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Advanced Prostate Cancer
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PCa/Treatments and Immune System

I am Stage IV with some metastases in lung and bone, currently on Lupron, Zytiga, and Prednisone for the last 2 years. This past year my colds have become more severe and have lasted longer (up to 4 weeks). Could this be a weakening of my immune system due to PCa and/or the medications I have to take?

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Prednisone is an immunosuppressant med.

-Patrick

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Yes, these medicines do suppress the immune system. Radiation also suppresses the immune system. Being stage IV myself when I was on the same medicines, Dr. Charles Meyers said when I first went to him, "we should check your immune system -- the cancer, radiation treatments, and some of the medicines you are taking will most certainly suppress your immune system." When we checked my immune system, much to my surprise my immune system was just above the level of those suffering HIV --we are now working on restoring it and it must be working since once again I have allergies...

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I had the same issue with major colds/coughs two or three times a year which would last 6 to 8 weeks. I got checked by a pulmonary doctor and it turned out I had "late onset asthma". Now I use an inhaler everyday and I haven't had a cold in more than two years.

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Which drug is being dispensed from the inhaler? I also am having colds and bronchitis.

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QVAR

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how are you restoring your immune system? Would the strategy you are doing strengthen or maintain one's immune systems in anticipation of radiation or drugs like prednisone?

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Do you know what test(s) he used to check your immune system? This has never been suggested to me, & it certainly interests me in terms of being able to fight the PC.

But maybe my doctors haven't suggested it because I very rarely get sick, other than having advanced prostate cancer. I don't bother with flu vaccine. I do keep my vitamin D blood level high. My general good health hasn't changed in the 13 1/2 years since my diagnosis, or the years before the diagnosis when I had PC, from what it was before. That includes the last 2+ years on Zytiga/prednisone.

Is it possible that for some men, the weakening of the immune system either doesn't happen, or doesn't seem to affect general health?

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Oh yeah, I've also been taking a Host Defense supplement to support my immune system every morning for the last 10 years. It contains 17 Asian mushrooms, including shiitake & maitake. I eat lots of shiitakes too.

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can you tell me what conv treatments you had since you were diagnosed with PC 13 years ago? what was your gleason when first diagnosed? Thanks

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Hi! In April I had recurrent cough and colds. I went to the E.R. and they diagnosed me with influenza, even though I had a flu shot last fall. This was a different strain of the flu not covered by the shot. So I took Tami-flu and it cleared up. I also am on Lupron with metastases and my immune system is not like it used to be. So just ask a doctor about your colds and good luck.

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What aspect of the immune system is compromised?

?Radiation might kill marrow and lower cell counts, but across the board?

?Chemo can kill diving cells, so short lived cells are vulnerable, but can be checked with a CBC, especially for neutropenia.

A cold is a virus, so would be combatted by -- what?

Maybe similar to flu, which is combatted by activated T cells, created by the flu vaccine.

What does prednisone do?

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Martin, prednisone is needed as an adrenal hormone replacement when taking Zytiga because Zytiga blocks the synthesis of not only testosterone but some of the natural adrenal glucocorticosteroids like cortisol. So you can think of prednisone as a replacement for the body's own cortisol. Prednisone is actually more potent than cortisol, but they both act as anti-inflammatory agents.

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I meant what does prednisone do in the context of degrading the immune response. Does prednisone have a negative effect on the immune system, and if so, on which component. The original question was about lingering colds.

Yea I think prednisone has to do with the mineral corticosteroids - whatever those are.

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Prednisone is metabolized in the liver to the active form, prednisolone, which passes through the cell membrane and binds to intracellular glucocorticoid receptors. That complex is then translocated to the nucleus where it blocks the transcription of genes that activate the immune system, hence you get immunosuppression. Immune cells such as B- and T-lymphocytes are reduced in number. Hope that helps a bit. Btw, mineralocorticoids are corticosteroids that influence salt and water balances (electrolyte balance and fluid balance). Prednisone is a glucocorticoid. Both are produced in the adrenal glands.

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So if his immune system is being depressed by prednisone, the mechanism is a decrease in lympatic cells, and he can check his cell count to see. No harm in checking the neutrophil count.

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Glad to hear a nice clear explanation of why I need this drug, which causes easy bruising for me. They cut my dose in half, & the bruises are less thick & fragile.

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patandemma@Raff5757

you said "much to my surprise my immune system was just above the level of those suffering HIV "

I suspect Dr Myers was referring to your lymphocyte (NOT neutrophil) count at the time.

Docetaxel wil drop ALL the white cell elements.While Neulasta will raise your neutrophil count,it won;t do much for your lymphocyte count.

Lymphocytes are crucial in your immune system. If your lymphocyte count drops <900 cells per deciliter you may have problems.

", our data indicate that the development of

nonneutropenic febrile episodes in this patient population

was associated with a low absolute ( 900 cells

per deciliter) and CD4 ( 400 cells per deciliter)

lymphocyte count."

Cancer 2002;95:1326 –33.

© 2002 American Cancer Society.

DOI 10.1002/cncr.1080

A CD$4 count <400 is certaily AIDS =level immunocompromise

IWhat did Dr Myers do do,did it help?

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