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Advanced prostate cancer stage 4 w bone mets psa 1200 age 55

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Posted 1/5/2018 10:37 AM (GMT 0)
Thank you for the information. Do you think this psma is a cure? Cost is a huge factor do you know how long the treatment is? Weeks? Months? We have 3 kids and ailing parent and jobs to keep. Do you think we can do radium and parp and then psma? This is so overwhelming. They said he was a candidate for the radium and they did the genetic testing. Is this treatment for his cancer going to change things and make him weak and sick? He has never missed a day of work through all of this. The psma scan in calif is $7,000. We have a separate cancer policy but don’t think any of this would be covered?
Posted 1/5/2018 11:59 AM (GMT 0)
There are two versions of PSMA. One is the PSMA scan, its diagnostic - you can locate metastases with it very well. This is offered in Houston and California.

The other application is radiating the tumor internally with it. This requires several injections usually two months apart. Plus PSMA scans to monitor the results. This is not curative, since the metastases plus new ones do return after a while. You can expect to delay the disease for about up to a year with this treatment.

Yes, this is very expensive. Xtandi for a year is expensive too but covered by insurance.

The cost of the clinical trial at MSK that Allan mentioned may be covered by insurance or MSK.

George

Post Edited (George_) : 1/5/2018 5:03:51 AM (GMT-7)

Posted 1/5/2018 6:58 PM (GMT 0)
No, it is not a cure, unfortunately. There are no cures for metastatic prostate cancer. Some medicines extend life for a median of several months. However, keep in mind that life is extended for years in some men, but not at all in others. The clinical trials are trying to find what genetic characteristics determine who responds and who doesn't. MSK is a leader in genetic testing and precision medicine, I'm hopeful that the PARP inhibitor/platin will have a big effect.

I think your current plan to start with Xofigo is a good one. But do ask Scher about the trial of I-131-MIP-1095.

What Scher was talking about was not a PSMA scan. What he meant was a PSMA-based therapy. It is not available in California yet, as far as I know, only in Houston so far. They administer the drug once every 3 months for up to 4 cycles, so it is time consuming and expensive, and will not be covered by insurance.
Posted 1/5/2018 7:35 PM (GMT 0)
Yes, there is no cure but sometimes you can live for quite a long time with your metastases. Dr. Myers was diagnosed with mets in 1999 and now, 18 years later, he is still active.

However, he did not start with a PSA of 1200 I guess.

George
Posted 1/12/2018 5:02 PM (GMT 0)
Sorry to hear about husband but you need to be strong. I dont think he will respond to Xtandi. I suggest you to do PSMA scan for your husband. There are some radionucleotide therapies going on and they have shown very good responses in germany and at centres where they have been used. You can checl 177Lutetium PSMA therapy on google or you can search Xofigo also. But everytym treatment options depend upon response from person to person. Gleason 9 is considered to be aggressive. Discuss this with your MO and may be some other options which you are considering. My father is going from same scenario and our PSMA Lutetium therapy is scheduled on 17th this month. I have hopes with this therapy. Just be strong...
Posted 1/12/2018 5:05 PM (GMT 0)
PSMA scan is used to locate the metastatic locations and the sites which take uptake they target therapy whether Lutetium for them. But in some patients there are some lesions which dont take PSMA scans in that case the therapy wll not work against them.That is why its recommended to do PSMA scan first before this therapy. Is there not any insurance that is covering the expenses? PSMA scan is one day work and PSMA therapy is a single injection which is done and no severe toxic effects have been reported so far. Cost varies from one place to another. In India it is very costly but in one government hospital it is given free os cost .
Posted 1/12/2018 5:45 PM (GMT 0)
Update - yesterday we went for First radium 223. If all goes well with insurance also doing the parp inhibitor. No radiation at this time only 2 small spots and they feel the radium will address. they will be scanning and watching. Doctor said he is very strong and otherwise very healthy and believes this will go well. Have a lot of faith in msk. also waiting for the psma scan to be available
Here in New York, which I️ hear will be shortly. These insurance companies really put you through a lot.
Thank you all for the replies. Praying everyday for a cure. God bless
Posted 1/12/2018 8:28 PM (GMT 0)
Jannett,

the Lu177 therapy consists of several injections with usually about 8 weeks in between.

George
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