Xtandi did not work because you had Zytiga before. There is a cross-resistance between the drugs. Unfortunately I would also expect a cross-resistance with Nubeqa as well because it is similar to...
Here are additional links on this subject: https://www.medrxiv.org/content/10.1101/2020.06.03.20116988v1 https://www.thegreenjournal.com/article/S0167-8140(20)30185-7/fulltext...
I have the impression this is only the first part. E.g. the references are missing....
"hopefully start hormone therapy" I try to avoid ADT as long as I can. Some doctors recommend to start with ADT not before the mets hurt or become visible. If you start now you will become...
Casodex monotherapy is not mentioned in the guidelines and therefore your Urologist will probably not agree to continue with that. However, it is only a very small difference between Lupron and...
I take Ginseng according to this study and feel it has helped: https://www.mayo.edu/research/forefront/ginseng-fights-fatigue-cancer-patients On the other hand I stopped my ADT and the Hematocrit,...
I had four PSMA PET/CTs and three PSMA PET/MRIs done so far. I am in Germany and my insurance pays for these. No side effects. E.g. UCSF and UCLA offer these scans, one is about $ 2.500 as far as I...
It seems that the combined technique is currently just done within trials:...
Jerry, next time I would get an FDG PET/CT instead. This shows the bone mets just as well as your NA 18F-PET/CT but could detect lymph node and visceral mets too....
Traveller, I have no long term data to report. I added six months of Bicalutamide to my last metastasis directed radiation. Now, after over six months of holiday, my PSA value is rising rapidly. I...
Traveller, the doctor who mentioned intermittent ADT did this in the context of late ADT. His objective was that a rising PSA value, when you decide for late ADT, worries patients and this can be...
Alephnull, this are both blood tests you can ask for when you do your CBC. https://www.lifeextension.com/lab-testing/itemlc140848/chromogranin-a-blood-test...
Traveller, I discussed this with a doctor today because he detected neuroendocrine differentiation in my old biopsy probes. His statement was, the absolute CgA and NSE values are of no concern. You...
Alephnull, if you have a biochemical recurrence you can have Lupron for many, many years. Bicalutamide has not as many side effects as Lupron. It may not work all that well against cancer though....
Traveller, to check for a neuroendocrine tumor you can observe the Chromogranin A (CgA) and neuron-specific enolase (NSE) markers. If these rise continuously this can indicate a growing...
Stephen, a Lu177 treatment will treat what you see with a PSMA PET/CT. The PSMA PET/CT shows the PSMA expression of the tumor lesions which is sufficient for a Lu177 treatment. If you do not have...
If there would be cancer the PSA value would not decrease. It is very unlikely that your DH has cancer and all you should do is relax. It may be inflammation again....
Redwing, Grillmaster wrote: "RALP: 7/2013, 2 yrs Trelstar, 39 IMRT" so he had surgery and adjuvant or salvage radiation. After that you do not need to act if the PSA value gets above 0.2 ng/ml. All...
An amazing result for a Gleason 9. Further treatment should not start before the PSA value gets above 2.0 ng/ml. Even then you can just watch and wait. It will take years until you reach this PSA...
Island time, I did respond to Fairwind pointing out that you can repeat radiation in several situations. Regarding your question, no, metastasis directed treatment is not standard of care but I read...
You will treat mets mostly with SBRT radiation. This is an approved treatment. You can repeat the radiation if cells show up at different areas in the body. So you do not radiate the same area twice:...
This video is from an SNMMI conference in 2016, however, not much has changed apparently. When a patient sees his mets on a PSMA PET/CT he asks his doctor to remove these. He does not say: good to...
Robert, your URO tells you 0.4 because this study determined that the PSA value of about half of the patients stabilized at 0.4 ng/ml: https://www.ncbi.nlm.nih.gov/pubmed/11257657 For me you are an...
About 20% of the patients in your situation have the gene mutations that will make Olaparib work for them. So get the two tests (germline+somatic) to see if it will work for you. You will need both...
