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When to stop taking Zytiga

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Posted 8/27/2013 11:47 AM (GMT -5)

Hi You All:

I have been on Zytiga now for 11 months with PSA bouncing 0.1 or below for last 4 months (Testosterone undetectable).  I have been very lucky with almost nil side effects.  I just stopped the estrogen patch after 12 months because of enlarged and sore breasts (waiting for next monthly blood test to see effect, if any).  Again, I am fortunate to have my insurance cover cost.  Also, I have been on Trelstar plus Avodart for two years.

Now I am contemplating ceasing Zytiga and Trelstar to see what happens.  I know we all react differently, but has anyone stopped Zytiga while it may still be working?  Do you know someone who has?  My oncologists have no opinion, although one advises to consider stopping.  I would sure appreciate comments.

Houseboy

 

Posted 8/27/2013 1:42 PM (GMT -5)
Hello Houseboy, those are great results! This indeed is a very interesting question to which there is no answer written in stone, as there were no randomized control trials that show whether a break in Zytiga usage will have a survival advantage over the continuous use. Almost all the cases of Zytiga use that caught my eye on this forum are in the setting of "taking Zytiga until PSA starts to rise, then move to next medication". If we follow the logic of intermittent HT, then oncologists are split in their view, some like it, some not - especially after Dr.Hussein´s study that showed a slight surival benefit on continuous therapy vs. intermittent for men with metastasis. However, if the quality of life is important to you, you may want to undertake an experiment and see what the rise in T brings. My father has been on IHT, as you can see from the signature, however his T is returning very slowly, only at 190 now despite being OFF HT for more than a year now. And yes, his PSA is rising too. Difficult decision, but since you asked you probably have good reasons for asking.

You have so far been on the forefront of PC treatment and I have no doubt that you will make the best decision. Greetings!
Posted 8/27/2013 3:07 PM (GMT -5)
Hi Houseboy....That's a very good question. If I were you and the side effects were nil and the insurance covered it...Id stay on it. Ive ben on it for 4 months now and I went from a PSA of 381 to a 23....and it keeps getting lower each month. My doctors never gave me a time to stop...just as they didn't with HT. So Im assuming I will stay on it as long as it keeps working. Then move on to the next treatment if and when that time comes.

You being 72 years old....and a gleason 9 with initial PSA of 30...I would assume it would be wise to stay on it as long as it keeps working.....especially since its costing you nothing and you have no side effects.....but Im no doctor and don't know what the long term effects of Zytiga are.....good luck in your choices....chris
Posted 8/27/2013 4:25 PM (GMT -5)
Houseboy,
I've been following Casper's journey for a long time and believe that he makes very good decisions. I guess that I believe Chris approach is probably best logically. You have your boot on the snake's head so why take it off to see if you'll get bit!!
With no se's and cost a non issue, I don't understand what you would consider discontinuing it..Oh well.
Chris--The best of luck with provenge.
Bill
idea
Posted 8/27/2013 4:59 PM (GMT -5)
Hey guys and Special Lady:

Really appreciate your comments - I love my ' boot on the snake's head' expression! Will let you know what I choose to do.

Houseboy
Posted 8/27/2013 7:15 PM (GMT -5)
"Boots on the snakes head".... best expression of the month award to Bill. Love it.

I'm an intermittent HT g9 guy and find the question very intriguing. I guess if blood work and scans looked good, I'd consider cleaning the boots for a period of time.
Posted 8/28/2013 8:26 AM (GMT -5)
Hi Jerry L.
I was waiting for your post as the leading 'intermittent everything' guy, particularly since you are also a G9 who has had spot radiation. My concern with staying on Zytiga and Trelstar is the effect on the other parts of my body that needs the missing big 'T', as Dr. Myers warns.

I also do not know whether the Zytiga is actually working, or whether my spot radiation shoved my PCa into remission (or, indeed, perhaps the Estrogen patch did).

My other concern is when my PCa turned refractory last year, my PSADT was 6 weeks, well into the danger zone.

And, as Casper and Gunfighter point out, why spoil a good thing that I have going now? For 75 years of age, I am in top shape, work out every two days, and look to be in my 50s.

Decisions, decisions.....

Houseboy
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