My husband has prostate cancer that has spread to his bones. Would appreciate information.
My husband has prostate cancer. He was treated with lupron, zometa, and casodex. His PSA declined initially, but has now began climbing. The casodex made him sick, so it has been stopped. Now, however, the cancer has spread to his leg bones. A tumor was found on his lower spine (lumbar) and was treated with radiation, which ended two plus weeks ago. He is still very weak and can't seem to regain his energy. What is the prognosis that the cancer spread has been stopped or slowed, and what can we do to increase his energy and regain some strength? Our next lupron and zometa treatment will occur Dec 30, 2008. Thank you for your input.
Zometa is a treatment that helps prevent calcium loss from bones, preventing excessive bone loss in patients with bone metastasis. Its use has been associated with a decrease or delay in patients developing skeletal related events such as collapse of bone or pathologic fractures. Fatigue is not associated with the use of Zometa. Lupron has been associated with fatigue due to its association with creating a castrate state. Without testosterone, patients experience fatigue. Local radiation therapy may cause some additional fatigue. A good diet high in protein and carbohydrates and the use of multi-vitamins is often recommended to help address this.
A rising PSA while on Lupron is considered hormonally-resistant prostate cancer. Lupron does not represent a complete androgen blockade, and ideally an anti-androgen such as Casodex would ideally be utilized, however given your husband's inability to tolerate this agent, this is not going to be possible. Other antipandrogens such as flutamide can be tried, but in all likelihood, if your husband is not able to tolerate the Casodex, it is unlikely that he would be able to tolerate the flutamide.
Hormonally resistant disease is difficult to treat and chemotherapeutic alternative may be considered. A consultation with an oncologist is something that you should consider.
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