommend a break from (or dose reduction of) the enzalutamide, on the grounds of improving his QOL, that chemo would be an option if he were stronger. Does anyone have any experience of taking breaks from enzalutamide? We don't know if his inability to increase his mobility relates to the spinal cord damage itself, or the lack of physiotherapy, or the fatigue from the enzalutamide.

User
Posted 13 Apr 2021 at 23:46

Ladyisles, important to understand what R223 can and can't do. It doesn't treat the prostate cancer or extend life particularly, but can make life more comfortable if someone is experiencing significant pain from the bone mets. It also can have quite severe side effects or increase the pain as Sanders found.

If your dad isn't having a huge amount of bone pain, I would want to clarify what benefits the onco thinks Radium might bring?

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

User
Posted 13 Apr 2021 at 20:05

Hi Ladyisles,

If you have a look at my thread regarding R223 it will give you a more detailed account of my journey through R223. I persevered with the 6 cycles but my OH wanted me to stop after the 3rd sessiin due to the pain. I was assured at the time by oncologist that the pain was not associated with the Radium therapy. Get as much information prior to making your mind up.

After the 3rd session I started to experience pain. At present I have been diagnosed with Cushings syndrome, they say that they cannot associate it with PCa.

Cheers.

 

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User
Posted 10 Feb 2021 at 15:45

His PSA has risen from 8 to 25 since November; does this indicate the enzalutamide is no longer working anyway?

User
Posted 11 Feb 2021 at 08:24
I think the rise means it's no longer working. I would ask these questions of the oncologist. You also need to make sure you are in touch with the palliative care team.

User
Posted 11 Feb 2021 at 08:52

Hi artyfriend 

Enzaltumide only lasted approx 8 months for me too.

Due to psa rising I was taken off it and given a choice of chemo or Radium223. Presently undergoing R223.

So yes unfortunately it looks like Enzaltumide has started to fail.

Best wishes.

Sandy.

User
Posted 13 Apr 2021 at 19:49

Hi Sandy, my dad has been on enzalutimide but his PSA has started to rise so has been told to stop taking it. He has been put on steroids. He’s meeting with his onco next week. What is the Radium like??  He had already had chemo snd I know he won’t want to do that again as he is 82 this year. 

User
Posted 13 Apr 2021 at 20:05

Hi Ladyisles,

If you have a look at my thread regarding R223 it will give you a more detailed account of my journey through R223. I persevered with the 6 cycles but my OH wanted me to stop after the 3rd sessiin due to the pain. I was assured at the time by oncologist that the pain was not associated with the Radium therapy. Get as much information prior to making your mind up.

After the 3rd session I started to experience pain. At present I have been diagnosed with Cushings syndrome, they say that they cannot associate it with PCa.

Cheers.

 

User
Posted 13 Apr 2021 at 23:46

Ladyisles, important to understand what R223 can and can't do. It doesn't treat the prostate cancer or extend life particularly, but can make life more comfortable if someone is experiencing significant pain from the bone mets. It also can have quite severe side effects or increase the pain as Sanders found.

If your dad isn't having a huge amount of bone pain, I would want to clarify what benefits the onco thinks Radium might bring?

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

User
Posted 15 Apr 2021 at 23:28

Hi, my dad has no real bone pain. He is seeing his oncologist next week after his psa went up to 1.9 from 1.2. Also to discuss bone scans that he had done 2 weeks ago. I’m just so scared that treatments don’t seem to be working. He’s had chemo, then prostap ( which he still has) then enza and now what I wonder. 

User
Posted 16 Apr 2021 at 00:17
It might be worth trying stilboestrol which is quite an old fashioned drug now but because it works with oestrogen rather than testosterone, it can sometimes be successful where other hormone treatments gave failed. Certainly worth asking about. Also, if the chemo seemed to help last time and he tolerated it quite well, is he fit enough to have chemo a second time?
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

 
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