1. < Prostate Cancer

Prostate Cancer Returning, Looking For Options

Posted by hector13 @hector13, May 1, 2023

I need some help fellas, as I am sure some of you have been in my situation. Six years ago my urologist found my prostate cancer and removed my prostate. A few months later, I had 40 sessions of radiation to eliminate any remaining cancer. The radiation scarred my bladder and rectum, and I had to deal with internal bleeding by taking 40 sessions of oxygen treatments. After that, all was well. For 4 years, my PSA bloodwork was a constant 0.00. Then about a year ago it started to creep up, from 0.09 to 0.92. Oddly, it dropped for two blood works to 0.77 then 0.69. Now it is on the rise again to 1.10.
I believe that I will have a PSMA PET scan at the end of May, and if I am lucky, the cancer will be found, and it will only be in one location.
What I am looking for are options that will actually kill the cancer cells once and for all. I do not want to do hormone therapy; I am a healthy and active 68 year old, and my understanding of hormone therapy is that it only suppresses the cancer, and eventually the hormone is less effective and may cause damage to the heart. So anyone who has been in a similar situation of recurring cancer, do you have any recommendations of a treatment that actually kills the cancer? I am really hoping there is one!

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

kujhawk1978 | @kujhawk1978 | May 2, 2023

Well, there is a lot of debate about whether advanced prostate cancer can be cured or not.

To say ADT does not kill prostate cancer cells may not be correct. Since sone PCa cells must have testosterone they die when in a low testosterone environment. That is why as I understand when we go on ADT mono therapy initially our PSA drop and tumors shrink.

Some cells of course adapt and are able to live and thus replicate in a low T environment. That's a reason to do doublet therapy, adding a 2nd ADT, an ARI which can shut down T from the adrenal glands and prevent the PCa cells from binding with and thus using T to survive and advance.

Still, that doesn't get them all. So now you go to triplet therapy by say adding chemotherapy or perhaps radiation. Both kill prostate cancer cells.

Sorry about your situation with side affects from radiation, I've had three -SRT, PLN and now SBRT, 69 total, no SEs.

There is some discussion about advanced PCa as being curable.

oligometastasis
(AH-lih-goh-meh-TAS-tuh-sis)
A type of metastasis in which cancer cells from the original (primary) tumor travel through the body and form a small number of new tumors (metastatic tumors) in one or two other parts of the body. For example, cancer cells may spread from the breast to form one or two new tumors in the brain or spread from the colon to form new tumors in the liver. These types of tumors may be treatable.

So, when you have your scan and if it gives a location or locations you have a decision to make. If you are going for the cure, unlikely mono therapy gets you there. So, doublet or triplet therapy may be what you discuss with your medical team.

If not a cure, then think about options which provide a statistically significant probability of a durable and long term remission.

I just finished a 4-1/2 year remission, mine is back, Plarify scan showed a single PLN so we did five SBRT and are planning for six months of Reloguix then assess. I am not a fan or advocate of lifetime ADT and my medical team knows to suggest it only if defined periods are not working. We are not there.

Keep in mind that even if your image shows one or a few, say 3-5 sites there are likely many more, just too small to be seen by imagining. That's why systematic therapy is almost always in play in a treatment decision for advanced PCa unless it's palliative in nature.

Kevin
REPLY
2 replies
round5 | @round5 | May 3, 2023
In reply to @kujhawk1978 "Well, there is a lot of debate about whether advanced prostate cancer can be cured or..." + (show)
@kujhawk1978

Well, there is a lot of debate about whether advanced prostate cancer can be cured or not.

To say ADT does not kill prostate cancer cells may not be correct. Since sone PCa cells must have testosterone they die when in a low testosterone environment. That is why as I understand when we go on ADT mono therapy initially our PSA drop and tumors shrink.

Some cells of course adapt and are able to live and thus replicate in a low T environment. That's a reason to do doublet therapy, adding a 2nd ADT, an ARI which can shut down T from the adrenal glands and prevent the PCa cells from binding with and thus using T to survive and advance.

Still, that doesn't get them all. So now you go to triplet therapy by say adding chemotherapy or perhaps radiation. Both kill prostate cancer cells.

Sorry about your situation with side affects from radiation, I've had three -SRT, PLN and now SBRT, 69 total, no SEs.

There is some discussion about advanced PCa as being curable.

oligometastasis
(AH-lih-goh-meh-TAS-tuh-sis)
A type of metastasis in which cancer cells from the original (primary) tumor travel through the body and form a small number of new tumors (metastatic tumors) in one or two other parts of the body. For example, cancer cells may spread from the breast to form one or two new tumors in the brain or spread from the colon to form new tumors in the liver. These types of tumors may be treatable.

So, when you have your scan and if it gives a location or locations you have a decision to make. If you are going for the cure, unlikely mono therapy gets you there. So, doublet or triplet therapy may be what you discuss with your medical team.

If not a cure, then think about options which provide a statistically significant probability of a durable and long term remission.

I just finished a 4-1/2 year remission, mine is back, Plarify scan showed a single PLN so we did five SBRT and are planning for six months of Reloguix then assess. I am not a fan or advocate of lifetime ADT and my medical team knows to suggest it only if defined periods are not working. We are not there.

