Advanced prostate cancer treatment options.

There I was, a happy, healthy, fit 58 year old. A trip to the doctors for a minor water works problem soon escalated to a diagnosis of advanced prostate cancer.

Eight weeks, a course of Bicalutamide, an injection of Decapeptyl later and it's now time to make a decision about my treatment, a decision that I don't feel qualified to take.

Option 1 is Docetaxel chemotherapy with Darolutamide followed by radiotherapy.

Option 2 is Apalutamide with radiotherapy.  All of my research suggests that the chemotherapy is the standard way to proceed but my consultant oncologist strongly suggested that the Apalutamide, with radiotherapy but without chemotherapy was a preferable option.

Has anyone had any experience of this the Apalutamide without chemotherapy as a first treatment?


  • My husband was diagnosed over 6 years ago but opted for surgery and had his prostate removed and has been fine ever since 

    we were confused about making a decision about treatment but feel we made the right choice 

    good luck with what you choose I hope all goes well for you x

  • thanks for writing. good to hear.

    p.s. would be great if you could comment on side effects but no problem if not comfortable to do so. thanks again

  • He was lucky enough to get control back for his bladder but I’m afraid he had no luck with erections, tried tablets and injections but none worked

  • This is very interesting, my partner has had just this, he doesnt have his next injection until january, im apprehensive about it torso thought we could confir ontreatment and side effects, if you'd like to. My [lets call him Bob] Bob is just extremely tired but still up with the birds at 7:00, hes having pain in his neck and his hip but only moderate, and he's been cooking a bit on his food but he already has weak muscles in his throat and eosophagus from cancer 30 yrs ago. Im amazed by him hes 85 and never gives in, and today he went to help fit windows with a friend, so i hope this inspires you and keep in touch should you want to. 

  • Hi.  Curious what you and your husband decided.  What was his Gleason score ? And how did he get on with the Chemotherapy ?  I had the same initial treatment and am due to start Chemotherapy next month - hence my wondering. Thanks 

  • my husband had surgery and not chemo 

  • My partner was diagnosed just over 6 years ago with prostate cancer that hadn't metastasised but had come outside the prostate. He had hormone injections and chemo, followed by radiotherapy every day for about 3 weeks. The injections stopped about 3 years ago. They made him feel like a menopausal woman and he had no strength or energy and no libido. Once the injections stopped his PSA did gradually start to increase and he then had another scan where they found it had moved into a lymph node so he had 3 days of radiotherapy. Unfortunately we have just found out that the cancer has now metastasised and is in his lymph nodes and one rib so are now waiting to hear what happens next. It is now called advanced and all they can do it prolong his life. The even worse thing is that he was diagnosed with a melanoma in his eye in 2010, then prostate cancer in 2017, head and neck cancer in 2020 and bowel cancer in 2022 so also has a stoma. We knew one of them would get him, but just weren't sure which one it would be.

  • Hi I'm in a pretty similar position myself its tough to make a decision 

  • Hello John64.  How are you getting on and what did you ultimately decide for treatment.