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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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robert570 | @robert570 | Dec 2, 2023
In reply to @baxterlee77 "We are in Florida ! One of our good friends told us about his place in..." + (show)
@baxterlee77

We are in Florida ! One of our good friends told us about his place in Tijuana Mexico for cancer treatments! Hoxey clinics ! Have u heard of this ? 🤔

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No, I haven't.

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northoftheborder | @northoftheborder | Dec 2, 2023
In reply to @spino "Thanks for sharing this. That's definitely a encouraging clinical trial, assuming the results are comparable, which..." + (show)
@spino

Thanks for sharing this.
That's definitely a encouraging clinical trial, assuming the results are comparable, which I am unqualified to assess. If I understand correctly, from whatever the starting point was, the mean overall survival rate was 40 months for the standard of care treatment, and increased by over 20% to 52.2 months with the treatment plan undergoing the clinical trial. Yeah!
Also, great news that at 26 mos from this diagnosis you have no (noticeable) progression. That sounds great to me.
Note: I'm not sure if the other study starting point was newly diagnosed bone-metastatic prostate cancer either. I tried to note that in my comments, but I don't know if it came across. Since I am not a researcher in this field, I am really unqualified to make any independent assessment of these articles. When I summarize something, I'm just restating what [I think] I am reading.
With regard to the link you posted, I only got access to the abstract there. Perhaps the article itself is behind a paywall?
In any case, I have no idea what the actual situation is, but I certainly like 52 months better than a lower number for overall survival :-). Thanks for posting this. Since this was a phase 3 trial over 2 years ago and it went well, can I assume this is now a publicly available treatment option?!

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Thank you for your reply. Coincidentally, this morning my spouse was just going over her notes from the first few weeks after my diagnosis and surgery, when I was in a pretty bad place. The oncology team at our Cancer Centre told her that in a case like mine (single metastasis to the spine, though a big enough one to leave me temporarily paraplegic), I could expect 5 to 10 years before organ involvement, and even that might also be easily treatable depending on where the cancer moved. I assume that estimate was based on ADT alone, because we don't have 10 years of data for androgen-receptor inhibitors like Erleada yet, but it might also be an educated guess taking Erleada into account.

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1 reply
rathdowney | @rathdowney | Dec 3, 2023

Hi All, I am Patrick and new to sharing, My Prostate Cancer has spread to 2nd and 6th ribs. I had the treatment's and am now on Enzalutamide tablets daily, I am 82 yo and have broken sleeps every night, whilst I don't share often, It's lovely to follow and know that I am not alone. I had a prostate operation about 4 yrs ago and they found (PC). PSA reading was above 10. I Had the treatments and PSA dropped down to 008, unfortunately it is now back up to 4.78 so they are keeping an eye on me, I am in no pain yet TG. Thank You for reading, and I wish you all a very happy Christmas and New Year and like You all I will keep exercising and searching for recovery. Much Love to all and God Bless.

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cal77 | @cal77 | Dec 3, 2023
In reply to @northoftheborder "Yes, with widespread metastases, Dr Kwon's triple approach would apply (from my layperson's understanding of his..." + (show)
@northoftheborder

Yes, with widespread metastases, Dr Kwon's triple approach would apply (from my layperson's understanding of his videos).

At my cancer centre (in a different Canadian province), I've been closely consulted and offered information and choices for every stage of my treatment. I know it's hard when you're already sick and low on energy, but I suggest moving heaven and earth to get into your cancer centre in Calgary — a team approach is always better than one (possibly-opinionated) urologist. You could even cold call the cancer centre to find out what referrals you need.

I'd hate for you to spend your retirement savings getting treatment in the US. What you want is available free here in Canada, probably even in your own city — my friend with lymphoma in my city was offered every available treatment, up to and including some brand-new genetic stuff and CAR-T (oncology's last, desperate Hail-Mary pass).

You deserve at least a good explanation of why your urologist is not offering you the option of chemo together with your ADT and radiation (they might have a good reason, but they don't seem to be communicating it to you if they do).

Best of luck, and remember that you're your own best advocate. DM me if you want to discuss further.

