Introduction to my fellow fighters.

[Marlin25]

Diagnosed in 2006, psa 37, gleason 8, stage T3b. Radiotherapy, Zoladex for 2 years. psa 0.05 for further 2 years, then rapid rise to 14, zoladex recommenced kept psa down, 12 months ago again rapid rise to 13. Started bicalutamide additional to zoladex 4 weeks ago. Recent nuclear bone scan clear. Awaiting CT scan then psa test to see if bicalutamide is reducing psa. Should I be doing anything else? Resident near Manchester in UK.

[AlanMeyer]

Trying Casodex was a good idea, though if your PSA went quickly up to 14 I'm not optimistic that it will work.

I suggest looking up the "chaarted" (two 'a's) and "stampede" trials, which appear to indicate that early chemotherapy combined with hormone therapy significantly increases survival time. Also lookup Xtandi and Zytiga, which are more powerful hormone therapies that can be used when Zoladex fails. I would then ask your oncologist what he thinks of the trials and what he thinks of combination chemo and hormone therapy.

If he says "huh?" or he says "let's just do it the way we've always done it", and if he can't be persuaded to read the results or think about the issues seriously, then it may be time to change doctors.

I don't know if Zytiga or Xtandi are right for you, or if chemo should be combined with them. But I'd want to discuss the possibilities with a doctor who is at least aware of the issues and doesn't just think that what they've always done is good enough.

Best of luck.

Alan

[Dan59]

Welcome to the group Marlin. Good info from Alan above. You have lots of therapies to try yet , that is a good thing. I wish you the best.

[Aussiedad]

The bone scan is a Dexa scan and shows up any spread to bones (metastases)... besides that, see if you can get a Gallium 60a nuclear scan which shows up cancer in the cells down to 2 microns.

Get yourself on to Astrogalus 8 which boosts your immune system (it's based on a traditional Chinese herb which has been used for centuries ... a double blind study of it's use in a large Japanese hospital - all patients involved and 50% were given the Astragalus 8 and 50% no ... those receiving it went home earlier than the others ... an that's with whatever they were in hospital for!

Most Astragalus 8 is sold with additional, compatible herbs.. I use straforte made by Thompson's in Australia ... about $30 Au for 80 capsules ... start off with a two a day (divided dose) then take three a day for a month or two then you can drop back to one or two.

Stay positive, active, keep up social contacts and take up new interests/activities.

Cheers, Aussiedad

p.s. You'll find a range of my entries which details my situation.

[Aussiedad in reply to Aussiedad]

That of course should have been Astraforte ... sorry for the typo. Eat healthy food ... try the Mediterranean diet (CSIRO diet is good too);

Cheers, Aussiedad

[ctarleton]

You might spend some time researching the possibility of a C11 CholinePET scan at Oxford Churchill hospital by the NHS, which might detect additional "hot spot(s)" that may be causing the new PSA rises. And, if so, might afford an opportunity for an interventional cure attempt, perhaps via targeted radiation.

Similarly, you might research the possibility of a PSMA PET scan in Munich:

mri.tum.de/node/555

Related Reference:

community.prostatecanceruk....

[Sisira]

I fully agree with Alan. You are confronting the present situation after 11 years. I do not know what your age is. Please try to understand the nature of your cancer first. It is a genetic malfunction and a DNA mutation problem. Different varieties of cancer cells are involved. Hormone dependent ( hormone sensitive ), hormone independent ( hormone insensitive/refractive ), PSA producing ( PSA positive ), PSA not producing ( PSA negative ) etc. Your main cancer dynamo is still inside your body ( the prostate gland ) Radiation being a focal therapy would have killed some of the cancer cells of all types in the prostate gland and in the pelvic area. But being GS8, your cancer is high risk/grade and according to the grading T3b it has escaped the capsule and the cells may be floating all over the body ( micro meastasis ). Your ADT treatment would have been able to kill some of the hormone dependent/sensitive cancer cells and also for a considerable time suppress the growth and progression of hormone sensitive cancer cells. These cells also eventually become hormone/castrate resistant like other germs against antibiotics after some period of use. That is why Zoladex is no more effective. There are other stronger ADT agents such as Zytiga and Xtandi which can be used as mentioned by Alan. But don't forget about the fact, the heterogeneous nature of your PCa and the presence of hormone insensitive and most dangerous type of cancer cells. So at this stage I think it is more advisable to think of a strategy that can kill all types of PCa cells instead of palliative suppression.

The important thing is not to avoid the side effects of treatments. The philosophy is to hit the aggressive cancer as hard as possible and as early as possible. I am also an advocate of the early use of chemotherapy combined with other treatments. Life and survival is more important than anything else. Time is really crucial for you. Don't play games with a high risk PCa and regret later.

Detecting the locations of metastases will be useful too. You have done only a basic bone scan. But with this rapid rising of PSA they can be in other parts of the body too. C11 Choline PET/CT scan ( I think only available at the Mayo Clinic ) and Gallium 68 PSMA PET/CT Scan are two powerful scans which can identify even tiny metastases at very low PSA levels. If they cannot be radiated or removed by surgery, only a systemic ( whole body ) treatment like Chemotherapy can kill the cancer cells. Efficacy of chemotherapy is more only when used at early stages, still chemotherapy cannot cure PCa.

Let fortune favour you in this battle and I wish you good luck.

Thanks for joining us.

Sisira

[WinnipesaukeeBob]

Marlin,

There are also a few off label drugs often used in the US to retard the spread of aggressive PC. They have few side effects compared to hormone therapy and may help you.

Metformin helps your body process sugar more evenly which reduces inflamation. It is a fifty year old well-tolerated diabetes drug and is very inexpensive.

Crestor, a statin, helps lower your cholesterol. LDL cholesterol is a second choice food for PC after androgen is controlled.

And Avodart helps prevent the conversion of testosterone into androgen.

Dr. Charles Myers has written extensively on the benefit of these common prescription drugs in controlling PC, as have many of the men on this site.

These drugs have been valuable to me, in addition to supplements and a healthy Mediterranean diet.

Bob

[Break60 in reply to WinnipesaukeeBob]

I take all of those drugs plus finasteride. I hope it's helping!

[Pennysue1]

I have a question regarding my husband Mike-he just finished provenge-starting Xtandi Monday-he's always very sick-can't eat-takes prescription pills for nausea (prochlorperazine 10 mg for nausea. What do you suggest?

By the way, great info above -thanks

[herb1]

Marlin,

But what is your psa at the time of your scans? If your psa is very low (success of Zoladex, even if of short duration) at the time, it's unlikely that the scans will see anything. The mets appear to shrink under ADT. I have the same problem with my docs--most of my scans were done with psa <<1, making it unlikely that anything would be seen.

herb

[Break60]

Marlin

Still being around 11 years after Dx with t3b is encouraging to me , also stage t3b albeit gl9. I'm awaiting an axumin scan when PSA rises closer to 2.0 . Then back to the race track after being on a pit stop for three months.

Bob