Provenge..Yes or NO

[gusgold]

Is Provenge worth trying. I ask this because an ocologist at The Mayo Clinic said they have seen a number of patients where Provenge weakened the immune system and the PCa took off like a rocket.

Gus

[YostConner]

I did Provenge followed almost immediately by Zytiga. I'm 22 months in with good result so far. My PSA is rising, but my bone mets are improved. Next bone scan is in three months.

[RJ-MN]

Sipuleucel-T did not slow my PSA's rise one bit (also done @ Mayo), but it did not spike it either. It simply kept rising up to 17 until I found, qualified for and entered a clinical trial at the NIH using both enzalutamide & Prostvac-Tricom. (Which has sustained me for 32 months.) Of course, Provenge may have slowed that six month rise to 17 from what it might have been. It's T-Cell activation may even be working now. Or, it may have been totally non-efficacious for me. I've never been informed if Mayo had a way of measuring these things.

[JoelT in reply to RJ-MN]

There is no way to measure if any individual has received any benefit from Provenge. We do have phase 3 clinical trial evidence that it does extend life and we also know from the trials that there is a very large survival clinical trial tail.

Provenge has gotten an undeserved negative rap because it operates differently than our other treatments which also means that our usual measure don't work.

The clinical trial data was very clear. Statistically there is a survival advantage, we just can not point to you and say that you were one of those who be fitted.

Joel

[sidnw in reply to JoelT]

I had the Provenge treatments in December....Unfortunately I am not the same person...I have had a serious case of absolute exhaustion. and just felt very bad. I was referred to a well known Oncologist by our friend Joel (thank you Joel) ..saw her last week. Now, this was just her opinion. She just wasn't too hot on Provenge. Today entered Rush North Skokie Hospital. Onc. suggested I decide about being hospitalized feeling so sick. They took in Emergency Room on my Dr.'s advice chest xrays. blood tests, found I was dehydrated and started treatment with that. Temp seemed orally normal but rectally 101.3...My Dr. suspected an infection somewhere ....I am not sayingit was definitely Provenge ...but will start knowing more here tom...when my Oncol. comes to see me. He had said he suspected an infection somewhere....Provenge treatments???? Will know more tom.

My wife Shyrlene is typing this, and she is very worried. (Yes, I certainly am!)

Any comments from you terrific followers?

sidnw

[sgrama in reply to sidnw]

Was there a infection?

Thank-you

[stvbal]

I had Provenge in Dec. 2015 at Dana-Farber in Boston. After that, my PSA has had a rapid rise that caused me to begin chemotherapy. I previously had a good run on Abiraterone, almost 3 yrs., but failed enzalutamide after a few months which led to Provenge.

While medicare paid the $300k bill, I don't think I would do this again. I think it is very difficult to measure effectiveness of this treatment.

[gusgold in reply to stvbal]

That is why I am hesitant about Provenge...Doc at mayo said a lot of men have rapid rise in PSA from weakened imune system

[JoelT]

I have been very involved in the Provenge discussion from the very beginning. I have not see of or heard any evidence that Provenge weakens the immune system, on the contrary it should strengthen it.

The confusion is that it takes a while for it to to become active and start to push the immune system to fight the prostate cancer. This means that you should expect your PSA as well as see scan evidence of disease progression as you take the treatments and some time after.

Provenge, does not work in the same way that our other toxic treatments work. The re-introduced cells need time to recruit the rest of the immune system to be responsive to the cancer. This is why patient selection is so important.

Provenge should only be given to men with less disease, men with very advanced disease are not good candidates for the treatment. Because you don't want the cancer to be given the cancer the extra time it takes for the treatment to become active. The very best candidates for Provenge are men who are castrate resistant, have low PSA scores or who have longer PSA doubling times.

If you want to lean more about Provenge go to the Advanced Prostste Cancer Blog (advancedprostatecancer.net) and search Provenge. I have placed an extraordinar amount of information in a number of posts.

Joel

[wellness in reply to JoelT]

Thanks so much for your service Joel. You are a gem.

[JoelT in reply to wellness]

Ah, Gee

[Hidden in reply to JoelT]

Provenge attempts to make PAP a target of the immune system. This is a nice idea, but is there evidence that Provenge is sucessful at doing that. There is (i assume) free floating PAP in the blood, but it is not clear to me at least how that PAP is harmful, assuming that the kidneys excrete it.

[Scoop65]

I had Provenge treatment 2012. Prior to that I had RP and radiation. I had metastasized lymph nodes and PSA was doubling every 3 months. 4 years down the road my PSA is stable at around 1. Also, I've been on various hormone treatments for 8 years. I guess I'm one of the fortunate patients. Medicare F covered 100% of the cost.

[Magnus1964]

The first expression of cancer outside of my prostate were nodules in my lungs found in January. I went on Provenge and the nodules disappeared, my PSA began to rise to 130. I am now on Xtandi, PSA drop[ping fast to 6.

[gusgold]

Did the Docs say why your PSA went to 130 after Provenge

[Cancersucks]

Ex did Provenge in February and March when PSA was 32, on Xtandi, moderate pain and hundreds of bone mets. PSA now over 1000 and pain worse. Zytiga not working either. Was probably not a good candidate for Provenge in the first place.

[gusgold in reply to Cancersucks]

What happened to your EX is what the DOC at Mayo Clinic told me happens to a lot of men after Provenge...was actually down on it

[mshariff]

Big No! From my side! A gimmick and costly procedure.