PROVENGE - If cost wasn't an issue, would you do it?

Tough question. I probably would not do it unless I had an unstable PSA. Right now all is well and we really are missing a lot of information about Provenge down the road.

Interestingly, you might get a different answer by someone who has good insurance but unstable work. They may be inclined to do it while the procedure is covered.

Tony

Provenge is high on my list of things to do when Lupron fails.

I read a post recetnly on US Too where the medical onco suggested to do Provenge and then go back onto Lupron as first remedy.

Based on what Todd says, seems 3 treatments over a short period of time may make all future treatments that much more effective.

I have also heard Zytiga as next remedy when Lupron fails, lus the usual triple blockade, Avodart, casodex etc. So no universal agreement on which to try first.

LupronJim

Absolutely would recommend Provenge to Frank as a first-line treatment if it was free or money was no object.

Lisa

If I reach the point where it's needed, and that is what my oncologist was recommending, I would be willing to try it.

I am under the impression (correct me if I am wrong), that Medicare will pay for Provenge, if so, then for me, cost wouldn't be a major factor.

David

As I have said, my husband was just diagnosed with PCa with bone mets throughout. He has had one shot of Lupron. I have already talked to his urologist about Provenge, and was surprised when the urologist said he had already talked to someone from the maker of Provenge about my husbands case. He is not yet qualified, needs to give other things a chance. However, Medicare does pay for Provenge. I am curious and concerned about the posts saying Provenge is best early on. I am not sure how to make that happen for my husband. I appreciate this group more than I can express, I am learning so much.

I'd been wondering the same thing and couldn't figure it out. It seems there were some trials using it prior to hormone resistence, but I couldn't find results.

Tony - what might long term implications be?

Yes, I would take it as soon as I could.

Melg,
I can't really answer that question. Long term side effects of Provenge are largely undocumented. Here are some of the SE's that have been documented:

www.rxlist.com/provenge-side-effects-drug-center.htm

Most of these are going to happen at the start of treatment but many are long term. I think from what I see that SE's can be managed. But an allergic reaction and such did happen. During the trial 1.5% had to discontinue the procedure. 98% of patients that had the procedure reported some level of toxicity. But most did well recovering.

Provenge was tested in men with advanced disease that was either metastatic and not responding to HT or non-metastatic that were in fact responding to HT. This tells me that many have since died from PCa as their cases were very advanced. To take Provenge for the sake of believing that it would help a man like me who was stage pT3b after surgery but completely dropped to a zero PSA without HT or radiation is completely a speculation as to whether it would have any positive oncological effect for me. But the SE's would be there to some degree. Until such a time trials are completed for patients with long term prognosis cases it is completely unknown if there is an oncological benefit. It is also unknown what long term side effects may persist.

As a G-9 with past doubling times in the 2 week periods and having multiple mets,....let me think..., Yep I would.

Tony - looking at the side effects in the link you provided says that nearly all the side effects occurred at about the same rate in the control group as in the Provenge group. In other words, the so-called side effects are simply the result of Provenge being tested on a very sick group of patients.

For example, 30.9% of the Provenge group experienced a grade 3-5 side effect (that means severe to fatal). At first reading, this sounds really scary. But it turns out that even more -- 32% -- of the people in the control group experienced a grade 3-5 side effect. In other words there was no EXTRA morbidity associated with the Provenge.

I agree this does not say anything about side effects long term, nor about side effects in a less sick group of patients. But it is good news so far.

Hello .......

   I was at a crossroad last August. My Oncologist suggested the possibility of Provenge. I did go to another Onco for a second opinion and for additional info.

   The second Onco's office was highly involved with Provenge treatments. I brought my recent catscan and bonescan report, and after reviewing, this Onco suggested that the Provenge may not be of any benefit to me. My PSA at that time was slightly over 60!

   I did, shortly after, decide to go onto Jevtana ... my original (and current) Oncologists other suggestion.

   If my PSA had been down - say at 10 or less, I may have considered the Provenge. My PSA however aggressively jumps (more than doubled in the past 7-weeks) after recently stopping the Jevtana - after 8-treatments.

   Good luck on your decision.

P.S. - Zytiga and Xtandi were NOT of any help to me - and costly even though mostly covered by insurance. Tough decisions with PCa!!!!!!

Rob & Gizmo