Chemo+ radiation+combo hormone therapy

Hi all,

My father is on his third cycle of taxotere and recently switched doctors within the same practice (language, scheduling, and one doc being out). I recall the first doctor noting that at some point my dad would go off casodex and just have Lupron and zomeda and that he didn't need to have radiation yet. When my dad went on his second visit to the new doctor and highlighted that he feels back pain, the doctor noticed an MRI result he didn't see before and said he does need radiation and a few weeks ago said he will do casodex and Lupron for the foreseeable future. Has anyone here started treatment for advanced Pca with chemo and Lupron and casodex and also radiation? Any concerns? And any info on whether combo hormone therapy results in one of the drugs to having a reverse effect over time ? I've read mixed reviews on this.

Your experience on this is much appreciated. The doctor said he is concerned over my dad's back pain which has caused additional stress.

Thank you,

Anna

42 Replies

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  • Hi Anna, Are You sure the back pain is PCa related, it could be something else perhaps, as a long time stage 4 patient we tend to think that any time we have bone pain it is the cancer. Once one has radiation to one area of the bone to reduce pain, I do not think reradiating there is a possibility. Is the pain constant? Over time a small percentage of men may have cells become mutated and the Cancer actually feel on drugs, like casodex and zytiga, if psa starts to rise you can switch to another antiandrogen. My thought is it is generally not worth waiting for a "antiandrogen withdrawl response" in what seems to be early in his disease, just to move onto a new drug when psa starts to rise. meanwhile casodex may be a good idea to get that psa down while on Lupron.When was your Dad diagnosed, what was his psa and Gleason score, How is the Lupron/Casodex working? What did the scans say?

    Dan

  • Hi my name is ed. I was diagnose with prostrate cancer last march. Psa was 3.2.in two months of excercise and no meat consumption i koweredit to 2.8. Stil i went to a uroralogist had a biopsy. Have cancer in my prostrate. I went the alternative route. Check out chipsas hospital in tijuana,nexico. The gerson therapy protocal has,been around for over 70 years. Please reserch this if coukd,save your life with no chemo or radiation.

  • Hi Ed,

    The Gerson Therapy sounds good, with all the juicing and natural foods, but, I didn't like the idea of juicing up on iodine. I'm not a Phd, but it doesn't sound like its too good for you.

    Joe

  • He started with a psa over 400 and gleason 10 so we had to go with treatment as soon as possible. NYU langone oncologist noted we should be starting immediately and going with aggressive treatment. At the same time, he is trying to do 10-15 minutes of exercise a day (too tired to do more) and cut red meat, dairy, and sugar (occasional cheating)

  • Oh please. Get real medical treatment. Don't be seduced by alternative treatments. This is your health you are playing with.

  • Oh,really so you,are suggesting that i poison my body with chemo. Did u relize that less than 2%of all doctors in the us. Would not even this chemo on their own families.,do you relize that the chemo radiation protacals totaly fund an amaIng amount of money for big pharma. Radiation and chemo destroys the good cells,of your body. Do you relize the stats of people living longer tgan 5 years with thus so xalked treament is staggeringly low. May i recommend you reading killilng cancer not people. Did you know that tfds outlawed b 17 which is simply appricot seeds. Look up the web site the truth about cancer the world global scare you my friend are the one that needs to see past the,forest because the tree keep getting in the way. Please,reply.

  • I was diagnosed with Gleason 8, aggressive cancer. I was told I wasn't a candidate for surgical removal of the prostate and was set to get 45 radiation treatments. I guess I share your concerns about the safety and efficacy of radiation. I opted for HIFU surgery instead -- more precise than radiation and only required one 4 hour treatment. I am hoping that I won't need radiation or chemo in the future. I was on ADT (eligard) prior to my surgery. It shrank the prostate from 34cc to 27cc, helping the surgery. The one thing I didn't do was to think that diet and magic potions would knock down my aggressive cancer. Good luck to you. At least get PSA testing and DRE exams. The medical establishment isn't a giant conspiracy -- lots of good, smart, dedicated people curing cancer and saving lives.

