Treatment for Recurrence

Hi Yorkist,

This is a difficult one for me to answer but will bump you up in the hope that those that have been through this might be able to offer advice. I’m wondering how you tolerated HT the last time? I note it was only for 7 months which seems quite a short time to me. I’ve been on it 2 years and am stopping early because of the side effects on my QOL…my Onco is happy for me to do this as PSA now undetectable. I am also 67. It was only diagnosed in 2022 and am quite interested in this as it’s always at the back of my mind that I might be in your position sometime in the future, but fingers crossed🤞

Some people tolerate HT well, others like me suffer, but I’m not sure if there’s any correlation between this and how people tolerate the other treatments you talk about.

I wish you all the best whatever you decide.

Derek

We know that when some patients have surgery, lymph nodes are sometimes removed, also that many surgeons will not do Prostatectomy after RT as it's much more difficult and the chances of urinary incontinence are vastly increased. However, if there is no cancer left in a Prostate, it having been dealt with by radiation, I would have thought it might just be possible to surgically remove the affected lymph nodes if these are not widespread but not the Prostate if this is clear. I know that this has been done in the USA, dependant on number and whereabouts of nodes. Maybe additionally any distant ones could be also be radiated. I would ask, you might find somebody who would be prepared to do this. Better to treat directly if feasible.

Edited by member 02 Jun 2024 at 20:34  | Reason: spelling

HI Yorkist

I was diagnosed with a biochemical recurrence in 2018 after HT/RT in 2009/2010. When my PSA went to 12ng/ml in May 2021 I was restarted on Zoladex which reduced my PSA for a couple of years. Unfortunately by August last year it had risen again to 3.1 ng/ml and I was started on enzalutamide as well as continuing the ADT.  My PSA is again very low (0.07 ng/ml) . The combination of ADT and enzalutamide may be an option for you. I've been told that chemo most likely docetaxel is being reserved if my current treatment fails. I may by one of the lucky ones that I have only few and small side effects from my treatment.

Tom

I see you've gone with triple therapy. That's what I did starting in March 2024, I've just finished the last round of chemotherapy. I started a thread on what to expect from docetaxol which you may find helpful. Look up my recent posts to find it.

People seem to get different side effects. For me, the biggest issue has been fatigue. Probably the chemo plus the hot flushes from the hormone/darolutamide. I'm frequently up 4-6 times a night due to hot flushes/needing to pee, which means my sleep is shot and I operated at about 50% energy thru the 6 cycles of chemo. I'm 3 weeks after the last chemo now, and waiting to see if the fatigue improves - not so much as yet.

I'm on decapeptyl and darolutamide indefinitely. Docetaxol has finished.

Best wishes as you go thru the treatment.

Mike

This is the first time I’ve seen your thread. Your diagnosis is similar to DH’s. He had brachytherapy in 2015 PSA remained at 0.01 for 5 or 6 years before creeping up. Last summer he had an MRI nothing showed up. So he had a psma scan. By then psa was 4.9 

Scan showed mets in several lymph nodes in his chest and high up in abdomen. His prostate is cancer free still, so the mets must’ve been there all along. He was put onto zoladex around September last year. Then they added enzalutamide a couple of months later. PSA very quickly fell to 0.01 again. Where it has stayed ever since.