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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Profile picture for northoftheborder @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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Profile picture for cal77 @cal77

Hi,
This is the link for Dr. Eugene Kwan explaining why the 'Triple Threat' works.


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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Profile picture for northoftheborder @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.


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.

REPLY
Profile picture for cal77 @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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Profile picture for cal77 @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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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.

REPLY

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

REPLY

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??

REPLY
Profile picture for northoftheborder @northoftheborder

I'm so sorry to hear about that. I also had pain and trouble closing my right fingers into a fist, about six months in. I don't know if it was the Erleada, early arthritis, or something else.

It was especially upsetting for me because I had played classical guitar before my cancer diagnosis and hospitalisation, and I didn't want to lose that on top of everything else.

I worked hand exercises into the physiotherapy I was already doing, including squeezing foam balls and then exercise grips. I still have some issues, but in my case the daily exercises eventually dealt with most of the pain and stiffness, and let me play guitar again (including at my daughter's wedding).

As always, your mileage may vary.

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That is good advise, thank you. I will get some foam balls and
grips and give it a try. I was learning the guitar but the hand issue put an end to that. I was told to try learning a keyboard.

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Profile picture for hbp @hbp

I had no joint pain for the 13 months on Erleada and the 10 months off of it but I now have a lot of joint pain in my right hand, can make a fist, 3 fingers can’t close, burning sensation in my palm, hard to write, hold fork and knife, etc. My left hand is now starting to stiffen up too. I would like some meds for this but I don’t want to be sleepy all day. This side effect is truly new to me and it is easy to hate.

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I'm so sorry to hear about that. I also had pain and trouble closing my right fingers into a fist, about six months in. I don't know if it was the Erleada, early arthritis, or something else.

It was especially upsetting for me because I had played classical guitar before my cancer diagnosis and hospitalisation, and I didn't want to lose that on top of everything else.

I worked hand exercises into the physiotherapy I was already doing, including squeezing foam balls and then exercise grips. I still have some issues, but in my case the daily exercises eventually dealt with most of the pain and stiffness, and let me play guitar again (including at my daughter's wedding).

As always, your mileage may vary.

REPLY
Profile picture for baxterlee77 @baxterlee77

Russ hates it ! Hurts bad pain joints and back ! Who wants to live on pain meds it sucks 😞 not sure what he will decide ! Taking a trip to Arizona for nice weather ! God bless 😊

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I had no joint pain for the 13 months on Erleada and the 10 months off of it but I now have a lot of joint pain in my right hand, can make a fist, 3 fingers can’t close, burning sensation in my palm, hard to write, hold fork and knife, etc. My left hand is now starting to stiffen up too. I would like some meds for this but I don’t want to be sleepy all day. This side effect is truly new to me and it is easy to hate.

REPLY
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