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Looking ahead to future treatment path

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Prostate Cancer
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Posted 6/16/2022 10:33 AM (GMT -5)
Asking for a friend,
Oncologist has told him that his future holds either Zytiga or Chemotherapy as the next step.
For both of them they put you on a steroid, usually prednisone.

Well, he looked at prednisone and you stand a good chance of being "addicted" to it as the swelling and other SEs for being on Zytiga or Chemo start to come back.
He knows there was a different discussion thread earlier.
But are there alternatives to steroids like P?

If given the option of which treatment he'd probably go for first, it would likely be chemo.
Being that is a short term treatment at least compared to Zytiga. Meaning less time on P.
Posted 6/16/2022 6:30 PM (GMT -5)
I had prednisone with Zytiga from Sept 2018 until Dec 2019. Small amount didn't seem to be an issue. I then went to an alternative "dexamethasone" with the Zytiga when the PSA started to rise. I was told by some that the switch to Dex might "shake things up." It actually did for a couple months with lower PSA one month, then after 4 months of Zytiga and Dex, my PSA was going up 33% per month. Then switched to Xtandi, then Nubeqa. By September 2019 I was deemed castrate-resistant.

Points are: I wouldn't worry about addictive nature of low dose prednisone or Dex; and a prednisone alternative is the dexamethasone. Hang in there. It's a journey. Best of luck. -Steve
Posted 6/16/2022 9:02 PM (GMT -5)
In addition to suppressing testosterone Zytiga suppresses the adrenal gland's production of cortisol, which our bodies need to regulate our metabolism, among other things. So the small dose of prednisone is standing in for the cortisol your body would normally be producing. I've been on Zytiga plus 5mg prednisone for 7 months now with no side-effects from either that I didn't already have from Lupron.

This small dosage is very different than prednisone prescribed for other conditions which is typically a much higher dosage - 40mg or 60 mg.
Jim
Posted 6/17/2022 1:40 AM (GMT -5)
Steve:

If I am reading your stats right, the LU177 is really working well. Am I correct?
Also, how are the SE? Have you had any scans since the C11 scan in 2017?

Mel
Posted 6/17/2022 6:10 AM (GMT -5)
Prednisone can be difficult to wean from. As long as you use the drug, your body doesn’t make cortisol so you have to come off very gradual to alert you body to start up again. Go too fast and you can have real problems. My mother-in-law was on a small dose and then taken off and it took well over a year. She was at one point cutting a 5mg pills in half.
Posted 6/17/2022 9:15 AM (GMT -5)
Mel - https://www.healingwell.com/community/default.aspx?f=35&m=4263170

Steve tells a great story in this thread
Posted 6/20/2022 5:19 PM (GMT -5)
My LU-177 has been working miracles. SE only a touch more fatigue. Had a PSMA scan after 4th LU-177. Showed major improvement over PSMA scan the year before. Will do another scan later this year. Novartis should have me do ads….
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