  • Apparently you havent studied anything and it sounds as if you work for the chemo guys. Look up gerson therapy its been around for over 70 years. Last year at chipsas hospital in tijuana mexico recieved a patient that was basically told by his doctors to put your things in order. He refused this crap. He had a tumor on his neck that was the size of a grapefruit. In three weeks of gerson therapy it wa s reduced to the size of a,walnut. Without any chemo or radiation. Show me any chemo or radiation program from anywhere that has done that. This has been documented. No fake news its real. Anyway thanks for listening.

  • And another thing. I was considering hifu. The cost was 25,000. Up front,the fda has finally approved this but its gonna,take 3 years before the coding is ready. I spent 21,000.00 up front at chipsas hospital. After theee weeks i lost 35 pounds. Brought my blood pressure down. When i went to see my oncoligist he was pissed and said obviously your in good health.see in 8 months to do another biopsy. He could care less about my psa. Which i have maintained under 3.0 that was 4 months ago i feel great and i m so glad to follow what i feel was the vest decision. Did i catch this early? Yes. Your inmube system

  • I hope things turn out OK for you. There is a lot of skepticism about Gerson.

    ncbi.nlm.nih.gov/pubmed/187...

  • Edd1717,

    In answer to your question about whether chemo or radiation ever cured anyone, I can tell you that I was treated with radiation + Lupron in 2003 and have not required any treatment since then. My last PSA reading in 2016 was 0.07.

    As for chemotherapy, it has not been demonstrated as a cure for prostate cancer but it has been demonstrated in clinical trials to prolong life for prostate cancer patients. I know of at least one case, reported by a member of this group ("Gourd Dancer") who had a combination of chemo + hormone therapy for his metastatic cancer. He finished the treatments, and has required no other treatment for some years.

    Chemotherapy has been used successfully to cure many other types of cancer.

    There are useful articles about Gerson Therapy on the website of the National Cancer Institute. See: cancer.gov/about-cancer/tre...

    I agree with WSOPeddle's recommendation. If your only treatment for prostate cancer was Gerson Therapy, keep watching your PSA. If your Gleason score was 6 and only one or two of your biopsy samples showed any cancer, and not too much of it, then you may get by without further treatment for many years.

    Alan

  • Hi Alan, Did you stay on lupron the entire time? The doctor recommended radiation while on chemo bc he feels an ache in his back that's continuous and mri showed a lot of mets. Doc is worried the tumor will impinge on his spine. However, we want to be sure it's the issue and not arthritis or something else since you can only radiate the same area once.

  • I had two Lupron injections, one was theoretically effective for 30 days and the second one for 90 more days. However it was more like 150 days before my testosterone began to rise and 180 before it reached normal levels. The doctor wanted to continue the ADT for at least a full year but there was some evidence of liver damage caused by the Lupron and we decided to stop ADT.

    I don't know how to tell whether the back pains are due to cancer or to arthritis. I assume there is some kind of imagery - MRI, x-ray, or CT scan that can give a reasonable idea of whether it's one or the other. If your oncologist isn't sure, maybe you or he can take the scans to a rheumatologist and get a second opinion.

    Good luck.

    Alan

  • What would you do in the face of an aggressive cancer with a short doubling time just go to some alternative guy with no advanced patients alive after 3 years, or maybe just start drinking Pom wonderful?Sorry I am with wsopeddie on this one

  • And, your life.

