What’s next - stage 4

hi anna42

i was diagnosed in january 2019 , gleeson 9 {5+4} advanced metastatic prostate cancer very aggressive . 

had docetaxal too much spread for radiotherapy , started on abiraterone as well as zoladex 12 weekly injections .

i'm still here fighting , working part time .

keep positive and exercise that will help with the side effects and the radiotherapy to come .

gd luck 

Thank you so much. I really needed to hear this and so pleased for you that you are responding so well to treatment. Do you mind me asking if you’ve had further treatment other than abiraterone since chemo? The next step now feels so uncertain and I think we need to focus on positive stories… thank you for taking time to respond 

Hi Anna42 I wrote a post some while back you might find interesting.  The end - straight to palliative care! .

You can also read my profile by clicking on my name or avatar.  Please ask any questions, the guys and girls on here are fantastic.  David

hi again 

no thats all i have been on since 

12 weekly zoladex injections and 1000mg of abiraterone a day 

my last psa was 0.2 and everything stable blood wise too 

Hello, sorry to hear your news and I hope you are both coping. 

To echo the previous posts here; there is scope for cautious optimism. Oncologists are, I think, pretty reserved when giving any kind of prognosis and many of them don't like to give one at all. As triplet therapy is fairly new as the 'standard' treatment for most stage 4 prostate cancer, there isn't much data on men 4-5 or more years on from their initial diagnosis. 

My situation was similar to your husband's, with triplet therapy Inc 6 sessions of Docetaxyl followed by radiotherapy on the primary tumour. My Oncologist said that this RT was palliative - I.e. to ease symptoms, and RT is not really viable for metastatic PC unless there are only a few tumours (worth asking about perhaps?). 

2 years down the line for me, and my PSA is stable at around 1, and latest scans were also stable. I will stay on 3 monthly injections and daily tablets of Darolutamide unless something changes. 

The hormone treatment resistance (known as castration resistant PC) is, pretty much, inevitable, but it is reassuring to know that other treatments - 2nd line and 3rd line - such as different hormone treatment, different chemo, targeted radiotherapy injections known as Lutetium-177, and maybe soon immunotherapy, are all 'in the locker'. In fact, the majority of Clinical trials are testing to find better treatments for this castration resistant form of PC. 

As a 46 year old, I am bloody well staying positive and doing all I can to aim for many many more healthy years! 

All the best x 

One thing that occurred to me here was that I have seen mentioned in notes backing up the notes American PRCI channel on YouTube mention of "de-bulking" which seems to be a process of dealing with the original site of the cancer as if it was newly discovered.

I wish I could find the original article again

It seemed as if the aim was not curative, but to significantly set the cancer back.

My memory says that it was quite successful.