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?

Thanks. 

Parents
  • 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.

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  • 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.

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