Posted 4/12/2015 6:58 PM (GMT 0)
PCRI (Prostate Cancer Research Institute) mid year update, LAX Marriot hotel, April 11. There were 230 of us in the room.
These were the speakers:
Daniel Margolis, MD, Multiparametric MRI instead of random needle biopsy biopsy
Take away: get fewer and better biopsy sticks to determine course of treatment. Many times random biopsy under states the disease risk.
Fabio Almeida, MD, PET-CT scans to detect and locate
Take away: if you have recurrent disease, figure out exactly where it is, and if ogliometastatic (5 or fewer spots (likely)) you can radiate the spots only with stronger beam and not a wide area. Dr. Almeida had found one lymph node on me that I just had treated.
Mark Scholz, MD, When men with prostate cancer can take testosterone
Take away: be careful it can make cancer worse, the best testosterone addition method is under the skin.
Mark Moyad, MD, The optimal cancer diet
Add fiber and protein. Consider Centrum vitamins as they have been compared to placebo in a large study.
Other take aways:
Since I am a recurrent patient, 12 years, most of these notes are slanted in that direction:
1. Prostvac is a vaccine in 3rd stage clinical trial and looks promising. If all goes well it could be an option within a year. A vaccine, need I say more.
2. Claris Life Cycle test, Foundation1 test Guardant Health test. These assess you genetically and recommend the drugs likely to work given your genetics. Saves you from taking something that fails.
3. Jevtana vs. Taxotere chemo. Jevtana is way better according to Dr. Scholz.
4. Xofigo is only given for six months, they are working on longer studies so that Medicare pays for longer use.
5. Augmenix a gel that separates rectum from prostate bed during radiation to reduce side effects.
6. “SAM”. If you were retreated recently and want to slow doubling times. Use a Statin, aspirin and Metformin. (SAM), I am pursuing this.
General feeling is that these protocols are changing rapidly. We can avoid random biopsies, generic radiation to the prostate bed, have new agents to knock back tumor size and possibly immune agents (the holy grail). Annual PCRI is in September.
==============================================================
Age 63
PSA 2.9 12/02, age 51
BX/DX, 9/03, G6, 4 of 12 cores
Brachytherapy 9/03
PSA nadir 1.1 5/08
PSA 1.8, 12/08
BX/DX, 2/09, G8, 1 of 12 cores
Hyperthermic, Hormone (one Lupron), IMRT (10) spring 2009
PSA nadir < 0.1 10/09 - 01/12
PSA 0.2 4/12
PSA 2.9 5/14
C11 Acetate PT/CT, found 2.0 cm lymph node 5/14
Lupron/Casodex 5/14
Nadir <0.01
2/15 SBRT to node
3/15 PSA 0.02, T=0