New Yorker Cancer Article is a must read

[timfiskwa]

I just finished a good article regarding Cancer in the 9/11 issue of the "New Yorker" entitled "The Invasion Equation". It documents the relationship between cancer cells and hosts. The immunotherapy looks promising, but expensive. Basically it says our resistance to tumor spread is gene based, individual, and extremely complex. It is good to know the research is progressing rapidly. It is general and not prostate cancer specific, but relates a lot to our condition.

I have been doing well after one year since my metastatic diagnosis. My orchiectomy frees me up from the Lupron shots and I have rejected chemo as it is palliative, not a cure. PSA stable for now at 1.1. Testosterone 3.6. I am retired now so I can enjoy life until the resistance begins. I am exercising more and changing to a diet with less meat. It seems to be working. I hope everyone can read this article, it is really good.

Thanks

Tim Fisk

[pjoshea13]

Tim,

For some reason, access is free:

newyorker.com/magazine/2017...

Siddhartha Mukherjee is author of:

"The Gene: An Intimate History"

"The Emperor of All Maladies: A Biography of Cancer"

"On average, they found, the tumor was sloughing off twenty thousand cancer cells into every millilitre of blood—roughly three million cells per gram of tumor every twenty-four hours."

& yet, in the case of PCa, metastasis is not the norm. For many men, their bodies seem to cope quite well with circulating cells. My view is that micro-clots up the risk of mets. A cell that docks on a microclot may escape being zapped. The odds of it ending up in a favorable place is still slim. Even so, I monitor coagulation factors & use nattokinase to keep D-dimer & fibrinogen low.

-Patrick

[Sisira]

The three strong points you have highlighted according to the article you have read, pertaining to any cancer - gene based, individual and extremely complex cannot be disputed by any one. But there can be more intricate aspects that we may have to deal with in different types of cancers such as PCa when it comes to treatment at different stages. Patrick has made this point clear in his analysis with deeper insights.

As far as I know, in the treatment of prostate cancer, Lupron ( ADT ) is considered as a palliative treatment whereas Chemo Therapy is considered as a systemic ( whole body ) and cytotoxic (killing cells) and thus not palliative but curative treatment in the same category with surgery and radiation. This is the standard usage of terminology but does not mean the cancer will be cured definitely with such curative treatments. You are correct, in many instances chemo therapy may not be able to cure PCa but unlike ADT it can destroy a wide spectrum of PCa cells including the hormone insensitive type. With palliative treatments you can only buy time - how long depends on the individual response until the cancer becomes CRPC.

You seem to be doing the right things to manage your PCa in the proper way. I don't have a sufficient knowledge about the pathology of your PCa but you have said it is metastatic and you have undergone surgical castration. Give some thoughts to the findings of STAMPEDE, CHAARTED and LATITUDE Trials to learn the benefits of using early chemo or abiraterone with ADT.

Thank you for your post and also for the support by Patrick.

Sisira

[Break60]

Very interesting!

Bob

[timfiskwa]

Sisira,

Thanks for the information. I read the CHAARTED study. The Chemotherapy plus ADT doesn't cure Pca, it extends the onset of hormone resistance for 13.7 months. For many, this is better than the ADT alone. I think Chemo works great on fast growing Cancers. For the slow growing cancers like breast and prostate, I believe that individual choice should determine treatment. I had three friends whose Chemo had minimal benefit so I choose to avoid the treatment. Once again, I stress it is the patients choice. Thank you for your input.

[AlanLawrenson]

I think the use of Theranostics (PSMA Lu-11 Therapy) is going to evolve very rapidly everywhere over the next few years. Its now routine therapy in Germany and is available in Australia where my brother with CRPC has seen his PSA reduce to about 1.4 and his metastatic cancer load almost entirely disappear on PSMA PET scan.

There are numerous clinical studies under way at present with some having already report significant gains. I talk a little more about it in my free ProstateTalk Newsletter #7 accessible at anabcofprostatecancer.com.au.

[leswell]

We appreciated your post, Tim, and the clear and helpful replies. I will read Alan’s newsletter and have saved Patrick’s last sentence to ponder.

The Mukherjee article was worth rereading at 3 a.m. What a writer!Lake Michigan’s condition is an apt representation of my husband’s skeleton. ☹️ Cytotoxic chemotherapy was successful at removing many mets—just not enough. All is palliative. So Leswell is facing subcapsular (we think) orchiectomy within the month. (However will we get the garden put to bed?)

As it was for you, Tim, it will be good to be done with monthly Lupron injections. Our oncologist has set up an appointment with the surgeon who was also the urologist who diagnosed Les’s PCa a year and a half ago.

Other than freezing more tomato sauces today, I have viewed two subcapsular orchiectomies on YouTube. Metastasis is a horror but not the surgery. Leswell will survive that. Thanks for this exchange.

P.S. Good to have you back, Dan59! Go well everybody. Leswell’s wife since ‘62