Posted 9/13/2018 3:36 AM (GMT 0)
A short report. I've written on this subject here before.
Started beginning 2017 with PSA 250, Got Lupron, Docetaxel, Prostvac (clnical trial) and Provenge. PSA down to 0.7 nadir.
Started Abiraterone. Two weeks later 0.3. Ten days after that 0.216.
Went to radiation oncologist today and said I wanted my metastases zapped. Met first with resident who said I was not really a candidate for radiation yet as other treatments are working well. I explained that, based upon my reading, there appeared to be a couple of reasons to do it. First: Overall reduction in cancer volume. If you know it's there then kill it. Not sophisticated analysis I acknowledge, but there is support for that. Equally important is that there's lots of writing on radiation boosting the effectiveness of immuno. Months count here.
My regular ONC told me "best Medical Practice" is to radiate only if there are three or fewer metastases. Quite honestly I think that's rather arbitrary, which he acknowledged, and I suspect, prompted at least in part by the amount of time required to radiate more than three. The radiation ONC said "well maybe we'll do 5/5/5 -- i.e five treatments for two and then do it again with others.
So, on with the quest to pull out all the stops.
This is an incredible area of science. Things are changing SO fast. As far as I'm concerned by the time they figure out best medical practice at my stage I'll be gone. We're in a dynamic situation. I figure if I can hold this thing off long enough there will be more meds or they will figure out which of the many meds out now might work on me. Or, who knows . . . . maybe Car-T if I can live long enough.
Some like to keep their powder dry and hold off use of other agents until needed. No one knows the right answer. I'm rolling the dice with kicking the you-know-what out of it when it's down.
Best to all.