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Re: Why does Zytiga fail?

Boys,

I'm surprised that you seem to be still looking for certainty when there is none.

I realised a long time ago that much of the treatment offered to us PCa men is based on what I have referred to as "Medical Beliefs" rather than sound science. Indeed science which challenges the status quo is often ignored because it clashes with these beliefs. In days when I was more active on the web I would challenge doctors who posted "this is the way" to share with us the studies that supported their views, since they demanded that from us when we put forward alternative views. They could not - because often there were no such studies.

I've just had a series of discussions with my oncologist concerning my next step, given that the current combination of Androcur and Lupron seems to have failed. He suggested Zytiga (Abiraterone) despite the fact that it has only been approved for men who have failed chemotherapy, which is not the case for me. Although Zytiga is on the Pharmaceutical Benefits Scheme for men with failed chemo and would therefore cost me $5.60 a month if that was my case, since it is not it would cost $4,000 a month.

I suggested again that I should try diethylstilboestrol (DES) but he, as all doctors will objected on the grounds that it was a very dangerous medication with a high risk of heart failure. I tried to point out that applied to 5mg doses not the 1 mg dose I wanted. He finally agreed, very reluctantly on the basis “Well, it’s your life.” I have sent him this study 2003 DES Study and hope it will help him understand that there is good scientific evidence to support my case. I started DES yesterday.

Re: Why does Zytiga fail?

Terry,

I pretty much agree with all that you say. Just an update. The FDA, in December 2012, approved Zytiga for the use in metastatic castrate resistant cancer before chemo.

Fred

Re: Why does Zytiga fail?

And in the UK Zytiga is in use for non-metastatic PCa where ADT has failed, apparently approved by NICE and I think OK'd by the European Regulator too. Oz needs to catch up!

You're quite right to chastise me about seeking certainty but I was trained as a Physicist/Mathematician and old habits die hard and I do think Oncologists should know why a treatment fails so that they can sensibly prescribe something else. Good Luck with DES - my oncologist poo-poo'd this when I raised it as a possibility some months back!

OC in England

Re: Why does Zytiga fail?

Terry,

I hope you have good results with your new therapy. I do have questions, just out curiosity, about your stent situation, but I don't want to burden you.

Jack from Jersey

Re: Why does Zytiga fail?

Fire away Jack - I assume you've read the updates regarding the stents on my story at Terry Herbert?

All the best
Terry in Australia

Re: Why does Zytiga fail?

Hi Terry,

Were you sedated for the cystoscopy when the stent was put in and then removed? My urologist used the cystoscope just to take a quick around in the bladder. He used what I suppose was lidocaine and it turned out to be the most painful procedure I have experienced which lasted fortunately for only two minutes.

G'day

Re: Why does Zytiga fail?

I had a full anaesthetic Jack. The first procedure took over and hour and the second about forty minutes. I don't think the placement and replacement of stents could have been dealt with in any other way. The cystoscopy was incidental to the main procedure.

All the best

Terry

Re: Why does Zytiga fail?

Terry,

I appreciate the non-judgmental tone of your response. I couldn't fault you for thinking:

I don't think the placement and replacement of stents could have been dealt with in any other way, you idiot.

Jack from Jersey

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