Posted 4/12/2016 9:38 PM (GMT 0)
Dear MTNWIFE,
I've been following your posts and you've had some success in lowering the PSA score with the orchiectomy surgery and other treatments.
I will echo what our comrade ALMOST A 10 shared in his post written above, as his experiences overlap my same experiences, in many regards. I've pursued the ADT hormone shots, then followed up with a series of Taxotere chemo infusions, and then followed that up with ZYTIGA --- all in careful consultation with my local medical team comprised of my urologist and medical oncologist, with additional consultation from a certified urology oncologist who specializes in advanced prostate cancer.
From your post, it's evident that you've got some residual "glowing embers still smoldering in your campfire" that need to be CLOSELY monitored. You've tampered down the PSA with your actions to date --- so those are important strides --- but from the details that you have posted, I believe that you would qualify at this time for chemo treatments, as an additional weapon of attack against your residual cancer.
My experience closely matches what ALMOST A 10 described in his post shown above --- adding chemo to my ADT hormone shots drove my PSA down to the lowest level I had ever experienced to date. The decision to add chemo for advanced cases is verified by the landmark clinical studies known as the CHAARTED study and also the STAMPEDE study --- you can refer to them, and both of them clearly show a survival advantage for using chemotherapy treatments as a FRONTLINE method of attack.
Your scans indicate involvement in lymph nodes, as you described in your post. It can't be emphasized enough for complex cases when residual or micrometastic cancer is present, that adding chemotherapy treatments adds an entirely different form of attack to combat against residual cancer cells. Chemo attacks stubborn forms of cancer cells that the ADT hormone shots or orchiectomy surgery did not fully attack. Cells that are not hormone sensitive remain --- chemo treatments attack those remaining cells. It's what I call the double-barreled shotgun approach --- you've been doing what you've done so far, but adding chemo adds an extra bullet to the shotgun. It's an important consideration --- each case is unique --- but you should seriously consider adding a series of chemo treatments, and have an honest and detailed consultation with your oncologist about this possibility.
It's been almost two years now since I finished up my chemo treatments in 2014. I'm working full-time in a rewarding career and keep up with my family, friends, volunteer projects, and social life. Fortunately, my side effects were quite mild and I went to work each day all during my series of chemo treatments. I witnessed first-hand the impact that each chemo treatment had in my case, as we charted the PSA with each subsequent chemo infusion to measure its impact. From there, my oncologist and I discussed the value of adding either XTANDI or ZYTIGA, to continue suppressing my PSA levels after my chemo treatments were over. In my case, we decided to try ZYTIGA, and my PSA remains even lower than it did while I was on chemo treatments. I feel that pursuing the chemo treatments FIRST, helped knock down my PSA level, which then led me on to some further success after I added ZYTIGA to my sequence of treatments, to date.
Other direct friends of mine in this same boat have also pursued Taxotere chemo treatments, just as soon as they were diagnosed with systemic or advanced prostate cancer. Adding chemo treatments upfront to the treatment protocol has been widely implemented in clinical practice across the country in very recent years, representing a transformational paradigm shift in the "early use" of chemo for advanced cases. We have many members here with more advanced cases who have pursued the "early chemo plan" --- past, present, and now ongoing, as we speak. Since your scans showed lymph node involvement, I think it is a strategy that you would want to strongly consider --- ALWAYS with careful consultation and advisement from your medical team, as each case is unique in its own regard. For your case, stay in close connection with your doctor, of course !
As with all prostate cancers with any level of complexity, it is also worth mentioning that a second opinion can be a wise and valuable idea. As my original doctor states often, "A good doctor will ALWAYS encourage a patient to seek a second opinion." In my case, I had all my original medical documents re-assessed by another medical team, seeking their input and advice.
This past month, a good friend of mine who has advanced prostate cancer was hitting a "brick wall" with his local doctor as far as future treatment strategies and a rapidly rising PSA --- he sought a second opinion from a certified urology oncologist and came back with a whole new treatment strategy which is already underway. As he said, a second opinion opened up a whole new realm of possibilities that had never been presented or offered to him before.
In her writings from the 1800s, American poet Emily Dickinson once wrote, "Not knowing when the dawn will come, I open every door." The main theme of my message today is to keep EVERY DOOR open --- every possibility --- every treatment option --- as you continue to look ahead. Thankfully, there are many treatment options that are available in the arsenal of treatments --- options which have already helped me. They are there for you, whenever the need arises.
I just wanted to share some thoughts, ideas, and reflections --- to add to the range of responses you have received over time on your original post and subsequent updates. It helps to hear from a wide range of respondents --- helps to trigger further reflections --- additional considerations --- and possible treatment strategy possibilities. MTNWIFE ~ My best to you, looking ahead down TREATMENT TRAIL ...
Sending along my care, concern, and compassion ~
"Cyclone" From Iowa State University