  • Hi Dan, thanks for the quick reply. We think he may have had the cancer for over a year before we caught it so psa over 400 and Gleason 10. He has aches but the back pain is more consistent and he has limited mobility. Can't do any floor exercises. He started casodex, Lupron, and taxotere within a month of each other . Psa dropped to about 34. Didn't move much (very slight increase) after 2nd cycle. Doctor recommended we don't check again until after 4th when it stabilizes. He just had his third cycle last week

  • welcome to the club! I was dxed in 2006 with a psa of 148 and a gleason 10( which I do not see very often) n June 2006 with widespread metastatic disease. I am starting my first chemo in 1 hour so I will make this short till after chemo. In those days we did not know of the benefit of early chemo. after first 2 months on Lupron my psa was still over 20, but it did eventually drop to 3. more later

  • Dan, best of luck today! You must have reacted well to the drugs to avoid chemo for ten years. I sometimes wonder if there is still an advantage of postponing it because there should be a plus to keeping the immune system strong through all this.

  • I am home now, whew long day, I was just lucky to be able to take advantage of new drugs like xtandi and zytiga. There is a recent study that shows increased survival in Men who do 6 cycles early with hormone therapy, If is too much the Dr. may stop the chemo. This is a great site , lots of very Knowledgeable guys on hear, I am sure others will chime in, I am going to take my nap now, and be back on later.

    Dan

  • So far the worst side effects have been exhaustion, shortness of breath, hair loss and increase in uric acid. after getting meds to deal with the increase in uric acid it was manageable but still back pain which I guess is why they are recommending radiation

  • Hi Anna,

    After seven years on ADT, I can say this much, pain is a pain. I've had back, neck, shoulder, rib, spine, and skull pain. I also had scans. The funny thing is, none of the pain I had was from any of the mets I have. The doc's say it's from bone compression, arthritis, or some other something. It comes and goes, but now I know what it is, so I don't fret over it. I hope your dads pain is controllable without the opiods getting involved.

    And, the ADT is a royal bitch, sorry to put it that way, but there's no other way to put it. Read each and every major side effect, then prepare for them. Watch the diet first, I put on 50 lbs. quickly. I don't want to get into every detail, but please, be prepared for the worse case scenario. If you don't happen to get all the side effects, great, but better for you that you were prepared, anyway.

    Best Wishes,

    Joe

  • Thanks Joe, he started ADT in December and seems to be managing. My concern is the difficulty in discerning what's regular pain and what is associated with the mets. The oncologist just noticed a few things in the mri that made him concerned and recommended radiation, but he hasn't had a pet scan completed yet bc they said an mri is enough given the blood tests they've been running. I have a feeling the radiation oncologist will recommend a pet scan before anything is done anyway. Are you evaluating what is and isn't related to mets based on frequent scans?

  • I was being imaged every 4 months while on a study. I also had interval imaging done by my uro/onc group. I have mets on my hip, sacrum, and spine. None of these bother me. They were last verified by an F-18 pet scan.

  • And if you were feeling pain in your back from arthritis (or other reasons) and they saw mets in the spine, how did they know it wasn't the cause? or the pain wasn't in the spine (I thought this could cause bone compression)?

  • OK, it's a bit weird how this worked out, so....I was having severe pain in my neck and shoulder area, and I told my uro about it. So he wants me to see an oncologist asap, thinking it's mets, and gives me a script for Vicodin. I go see the onc, and he asks me what I'm doing there. I tell him, he leaves the room. A few minutes later he comes back in the room and tells me I have arthritis. The Vicodin cleared up the pain. I have since found that I do have some compression going on, and that's not an issue at this time. My spine mets are in the L4 and L5, which are in the lower back.

  • Interesting. His pain is in the lower back and I believe he has mets there based on the mri

  • I can not tell you the times I had back pain, thought it was the cancer, but.as you say went away with ,good chiropractor, Advil or just stretching then thinking back and thinking I should have a lot of artheritis with the injuries I have sustained in my youth.

    Dan

  • Joe, I am having that problem with weight gain since I received my six month eligard (ADT) shot. My appetite seems insatiable and my will power missing in action. The wife bringing home girl scout cookies doesn't help.

  • Stay away from FAST FOOD. Girl Scout cookies are OK. I gorged on double cheeseburgers, I couldn't help it. Once I quit them my cholesterol returned to normal. Gotta go, pasta cometh.