Keep in mind that even if your image shows one or a few, say 3-5 sites there are likely many more, just too small to be seen by imagining. That's why systematic therapy is almost always in play in a treatment decision for advanced PCa unless it's palliative in nature.

Kevin

Jump to this post

Very well said. I totally agree with your assumption.

REPLY
wellness100 | @wellness100 | May 3, 2023

Second that. Also like to add that be very careful reading the clinical studies. Their methodologies, parameters, aims etc. They may draw different conclusions from those practioners who treat more than 2000 patients a year, over more than 10 years. A typical trial sample would be less than 2000 and no more than 4 years.

REPLY
wellness100 | @wellness100 | May 3, 2023
In reply to @kujhawk1978 "Well, there is a lot of debate about whether advanced prostate cancer can be cured or..." + (show)
@kujhawk1978

Well, there is a lot of debate about whether advanced prostate cancer can be cured or not.

To say ADT does not kill prostate cancer cells may not be correct. Since sone PCa cells must have testosterone they die when in a low testosterone environment. That is why as I understand when we go on ADT mono therapy initially our PSA drop and tumors shrink.

Some cells of course adapt and are able to live and thus replicate in a low T environment. That's a reason to do doublet therapy, adding a 2nd ADT, an ARI which can shut down T from the adrenal glands and prevent the PCa cells from binding with and thus using T to survive and advance.

Still, that doesn't get them all. So now you go to triplet therapy by say adding chemotherapy or perhaps radiation. Both kill prostate cancer cells.

Sorry about your situation with side affects from radiation, I've had three -SRT, PLN and now SBRT, 69 total, no SEs.

There is some discussion about advanced PCa as being curable.

oligometastasis
(AH-lih-goh-meh-TAS-tuh-sis)
A type of metastasis in which cancer cells from the original (primary) tumor travel through the body and form a small number of new tumors (metastatic tumors) in one or two other parts of the body. For example, cancer cells may spread from the breast to form one or two new tumors in the brain or spread from the colon to form new tumors in the liver. These types of tumors may be treatable.

So, when you have your scan and if it gives a location or locations you have a decision to make. If you are going for the cure, unlikely mono therapy gets you there. So, doublet or triplet therapy may be what you discuss with your medical team.

If not a cure, then think about options which provide a statistically significant probability of a durable and long term remission.

I just finished a 4-1/2 year remission, mine is back, Plarify scan showed a single PLN so we did five SBRT and are planning for six months of Reloguix then assess. I am not a fan or advocate of lifetime ADT and my medical team knows to suggest it only if defined periods are not working. We are not there.

Keep in mind that even if your image shows one or a few, say 3-5 sites there are likely many more, just too small to be seen by imagining. That's why systematic therapy is almost always in play in a treatment decision for advanced PCa unless it's palliative in nature.

Kevin

Jump to this post

Recently found that the kidney also can produce some hormone. That may account partly for resistance, when in fact it is not exactly. Anyhow, AR blocker deals with that.

REPLY
melcanada | @melcanada | May 4, 2023

Get on Zolodex injections every 3 mos 2 yrs later now added Xtandi or Enzulutimide 4 easy swallow pills a day Just added Xgeva injections to move calcium into bones

It works No big side effects Tired a bit but this side of the grass for 5 more plus they say then other plans 78

REPLY
1 reply
conway | @conway | Jul 18, 2023
In reply to @melcanada "Get on Zolodex injections every 3 mos 2 yrs later now added Xtandi or Enzulutimide 4..." + (show)
@melcanada

Get on Zolodex injections every 3 mos 2 yrs later now added Xtandi or Enzulutimide 4 easy swallow pills a day Just added Xgeva injections to move calcium into bones

It works No big side effects Tired a bit but this side of the grass for 5 more plus they say then other plans 78

Jump to this post

Stage 4 Metastatic Prostate - in Lymph nodes, spot treated successfully on C7 and new spot on my hip bone. Xtandi stopped working after a year. Blood platelet level is too low for the Provenge treatment. Had discarded the idea of chemotherapy but worry that may be my only option.

REPLY
2 replies
melcanada | @melcanada | Jul 18, 2023
In reply to @conway "Stage 4 Metastatic Prostate - in Lymph nodes, spot treated successfully on C7 and new spot..." + (show)
@conway

Stage 4 Metastatic Prostate - in Lymph nodes, spot treated successfully on C7 and new spot on my hip bone. Xtandi stopped working after a year. Blood platelet level is too low for the Provenge treatment. Had discarded the idea of chemotherapy but worry that may be my only option.

Jump to this post

Was spot treatment radiation

My oncologist has ordered genealogy blood work as if 10 % is hereditary they have a new drugs to add to xtandi if it stop working

Else there are several others now approved

REPLY
melcanada | @melcanada | Jul 21, 2023
In reply to @conway "Stage 4 Metastatic Prostate - in Lymph nodes, spot treated successfully on C7 and new spot..." + (show)
@conway

Stage 4 Metastatic Prostate - in Lymph nodes, spot treated successfully on C7 and new spot on my hip bone. Xtandi stopped working after a year. Blood platelet level is too low for the Provenge treatment. Had discarded the idea of chemotherapy but worry that may be my only option.

Jump to this post

What about Daralutimide or apalutimide Then PL171

Is Chemo last resort?

REPLY
Please sign in or register to post a reply.