Saturday, March 4, 2017

Looking ahead

   I have been on the oral chemotherapy Zytiga for the past 42 months. I am currently undetectable in regards to scans and PSA.
I have been doing so well for so long that contemplating what comes next seems someone moot.  I guess however I have always believed that if Zytiga ever failed I would simply move on to Xtandi.
   A couple nights ago, I shared a phone conversation with a friend of mine who lives in Pennsylvania. He was on Zytiga for 44 months.
   Typical ADT stops the production of testosterone by the testicles. Prostate cancer, starved of its favorite food, begins to die. Often , typical ADT, can keep cancer at bay for months and years. Eventually however, the cancer adapts in a way that allows it to survive and thrive on the residual testosterone produced by the adrenal gland. Enter Zytiga
   Zytiga shuts down the production of testosterone by the adrenal gland. Actually it shuts down the adrenal gland all together which is why Prednisone must be taken with Zytiga. 
   6 months ago, my friend in Pennsylvania, was seeing a rising PSA despite being on Zytiga. Last month, his doctor felt it was time to change his course of treatment. The transition was far from smooth. He has been on Zytiga for so long that after going off of the drug, his adrenal gland appears to be shut down permanently. I don't know what percentage of men this happens to. The drug is too new to have a lot of documented history. I have to say though, I am just a tad concerned about my future. I have now been on Zytiga for 42 months. Is my adrenal gland dead as well?
   I realize that the results of one patient do not  amount to a hill of beans. It does however cause one to ask many questions.
  Should a man go on Zytiga and stay on it or should it be given intermittently. Will Zytiga be found to completely shut down the adrenal gland permanently with long term use. If so, might surgical removal be a possibility. I am not a doctor. I am not a scientist. No degrees in molecular biology. Hell, I am not even that smart. I just ask lots of stupid questions. There is "1" thing I do know for sure. We are the first generation of men to use these new weapons against cancer. We are pioneers. Long term side effects will be made manifest in our lifetime. I guess there are 2 things I know for sure. Whether these new drugs give us super powers or cause is to grow a third eye, we are in a much better place with em than without em!!! Yolo, Todd..."life is good, live it loud"