Abiraterone and olaparib not working

Hello Bernie34

im sorry to hear of your husband’s poor health. Before anything else, I must stress that I am not a medical expert!

These, though, are the questions I would be asking:

Is the bladder tumour secondary to the prostate cancer or is it a new tumour of a different ‘make up’ which would therefore not respond to prostate cancer drugs?

Is this tumour contained within the bladder or spread outside?

what treatment options are available? Eg removal of the bladder ( if tumour contained but this would mean permanent nephrostomy) or radiotherapy and or chemotherapy. 

As your husband is unwell, I would also ask for a full blood screen to check for things like anaemia ( due to blood loss) organ function ( especially kidneys due to recent problems) etc

Im not sure that I have really helped but it might help your questioning? 

I hope the picture becomes clearer for you quickly and that your husband feels better soon.

Thanks worriedwife. There was a delay getting diagnosed the tumour as a rare one. Tissue samples went to a number of labs and eventually to Christys manchester who confirmed prostate cancer that has spread into bladder. He has full bloods every couple of weeks and had to have blood transfusions a month ago. This time apparently has an infection . Probably from nephrostomys andd catheter, low potassium and sodium. I wish he could have a period of stability after a very horrend8 months for him. Thanks for your lovely reply and I hope all goes well for you. We should no this morning if any other treatment can be given.  

Hello Bernie34 . I am sorry to hear that current therapies are no longer working. I have had a couple of thoughts. As your husband has been on Abiraterone and steroids it can be possible to switch onto something like Enzalutamide. Also you need to find out the origin of the cancer in the bladder as the treatment could be different e.g. BCG bladder injections has been shown to be effective for both bladder cancer and possibly bladder mets from prostate cancer. Bladder surgery might be an option to remove the bladder and relieve the pressure on the kidneys. Your husband might also be eligible for something like Lutetium 177 which is a radionuclide therapy based on having a PSA. It is possible to have more chemotherapy - my husband was told that they could rechallenge with Docetaxel, if that didn't work then Cabazitaxel, and if that didn't work then a platinum based chemo like Carboplatin particularly if BRCA mutations are present.

I hope you get some answers soon and that your husband starts to feel better.

That's positive and sounds like there are other options. The tumour has been diagnosed as a progression of the prostate cancer rather than bladder cancer. So don't think removal of bladder an option for him as it was discussed. Thanks you have given me some hope. To be fair I just want him to feel better for a time.

Hello Bernie, it sounds as if your husband’s team are well and truly ‘on the case’ and that’s reassuring. I know what you mean when you say you want him well again. We had a dreadful couple of years with my husband’s health. You name it - he seemed to get it! It was so very exhausting for both of us. We seemed to be forever going to and from medical appointments. It was like we were on a treadmill that we just could not get off. Thankfully he seems to be ‘released’ from some of the appointments now and is a lot better in himself. So, when he’s ok, I’m ok:)  I think medicine has advanced incredibly in the last years but I don’t think it takes into account the emotional impact of it all on the patient or the family.

i really do wish you and your husband well and some good health in the near future x

Hi Bernie34 , thinking of you.  Hope you are both doing OK.  David

Thanks david.

The emotional side is hardest. Wishing you and your family all the best too.