My first thought was, this is a clear trend of the PSA value, one could already radiate now. However, after I calculated your PSA doubling time I recommend to wait. You have a doubling time of 33.7...
Sorry you did not get in the treatment arm. At the link to clinicaltrials.gov you provided it says: "Best supportive/best standard of care will be determined by the treating physician/investigator...
Steve, if your doctor follows these instructions: https://firmagon.com/hcp/dosing-and-administration/ the injection will not be painful. I always asked them not to shake the vial as this will cause...
Jeff, Metformin and a low-carb diet got me to shed, believe it or not, 30 pounds in about six months. However, after stopping this I have ten pounds more weight now. I started with low-carb after...
In this video Dr. Mulhall, after talking about the effects of the lack of testosterone, presents his study about testosterone recovery after cessation of ADT (at minute 10.25) and gives the following...
"The area covered would be the prostate bed and lymph node area, too." You probably mean 6800 centiGy or 68 Gy. You should not radiate the lymph node area with a higher dose, you could radiate the...
Jeff, let me cite the NCCN guidelines: "Patients with an increasing PSA level and with no symptomatic or clinical evidence of cancer after definitive treatment present a therapeutic dilemma regarding...
In the video Dr. Kwon does not show the situation of the patients he presented about a year after his treatments. From what I learned in the meantime, usually new mets appear after treating the...
I have not heard from anybody dying from lymph node mets. Bone mets or liver mets can kill you but lymph node mets will not. InTheShop is right, you can get spot radiation, i.e. Cyberknife, to treat...
ADT will stop the tumor to progress for quite some time, but then the cancer will do so. The NCCN prostate cancer guidelines recommend radiating the prostate in your case and you may also get the...
This biopsy result allows to do active surveillance for up to ten years. I would choose that....
Zytiga and Abiraterone were approved first to be used after chemo for CRPC patients. They showed a benefit in this situation. So you should try these drugs after your chemo. But do not forget to try...
From what I heard, radiating that met will reduce the PSA value by more than 50% - without ADT. So yes, debulking tumor should be beneficial....
They recommend neoadjuvant (before RT) and adjuvant (after RT) ADT with the radiation. I do not think the guidelines recommend that but I would do that too. I hope they do not want you to do 18 or 36...
Argent, you wrote "I am waiting to hear back on recommended treatment." Did you hear anything yet? I ask because the patient usually wants to get rid of the mets while the doctors recommend ADT...
Your past treatments seem like a kitchen sink approach to me. Since your PSA is .03, all you have to do now is continue with ADT and bicalutamide and observe the PSA value. Call back in ten years...
mattam, I would start with Zytiga or Xtandi when the patient has become castration resistant, not after one year of ADT. And you have to have a PSA value of 2.0 ng/ml + Nadir to be definitely...
I wish I would ever get PSA values that low again. This is so low that it probably is just the lab not being able to measure exactly in this low range....
PSA Velocity does not matter if you have no prostate cancer. The PSA values are so low that I would not worry about cancer. However, you may have a biopsy if you want to....
I would not worry about the rise too. There is nothing you can do at the moment but to stay on ADT until he becomes resistant....
I expect Lupron to work for two to four years from now. Since you already combined ADT and Docetaxel, I would wait with Zytiga or Xtandi until he becomes resistant to ADT. An alternative outside the...
I think the technician meant 180 CentiGray. This is 1.8 Gy and the daily radiation dose he receives with each session. Very common dose....
I know a patient who uses Toremifene to raise his testosterone level after ADT. Here is an overview which provides a different recommendation though:...
Some cancer cells die, some become dormant and do not progress any more and some are already resistant and continue to grow. Further, some cancer cells escape the ADT treatment by mutating to...
I would choose active surveillance. This requires another biopsy in about a year. You can then send the result to Epstein again and maybe the pathologists do no longer disagree....
Lupron causes microflares with each new shot. You will usually not notice that, just you cancer gets some additional food. Degarelix and some other drugs do not cause these microflares....