Treatment for Prostate Cancer Metastasized to Bones

Posted by cal77 @cal77, Aug 27, 2023

4 months ago diagnosed with Prostate Cancer that has Metasized into Bones. So far, just getting Hormone Treatment...Eligard and Erleada....Feeling so tired...Is this normal? Is there any other treatment available?

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@cal77

I forgot to add that the Prostate Cancer has metasasized into the bones

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More information — I just found this video by Dr Kwan explaining why he doesn't usually recommend a three-pronged approach for oligometastatic prostate cancer:

It sounds like my onco team in Canada followed the same approach he described — we radiated the one metastasis to my spine (after debulking) and the prostate itself, then waited to see if that did the trick (with help from ADT+Erleada) rather than progressing straight to chemo.

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@northoftheborder

Thanks for your post. I'm in a similar situation in Canada — on Firmagon and Erleada, with bone-oligometastatic prostate cancer. My onco team is sticking with that because I'm tolerating it well and it's keeping my PSA undetectable and other bloodwork and tests in a healthy range. The team lead told me there are "lots of other things" to try if this stops working, but also that he's had patients in my situation go many years without any progression.

I don't have the expertise to evaluate the scientific papers that I have skimmed, but my impression is that the 3-pronged approach is still very experimental and based on early research — it might help or it might make you feel worse.

I don't think there's a consensus in oncology yet that metastatic prostate cancer is curable per se, although some researchers believe that oligometastatic prostate cancer might be, and I had curative (rather than palliative) doses of radiation myself.

The thing about ADT and Erleada is that there's really solid research showing its effectiveness in postponing progression (the Titan study). I, too, will be keeping an eye on other options and discussing them with my team.

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Hi,
This is the link for Dr. Eugene Kwan explaining why the 'Triple Threat' works.
https://www.youtube.com/watch?v=-RVVq0uDAEE&t=8s

When I watched his video, he says that just treating the cancer with hormone therapy is like trying to stop a tiger by stepping on it's tail.

Canada always seems behind when there is new treatments. Sometimes this is because they are expensive and the health care doesn't want to pay.

I hope to see my Urologist and find out what he knows about the 'triple treatment'.
I'll keep you posted.

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@cal77

Hi,
This is the link for Dr. Eugene Kwan explaining why the 'Triple Threat' works.
https://www.youtube.com/watch?v=-RVVq0uDAEE&t=8s

When I watched his video, he says that just treating the cancer with hormone therapy is like trying to stop a tiger by stepping on it's tail.

Canada always seems behind when there is new treatments. Sometimes this is because they are expensive and the health care doesn't want to pay.

I hope to see my Urologist and find out what he knows about the 'triple treatment'.
I'll keep you posted.

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I replied privately. If anyone else has questions about my own different (very positive) experiences as a cancer patient in the Canadian healthcare system, please send me a private message and I'll be happy to share one-on-one.

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@northoftheborder

I'm sorry to hear that. I hate pain meds too.

I've been trying for over a year to slowly titrate off Pregabalin (Lyrica) because it increases my feelings of numbness, which are already bad enough after the spinal damage. But every time I get it down (gradually reducing over a month or two), it seems ok for a week or so and then pain roars back like an express train.

I've decided to give up the struggle for 2023, but might try again in 2024.

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So sorry my friend 🤗

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@cal77

I just watched a video given by Dr. Eugen Kwan at the Mayo Clinic. He recommends a 3-pronged treatment plan. First being Eligard, then along with Doralutamide or Abiraterone and then 6 cycles of IV infusion given once every 3 weeks of Docetaxel.

I'm in Canada. The Urologist here is giving me Eligard and Apalutamide.
According to Dr. Kwan the 'Triple Therapy' is a cure.

I have to now ask my Urologist why he is only giving me the Hormone Treatment when the 'Triple Therapy' according to Dr., Kwan is the new "IT' treatment.

I guess I might have to go to the Mayo to get proper treatment.

Anyone else had this 'Triple Therapy'...Has it worked??

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Dr king is amazing in fridley Mn

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@cal77

I just watched a video given by Dr. Eugen Kwan at the Mayo Clinic. He recommends a 3-pronged treatment plan. First being Eligard, then along with Doralutamide or Abiraterone and then 6 cycles of IV infusion given once every 3 weeks of Docetaxel.

I'm in Canada. The Urologist here is giving me Eligard and Apalutamide.
According to Dr. Kwan the 'Triple Therapy' is a cure.

I have to now ask my Urologist why he is only giving me the Hormone Treatment when the 'Triple Therapy' according to Dr., Kwan is the new "IT' treatment.

I guess I might have to go to the Mayo to get proper treatment.

Anyone else had this 'Triple Therapy'...Has it worked??

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I don’t think he says it’s a cure,just a better chance. I am one of his patients and just completed triple therapy also had Carboplatin with the Docetaxel. My scans are now inconclusive so I have started Pluvicto.

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@kjbushur

My prostrate cancer once found metastasized to my bones too ( thats another story. I had 6 rounds of chemo. I'm currently on Abiraterone and Prednisone. I will start back on Zometa in about a week, this helps with the bones. I get an injection of Eligard every 3 months.
Sides effects- tiredness, muscle loss (due to testosterone removal),hot flashes and bone pain every so often. I had some issues with chemo brain but memory has returned.
Wish and hope for the best for us all

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How are you doing today? Russ had to stop the abratone ! Said his Psa went up 😞 he is on XTANDI !very nasty drug

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@baxterlee77

How are you doing today? Russ had to stop the abratone ! Said his Psa went up 😞 he is on XTANDI !very nasty drug

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Currently, the cancer is not moving g. With that being said I have some pain in my left hip and leg. My oncologist believes it's nerve issues, which in January of 2022 I had spine surgery to help correct left leg drop foot issue. And just a fyi- this past January I had another operation to correct a fistula of my Bladder and colon. One Dr commented it my have been caused from my chemo. But the bottom line is I'm seeing new days
I get another PSA in Dec of Jan, I need to get my calendar to see for sure
Let's all keep up our fight

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@round5

I don’t think he says it’s a cure,just a better chance. I am one of his patients and just completed triple therapy also had Carboplatin with the Docetaxel. My scans are now inconclusive so I have started Pluvicto.

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I'll re-watch the video. Dr. Kwan in the video said the standard "it' treatment now is the 'Triple Therapy' and to do it right away and this gives patients very good chances at getting rid of the cancer...
What did Dr. Kwan tell you have the triple therapy? What does he say about how long it takes to notice a difference?

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@cal77

I'll re-watch the video. Dr. Kwan in the video said the standard "it' treatment now is the 'Triple Therapy' and to do it right away and this gives patients very good chances at getting rid of the cancer...
What did Dr. Kwan tell you have the triple therapy? What does he say about how long it takes to notice a difference?

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I actually had quad therapy since they added the Carboplatin. I am now a few months past that. My post scans still showed the spots but they were smaller. He was unsure whether it was still active cancer or just the so called scar tissue of dead cancer cells. We could have just stopped and waited for another scan in a few months to see or hit it with a 5th. medication. He recommended the latter and gave me the choice and I chose to continue with the Pluvicto. I have completed 2 of the 6 doses. They will do a scan immediately prior to the 4th.dose then based on that scan we’ll decide whether to proceed with 5 and 6. If the scans show the cancer is gone or if it shows the Pluvicto is not working then I’ll probably not receive the 5th and 6th doses.

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