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If PSA does not halve after 1 month of Zytiga or Xtandi, these doctors recommend close monitoring


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Jim Marshall (not a doctor) said ...

The new drugs Zytiga (abiraterone) and Xtandi (enzalutamide) don't work for everyone.


The disease progresses within 3 months in one third of men treated with Zytiga, and one quarter of men treated with Xtandi.


In a small study of 57 men with castrate resistant prostate cancer, these doctors looked to see if they could pick the men who would progress quickly.


They found:

Half of the men whose PSA did not fall to at least half by the end of the first month had progressed by the end of the third month.


Don't panic:

Half the men whose PSA did not drop to half at the end of month one did NOT progress by the end month three.


In their surgeries these doctors use this rule:

If PSA does not fall to half or less at the end of one month a man should have scans at the end of three months to check if they are progressing.


This is a small study, and not set up to look at this question, and so not high quality evidence. But until a larger study is set up to look at this question, it may prompt your doctor to more intensively monitor you if your PSA has not halved at the end of one month.

... end Jim


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