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Treating de-novo metastatic prostate cancer
This 2023 paper reviews recent studies on the treatment of de-novo metastatic prostate cancer — cancer that had already metastasised when first discovered — and makes for interesting reading once you get past the scientific jargon:
https://pmc.ncbi.nlm.nih.gov/articles/PMC10605467/
For example, if I'm reading correctly, early chemotherapy (as part of "triplet" therapy) seems to provide a significant survival benefit for polymetastatic castrate-sensitive prostate cancer, but none for oligometastatic cancer. Radiation to the metastases *does* provide a big benefit for oligometastatic. And patients in both situations seem to benefit significantly from introducing an ARSI (like Enzalutamide or Apalutamide) beside ADT right at the start.
It's comforting knowing that my treatment programme for de-novo oligometastatic PCa (begun in 2021) matches exactly what I read here: ADT+Apalutamide from the very start, and radiation to the metastasis as well as the prostate, but not chemo (yet). I am endlessly grateful that I landed at a good Cancer Centre, with oncologists who were also researchers and were following the latest developments.
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As usual, I get lost in terminology, but it sure sounds like this is good news for you, and for that, I am very happy for you. Best to all.
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1 ReactionThat's fair. Here's my summary.
The paper, surveying several major reent studies, notes that for prostate cancer that
1. has already metastasised when it's first discovered and
2. still responds to hormone therapy,
best practice seems to be to combine ADT and something like one of the -lutamides right from the start (doublet therapy)
If there are lots of metastases, it often makes sense to add chemotherapy to those (triplet therapy).
If there are only a tiny number of metastases, chemo doesn't show a benefit at this point, but it's helpful to radiate the individual metastases.
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2 ReactionsI think it's wonderful that it's treatable! It goes to show that prostate cancer is not a certain death sentence for someone. Considering 1 in 8 will get PC, it's encouraging to know that even when we think someone is "worst case scenario" that they are not destined for doom.
It wasn't that long ago where a diagnosis of prostate cancer equated to death, and that was still in my head when I was diagnosed. I've now learned, in no uncertain terms, that this is not even close to the truth with today's medicine.
People often complain that, after all the money and research, that there is no cure - but that article along with so many positive results shows that science is well on its way to that. One day, perhaps, there will be a pill that just erases cancer from the body. Not in my lifetime, likely, but one day.
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2 Reactions"One day, perhaps, there will be a pill that just erases cancer from the body. Not in my lifetime, likely, but one day."
Yes, I'm not expecting to see a full cure in time either, but if advanced prostate cancer becomes a manageable chronic disease in my lifetime, like diabetes and HIV have become, that would be good enough.
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1 ReactionJust wanted to say, getting lost in the terminology is on me, not your post. I often need to search for the meaning of terms used. I read the meaning and then next time I see them, of course I'm back to searching again. For now, they just don't seem to stick with me. I thank everyone whom is always answering all the questions some of us are posting. Best to all.
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