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How soon should treatment start for aggressive cancer?
Prostate Cancer | Last Active: May 16 7:41am | Replies (25)Comment receiving replies
I am interested in the sequencing of your therapies as I am in the same boat. Now on Lupron and will begin Proton the end of May. I am concerned my treatment pathway may not be aggressive enough given 4+5 and metastasis to the pelvic region.
Could you be more specific about how long after Lupron you started darolutamide? Did you start docetaxal simultaneously with darolutamide? I presume the six sessions of docetaxel were three weeks apart. How long after last session of docetaxal was IMRT started? And if I understand correctly you were taking Lupron and darolutamide during IMRT.
Many thanks for any info, Rick
Replies to "@mmacaulay I am interested in the sequencing of your therapies as I am in the same..."
Although you didn't ask me specifically, my story is similar so I will give you my sequencing.
G9 diagnosed in 2021 with RP in 10/21. PSMA PET 6 months later with single T8 met. Treated with SBRT. 4 months later after rising PSA, PET showed another met in pelvic node. I consulted MO at Johns Hopkins. Very experience MO who only treats prostate cancer.
Time line and therapy:
Oct-Dec 2022 triplet therapy with every 3 month Lupron injections, doceltaxel chemo x4 every 3 weeks and 3 months of Darolutamide.
Had whole pelvic radiation with boost to the single node and prostate bed March/April 2023 with a total of 37 treatments.
PSA became undetectable (from around 7) after 2nd chemo session) and has remained so.
Lupron was discontinued after one year-last 3 month injection was July 2023).
From discussions and literature I realize my shorter course Darolutamide (3 months) and fewer chemo treatments (4) are atypical. But my experienced MO who treats many patients with my same Stage disease has his reasons.
That's my experience.
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I kept a diary, which I strongly recommend. Started Lupron 10/13/22, injections every three months, transitioned to once-monthly as of 12/5/23. Started chemo 10/28/22, docetaxel + darolutamide, Ended chemo 2/10/23. PET scan 3/9/23 indicated chemo was very effective. Started IMRT 3/31/23, 26 sessions. Last Lupron injection 2/23/24. Still on darolutamide.