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After taking the ADT treatment for 18 months, my father's PSA level started to increase since mid of 2014 (hormone refractory prostate cancer?). Changing the Lucrine to Zoladex did not help with the PSA. At the moment my father is still doing his activities normally and exercise regularly.
The doctor advised my father to try Zytiga, but due to high costs and unclear benefit of it looks like we will not do it. Can anyone share their experience and alternative treatment for the hormone refractory prostate cancer? Since hormone injection and casodex are no longer effective, should we just stop it?
At the moment our preference is to continue the herbal treatment and maintain the current quality of life.
Below is the history of my father's treatment so far:
A patient in Bandung, Indonesia.
Age at diagnosis: 72 years.
Family History: No PCa in family, no cancer history.
Past surgeries: None.
Other health problem: None.
Diet: Vegan, since herbal treatment was started in Jan. '13.
17 Dec. '12: PSA of 518.28
20 Dec. '12: Did the PSA Test, DRE, MRI and Biopsy.
PSA level of 445.5. MRI conclusion states "Thoracolumbar spines: Thoracic and Lumbar Metastasis".
31 Dec. '12: Biopsy results: Gleason Score 4+4
7 Jan. '13: Took Lucrine 11.25 mg injection and start Casodex 50 mg daily for 2 weeks
8 Jan. '13: Start herbal treatment from Ca Care (www.cacare.com), start vegan diet.
9 Jan. '13: PSA of 455.43
9 Feb. '13: PSA of 21.29
9 Mar. '13: PSA of 8.18
9 Apr. '13: Took Lucrine 11.25 mg injection and Casodex 50 mg daily for 2 weeks
10 May '13: PSA of 1.26
10 Jun '13: PSA of 1.33
9 Jul. '13: Took Lucrine 11.25 mg injection and Casodex 50 mg daily for 2 weeks
9 Sep. '13: PSA of 1.28
1 Oct. '13: Took Lucrine 11.25 mg injection. Stopped Casodex based on the advise from the urologist.
20 Dec. '13: PSA of 2.38
22 Dec. '13: Took Lucrine 11.25 mg injection and start Casodex 50 mg daily for 1 month.
24 Jan. '14: PSA of 1.29
18 Mar. '14: PSA of 2.13
18 Mar. '14: Took Lucrine 11.25 mg injection and Casodex 50 mg daily for 1 month.
10 Jun. '14: PSA of 5.77
10 Jun. '14: Took Lucrine 11.25 mg injection and Casodex 50 mg daily for 3 months.
8 Sep. '14: PSA of 6.34
8 Sep. '14: Took Lucrine 11.25 mg injection and Casodex 50 mg daily for 3 months.
10 Oct. '14: PSA of 10.48
3 Dec. '14: Change to Zoladex injection and continue Casodex 50 mg daily for 3 months.
2 Mar. '15: PSA of 18.41
2 Mar. '15: Took Zoladex injection and Casodex 50 mg daily for 3 months.
1 Apr. '15: PSA of 27.55
1 Jun. '15: PSA of 49.06
1 Jun. '15: Took Zoladex injection and Casodex 50 mg daily for 3 months.
Hi Roni and welcome. I note what you have said regarding your Dad now becoming hormone refractory and your question regrading where to from here? Well that very much depends on the availability of the newer drugs in Indonesia. Given that these drugs are only just now starting to become available in Australia, I think it unlikely that they would be currently available in Indonesia. It would of course be possible for you Dad to receive the new drugs in another country such as Australia or the United States but the cost would run into many tens of thousands of dollars. Perhaps you need to weigh up what sought of life from here on in you would want for your Dad? Most men in your Dad's situation will choose quality over quantity. The new drugs in question may extend your dad's life by several years but he would need expert care under a skilled Medical Oncologist. Have a good think about what you are doing, perhaps your current pathway is in your Dad's best interests.
If your Dad is an otherwise healthy 75 I might try docetaxel which is cheap (but harsh)and very recent research suggests it increases life expectancy by about 2 extra years for situations like your father's. That is better than Zytiga.