  • The Mediterranean diet is the way to go,could I stick to it, not always but I tried to. Here I sit alone day after first chemo, feeling a lil low back pain, can't take aleve.I

    thilnk it will go away when I get off the dexamethesoneand finally get a good night sleep. yesterday I was a mad man doing projects for the wife cooking a big dinner and doing laundry, could not slow down. That diner was a chicken breast stir fry with sliced carrots, red peppers,broccoli and lots of gravy over brown rice.

    Dan

  • It's good to stay active. Are you also getting a nuelasta shot the day after?

  • Anya, Not getting nuelasta, she said she hates to give it, unless it is needed, will see labs in 3 weeks and see if whites have bounced back, meanwhile I will continue to follow my daily conition with the thought if I do not feel good and or have a temp of 100.4, I will be headed to er. I have felt a little better since walking around house today, looking out the new foot of snow and thinking I should really start the snowblower.

  • Anya- I think our fathers are at the same stage. My dad just finished third round deocetaxal, on Lupron, xgeva and prednisone. He has wide spread mets skull to humerus. Very little mobility. Recently had trouble breathing which we r hoping a change in pain meds will help. So emotionally draining and frustrating. His PSA dropped quick after first round but it second. Right now we need lots and lots of prayers that his body is strong enough to keep having treatment to at least 5 round. Please keep in touch.

  • I'm sorry to hear he is in pain. Is he able to take any walks? We've had my dad do some exercise and walk in the park as much as possible and it makes him feel better. He gets winded fast which I assume is the chemo. I agree, the emotional aspect has been the hardest. The past three months feel like a year has gone by. Has your dad undergone any radiation for his pain?

  • They will not do radiation at this time as they can't pinpoint one area. His mets are widespread. He is too winded to walk any distance. And so cold in east Canada not easy to walk. He's still having low oxygen and will get some physio while in the hospital. Ct scan showed nothing on the brain today. 🙏🏻 Amen.

  • Hope all goes well for him! If not prying, how old is he? did he have any issues with cardio prior to diagnosis? My father was diagnosed very late, which is why it's so advanced. gleason 10, psa >400 at diagnosis. He is relatively young so it's been a tough adjustment. He can still walk but has to push himself. I hope this goes away after chemo, though seeing others write of exhaustion after a few years on lupron.

  • He is 74. Had no previous heart issues. Had to force them to take blood today and his ANC count is .67 so he's finally getting a private room.

  • "any info on whether combo hormone therapy results in one of the drugs to having a reverse effect over time ? "

    Yes. After a certain point, not only does ADT stop working, but it actually feeds the cancer. I got that from the Compassionate Oncology / Leibowitz website at

    compassionateoncology.org/

    specifically his paper at

    compassionateoncology.org/p...

    My layman's (but well-read) take on the red meat/dairy ban is that it:

    • Applies mainly to seared/blackened meats.

    • Is a hangover from the old days when saturated fats were thought to be inherently harmful.

    • Applies, if at all, to the odds of developing PC in the first place, not so much to progression.

    As for sugar, it's unhealthy for anyone who's overweight, has insulin resistance/metabolic syndrome (75% of American adults), has prediabetes or type II diabetes, gets carb cravings, has a noticeable belly, etc. Unfortunately, "sugar" include all grains, potatoes, tropical fruits, pasta, starches ... darned near all white foods. They trigger insulin, insulin stores fat and triggers carcinogenic hormones, and away we go. In MANY people, wheat also triggers inflammation, which exacerbates most diseases.

  • I do not believe radiation and chemo can be given simultaneously. At least that has always been the case with my husband.

  • I thought they tried to avoid the two being given at the same time as well. However, I did read that in other cancers chemo can increase effectiveness of radiation though you have to be careful with the dose. I haven't seen as much on PC

  • Interesting study :https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4530376/

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