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Thanks for your reply..
The more I watch Eugene Kwon's, the more I don't understand the Urologist..
He just told me that there were some very bad side effects with the chemo..
When I asked about where the bone metasis was, he said everywhere...but then didn't offer me the report...
I think you are right, and to get my family Dr. to refer me to the Cancer Clinic and at least get a second opinion there.
I was thinking of sending all my reports to Dr. Kwon to get his opinion, but not sure he will consult over the phone..
Thanks again for your info..

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hbp | @hbp | Dec 3, 2023
In reply to @northoftheborder "I think that's a little harsh, and unnecessarily discouraging for people with newly-diagnosed bone-metastatic prostate cancer...." + (show)
@northoftheborder

I think that's a little harsh, and unnecessarily discouraging for people with newly-diagnosed bone-metastatic prostate cancer. It really depends on the number of metastases, and even then, there's huge benefit from introducing androgen-reception inhibitors like Apalutamide. I'm at 26 months now, with PSA still undetectable (< 0.01) — tested today — and no progression. I had the metastasis in my spine radiated, as well as the primary tumour in my prostate.

The TITAN study for metastatic, castrate-sensitive prostate cancer (using ADT and Apalutamide) did not even reach median overall survival at 52.2 months. Median overall survival with ADT and placebo was still almost 40 months.

Source: https://ascopubs.org/doi/abs/10.1200/JCO.2021.39.6_suppl.11

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North…. I have been on a clinical trial with Erleada and lupron and had those drugs for 13 months with surgery after the 6 th month. I am now 24 months since beginning g the trial. I understood that in this trial event free survival would be approximately 41 months and survival would be not more than 66 months. Did I misunderstand the results of this trial?

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1 reply
melcanada | @melcanada | Dec 3, 2023

At night I get tingles but it the need for neck pillow On CPAC so get dry mouth Finally a mouth C patient I met in Jamaica said buy at Shoppers these tablets Xylimelts see http://www.oracoat.com They work

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northoftheborder | @northoftheborder | Dec 3, 2023
In reply to @hbp "North…. I have been on a clinical trial with Erleada and lupron and had those drugs..." + (show)
@hbp

North…. I have been on a clinical trial with Erleada and lupron and had those drugs for 13 months with surgery after the 6 th month. I am now 24 months since beginning g the trial. I understood that in this trial event free survival would be approximately 41 months and survival would be not more than 66 months. Did I misunderstand the results of this trial?

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The last I saw they had not yet reached median survival at 52.2 months for Erleada + ADT in followups to TITAN. Perhaps there was a later followup where they found it at 66 months (??). If so, that would still mean that half of people were alive.

I'm also in the IRONMAN registry/study (administered by TrueNTH up here) — it means I get bloodwork every 3 months instead of every 6.

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northoftheborder | @northoftheborder | Dec 3, 2023
In reply to @melcanada "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10000416/#" + (show)

Thanks for the link.

While the paper is from 2023, the study that it cites giving a 33% 5-year overall survival for bone metastatic prostate cancer is from 2007 (likely based on even-earlier data), before the widespread introduction of androgen-reception blockers (like Erleada) and long before treatments for oligometastatic and full-metastatic prostate cancer pioneered by Dr Kwon at Mayo and other oncologists.

Fortunately for all of us here, our options have improved a lot in 16+ years. If I'd been diagnosed even 5 years earlier (than 2021), my prospects would have been much-less encouraging.

(Former university prof here, so I always read the footnotes. 🙂 ).

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chefterry | @chefterry | Feb 18 5:43pm
In reply to @hbp "I was on lupron and Erleada for 13 months with RP after the 6 th month...." + (show)
@hbp

I was on lupron and Erleada for 13 months with RP after the 6 th month. Being tired is normal and expected, however, these meds worked well for me. I am now med free and cancer free and hope to stay that way. If the cancer returns, I will probably go back on these meds. I recommend that you put up with this side effect and that you continue with these meds unless they cease to work or that your side effects change and become unloveable. Good Luck.

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was it metastatic from the prostate

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