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The paradox of testosterone and ADT
Prostate Cancer | Last Active: 1 day ago | Replies (92)Comment receiving replies
The ‘Art’ of the science? I am not sure I could give an exact why, to be honest, other than the suspicion of a ‘sneaky’ cancer presenting very oddly. The ‘plan’ is coming from a CCOE and was modified by our local MO from what we are calling ‘quad’ therapy (triple therapy + the carboplatin) to double chemo, following by double ADT (+ ARPI) at the end of chemo. I guess we have to trust the unconventional for the win. Living with uncertainty may not be a fool’s errand.
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A couple of things about carboplatin
When combined with docetaxel, carboplatin has shown improved response rates and overall survival compared to single-agent chemotherapy in hard to treat cases
Patients with mutations in DNA repair genes (BRCA1/2 or other recombination repair HRR pathway genes) may respond better to carboplatin, as these tumors are more sensitive to platinum-based chemotherapy
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I have to think that although they did not test for androgen sensitivity, they did find ‘something’ in that biopsy that was different from ‘regular’ PCa metastasis - something seldom encountered.
And although it is concerning - what oddity isn’t? - at least you know they are not treating this ‘pro forma’.
I saw a website the other day concerned with breast cancer and I was blown away. In my ignorance, I thought there were 2 basic types, but there are something like 18 different and distinct types and all must be treated differently.
Prostate cancer, too, has many variants and your husband’s is probably one not commonly seen; remember, he was in remission for over 17 years and now this?? Definitely an odd case for sure.
Phil