treatment options for paratracheal lymph nodes with BRCA2

@jeffmarc

Thanks, Jeff ! Very good arcticle

I found this
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Taken together, studies show that cells most often remain dormant until the immune system is somehow disrupted, altering the balance enough for the cells to safely awaken. These changes can be associated with injury or disease, with research in recent years linking cellular damage¹3 and COVID-19 and influenza¹4 infections with the emergence of dormancy. Aging, fibrosis¹⁵ , chronic stress, or lifestyle factors can also contribute to awakening.
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This is the key, as I understand it, that you need less stress and a strong immune system.

But flu can make wake up cancer cells ...f......

I think it wouldn't hurt to discuss this article as a separate thread. Something like "What Possibly Affects Cancer Recurrence?

Thank you again!

@denis76
I was thinking the same thing. Will probably post it in a little while.

@denis76 My own father was exposed to asbestos continuously throughout his career in construction and shipbuilding.
Every time he had a chest Xray, the doctor would shake his head and ask my father to blow into a balloon; he usually blew until it exploded. Never, ever had symptoms of disease…
Fast forward to a double knee replacement done with a spinal ONLY since his lungs were deemed too ‘risky’ for general anesthesia. Can you even imagine this??! He also required 4 units of hospital blood, even though he had autodonated 4 of his own.
Weeks into his recovery he developed what his surgeon (the orthopedist for the NY Jets and Yankees) called a ‘kennel cough’. Well that progressed into full blown coughing fits and shortness of breath. Biopsy confirmed presence of extensive mesothelioma. He was dead, his spinal cord severed by the cancer, in 6 months…
Don’t tell me that this deadly cancer just suddenly grew; it was lying there dormant for years, viewable on Xray. His body fought or contained it somehow but that horrible operation - that incredible trauma and units of donor blood messed up his immune system entirely.
That cancer ‘knew’ it was time to party and those cells did in 6 months what they couldn’t do in a lifetime.
Wish I could know the exact mechanisms involved but that will remain a mystery. I do know, however, that in our lives health and disease are in a precarious balance and it can tip either way, at any time. Best,
Phil

@heavyphil

I'll say this: I had no health problems and no cancer until I got two vaccinations (hepatitis and flu). Then, magically, I developed cancer. I don't have my own lab, so maybe I'm just being paranoid, but I'm sometimes inclined to think it wasn't the vaccinations that I was given, but something that compromised my immune system and allowed it to miss the cancer! There are a lot of people who think like me, and they have good reason to believe it!

@denis76 Stories like yours abound and in fact, I had an aunt who got Guillan-Beret from a flu shot and lost the use of her legs…
I have a veterinarian friend who was the picture of health when she got the rabies vaccine over 40 years ago.
But within weeks she came down with weird symptoms and was diagnosed with multiple sclerosis.
Her life has been a mess ever since!
Her rheumatologist believes that the sunburn she got the day of her innoculation ‘activated’ something in the vaccine; it was probably attenuated virus, but maybe not fully?? We’ll never know…
BUT, she is an extremely delicate person and little things that you or I would shrug off can put her in the ER. So again, ‘host response’ is just so variable, right? One size will never fit all…
And knowing now that Covid and other viruses can activate dormant cancer cells, what do you do- sign up for every vaccine out there? Don’t get any for fear of causing some interaction that promotes cancer??
It’s simply too much to worry about after a while and you become exhausted…
I do think we are at an age now where things start to happen - sometimes two or three things at once. We look for cause and effect but usually there is none; just getting older and the shit hitting the fan…
Phil
Phil

Thank you for the information and thoughts, now reporting back with an update from my health team.

Radiation --- With the location of the lymph notes in my upper chest/neck area and so close to my heart and lungs, radiation is off the table. Overall, with BRCA2, there is less chance that radiation will ever be a end-all solution.

Scan --- We reviewed my scan and the team wasn't aware of any recent usage of the comparison of SUV uptake to the reading in the blood and liver. That approach might still have validity and be part of a management plan, but the team at my hospital that does 25 scans a day, they don't use this approach.

Start/Stop --- We reviewed the question of whether starting ADT and then stopping it and repeating this cycle can lead to a quick transition from castrate sensitive to castrate resistant and they were not aware of this. We are looking for some clinical trials or related data to support this.

Next steps --- We took a much closer look at the results of the EMBARK trial and explored options of monotherapy with just Enzalutamide, monotherapy with just Relugolix, and dual theory with Enzalutamide and Relugolix. This was a good trial with plenty of people in each arm. We took a look at the ARAMON trial for Darolutamide and while good results, with just 23 patients it would benefit from more data. For what it is worth, my doctor is a little (not much, but some) concerned about Darolutamide drug for the seizure risk. We came to the overall conclusion that some form of treatment is inevitable but not urgent, so I'm going to do more research to make an informed decision about mono versus dual therapy and also see if the team has any new findings from the February conference. However this works out, I'll be on treatment in March.

Onward!

@edmond1971
I’ve already mentioned to you. I have BRCA2 and I’ve had prostate cancer for 16 years. I’ve had surgery followed by salvage radiation. I’ve had four reoccurrences and I’m now on. Orgovyx and Darolutamide. Darolutamide Has been the absolute best. I’ve had no side effects from it and I know at least a dozen other people that are on it that have had no side effects. Some of them are taking it as their only drug. It doesn’t pass the blood brain barrier so it doesn’t cause brain fog. Previously, I was on Zytiga And it gave me 4 afib events, I also was only undetectable for one month in 2 1/2 years of taking Zytiga. The last Afib event landing me in the hospital for four days. I’ve been undetectable for 26 months due to Darolutamide.

I had surgery where they had to cut open part of my stomach, and one drug they didn’t have me get off of was Darolutamide. My oncologist said it would not be a problem and it wasn’t.

I’m not sure exactly what your doctor is talking about A seizure risk, I’ve never heard of anybody having that problem.

Enzalutamide causes a lot of fatigue for many people and has other side effects that are annoying. Much better to get on Darolutamide.

@jeffmarc
thank you! I am likely to get on either enzalutamide or darolutamide and my inclination is to start this out with a monotherapy approach, but I'm OK with having to add Orgovyx if that is what is needed.

@edmond1971
Some people get severe fatigue from Enzalutamide. That doesn’t occur with Darolutamide.