Dx 4/3/19 with GS 9, 12 cores, 6/12 Neg, 5/12 4+4, 1/12 4+5.
3/1/19, PSA 72.9;
3/13/19, on Firmagon
4/11/19, PSA 4
MO asks to take Chemo or Zytiga.
Not sure should I take Chemo or Zytiga? I wouldn’t like to do Chemo or Zytiga right away, is there any benefit to start right now, or I can wait until Firmagon fail and PSA goes up

Hey Dasyluo, sorry to hear of your diagnosis. It's quite a shock. It sounds like you're well begun on treatments, so that's important. With a high PSA, G9, metastatic, there's almost no way you could "over treat" this. It's kind of a hammer-and-tongs, kitchen-sink situation.

Maybe some of the guys who know more about those two options will be along to comment. My G9 case was treated with radiation and hormone therapy, as it did not appear to be metastatic at the time.

I will welcome you to our G9 Crew, a gathering place for those facing this significant diagnosis. We have a thread you can look through, to find others with similar diagnoses, and various treatment plans. Here's a link, and I've added you to the list (in the 4+5 group, by diagnosis date):
The Gleason 9 and 10 Crew - Welcome and how ya doin'? (Part 4, continued thread)

All the best to you as you work through the options, select and begin further treatments.

I had a high PSA and mets in my lungs and one hip. I did chemo 1st, radiation to my hip. I had to wait until I was castrate resistant before I could get Zytiga covered as I am not 65 yet. The Zytiga was not started until my PSA went from 0.016 after chemo to 4.8. I am in Canada so your plan could be very different on costs.

Thanks to all.
I am in Toronto, Everton. Where are you in Canada

Dasyluo said...
Thanks to all.
I am in Toronto, Everton. Where are you in Canada

I am in the K/W area.

As a G10 with metrs I faced much the same question. For me, Casodex, then Eligard and Zytiga combined have been very effective in lowering my PSA to undectable for nearly 6 months now. My MO has asked several times if I wanted to add chemo (Taxotere) to my regimen. I have answered each time that I prefer to add the chemo when we find the current combination is no longer controlling PSA. Everyone is different but I view chemo as my secondary line of attack

Thanks for everyone’s reply. After read all stories and information, I am still struggling to make decision on Chemo or Zytiga, hope God will guide me on this.

Mike,

Thanks for the advice.

Were you bone Mets with GS8, taking Firmagon in 2013, Zytiga in 2017 until 2019, am I right? I just like to get some idea how other people are doing with Firmagon and Zytiga.

I had surgery and then my PSA was not gone, in fact rising. Then bone mets were found. Lupron, Zytiga + prednisone have kept me in the zero club since starting that treatment. Hope you have good results with whatever you choose.

Hi Cyclone and GoBucks,

Thanks for sharing your stories. It is encouraging. I will keep in touch and updating my situation.

Dasyluo,
Your MO is offering what is considered the current standard of care. I faced a similar choice and for a number of personal reasons elected to save chemo for later. I am taking Xtandi, which has been shown to be as effective - and as expensive - as Zytiga.

There is good reason to believe the Zytiga can give you many years of remission.

Good luck!