Is it a failed treatment?

[yope4]

I have read quite a few posting, their's was a failed treatment; and most likely the reason why we're here on this forum. And it seemed it didn't matter what type of treatment one had. This may be an important observation to those who are considering their first treatment. The difficulty in coming up with the most effective treatment for one's cancer is knowing whether it's local or not. Current scan technology is unable to scan for micro metastatic cancer. And we don't know if and when those loose cancer cells will show up to become our Ca issue. Once it's systemic, it really doesn't matter what treatment one had; we're all in the same boat.

Additionally, there is that raging debate whether local treatment helps at all for systemic PCa. Any local treatment will always have some kind of side effect. It's hard to weigh benefit to side effect. 

In my view, we are totally dependent on having the medical provider who can come up with the best combo treatment you will best respond to. All doctors are not equal. And sharing your specific situation and outcome helps everyone else to what questions we need to raise to our own doctors. We think our direct participation to our treatment process is helpful to our doctors. Thank you for sharing.

[CERICWIN]

We don't as yet have a "silver bullet" which can send all prostate cancer into remission.      Most of the treatments fail at some point, because the cancer can adapt, and what was effective for months or years loses its efficacy.

Some lucky individuals go into remission, and some can stop the cancer's progression for even decades with hormone therapy like Lupron or Firmagon.

But more typically, the hormone treatments won't last for decades, but it does extend our lives.

And the more advanced the prostate cancer, the more likely the treatments will lose their effectiveness earlier.       Some of the gene therapies and immunotherapies show great promise, but they aren't perfect, and don't work for everyone.

I've been on Xtandi for about 21 months now, and it's showing signs of becoming less effective.   

CERICWIN

[DenDoc]

The one thing I have learned from my 17 years experience is that I never believe the people who write they "had treatment X... and are cured". Recurrence can come very late and I think with this disease the operative word is "controlled", not cured.

[Dr_WHO]

It is important that we all discuss treatment options with the doctors.  Do not be afraid to argue your case.  My cancer spread past the prostate into the local lymph nodes.  In my case I wanted to keep as many treatment options open as is possible.  For me that was surgery. At first the surgeon did not want to operate and wanted to start radiation.  However, I was able to convince him based on resent results that showed improved outcomes for surgery even if it has spread.  Having surgery first leaves open the options of radiation and hormonal treatments.  Having radiation first removes the option of surgery.  Turned out that I had a rare form of cancer (metastatic ductal adenocarcinoma, effecting less than 1% of prostate cancer patents).  In addition to the prostate, cancer was found in one of 14 lymph nodes that they removed.  The good news is that there is a chance that they may of caught it all.  (Will find out when I have the first post op. PSA test.)  If there is still some there, then I am ready for the next round of treatments.

[yope4 in reply to Dr_WHO]

Thank you for sharing. I hope they got all of it out. When you say local lymph node, it this a lymph not connected to the lymphatic system. A biopsy of my left iliac lymph node was positive for PCa, for which I began adt. At the time, I understood that once it's in your lymph, it could spread from there using the lymphatic system. I also hope my was contained in that one lymph node. My psa has been undetectable for 9 months now. My treatment plan is to treat this as a chronic disease. 

[Dr_WHO in reply to yope4]

Hope yours stay localized.  I just found out today that mine has spread.  Will be undergoing additional test to determine the full extent.  Oh well...

[yope4 in reply to Dr_WHO]

I wish you the best. Such is the nature of the beast. Despite advances in medicine, cell biology may the least understood. We're hopeful for the coming of the next genius to solve this in our lifetime. Goodluck. 

[Dr_WHO]

Hoping to hang in long enough for the next generation of treatments.  Lets all stay strong!