Enzalutamide or Apalutamide

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User

Posted 13 Jun 2024 at 21:51

5 years after finishing treatment including 2 years of LHRH and radiotherapy, neglagable psa has started rising.

After PSMA scan found 2 mets in pelvis. Now back on LHRH with proposal for Enzalutamide or Apalutamide.

My choice? Either or none !!

Have read 'list' of side effects, not a pleasant read !!!

Anyone any advice / info on which to choose?

Thanks.

User

Posted 14 Jun 2024 at 06:39

Hi Phil

I was an Enza man didn't have a choice of the other,Enza gave me 18 months before PSA began to rise but some men on here have been on it years,side effects were minimal for me but I was only 52 at the time and also dealing with a double nephrostmy as well,again all men react different to the drug,I think only you can make the choice and I think you have a window of 3 months to change if you don't react well.

All the best Phil

PS another Phil...lol...it's a popular name on this forum...is there a link !

User

Posted 14 Jun 2024 at 14:02

Hi Phil C, I've been on Enza since February 2021 (when I was 57 years old) and I've had no bad side-effects.

I have the occasional hot flush (usually at night, in bed) but they pass quickly. Other than that, I haven't had fatigue or 'brain fog' which are often reported. As Phil 1969 mentioned, you can switch if it isn't working for you.

cheers, Craig

User

Posted 14 Jun 2024 at 15:06

This is known as Metachronous Oligometastatic Prostate Cancer (a very small number of mets found only after a curative treatment).

Why are they not offering SABR (stereotactic radiotherapy) to the two mets, as a potential curative treatment, which is the standard of care for this case? It could be because the position of the mets is such that they cannot be treated without taking some tissues above their max lifetime radiotherapy dose, when added to the previous radiotherapy treatment, but that would probably require radiotherapy planning to discover.

If it's because they don't offer it locally, you should get a referral to somewhere else which does.

The cure rate isn't high, but even when it doesn't cure, it pushes off the need for life-long treatments and is considered worth it even on that basis.

Here's a link to the NHS Englind commissioning document for the treatment:
Clinical Commissioning Policy Stereotactic ablative radiotherapy (SABR) for patients with metachronous extracranial oligometastatic cancer (all ages) (URN: 1908) [200205P]

Edited by member 14 Jun 2024 at 15:30 | Reason: Not specified

User

Posted 17 Jun 2024 at 11:06

Hi Phil C, like Craig I've been on Enza since Feb '21 some hot flushes but not to bad, fatigue has been an issue although better now my dose has been reduced, again I had no choice at the time, hope this helps

DaveH

User

Posted 17 Jun 2024 at 14:28

Hi, thanks for all advice, appreciated.

Andy - Had max radiation dose as in same area - 2 months worth first time around!!

Looks like Enza

Thanks all. Phil

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