I wonder if this could work for prostate cancer bone mets, including those who have already had chemo. Given they are using the same chemo commonly used in 1st line treatment for Stage 4 prostate cancer, what is the difference, if any, using this same chemo in nanoparticles, as discussed in the article below:
"....researchers developed a nanoparticle containing the chemotherapy Taxotere (docetaxel)..."
Researchers Develop New Strategy to Target Breast Cancer Metastasis in Bones
Thank you so much for all of your very informative and encouraging posts.
My husband was admitted to the ER last Jan, 2017, for every test possible after suddenly having trouble with his tongue. It was going sideways and effecting his speech. Long story short, it turned out to be a bone met in one of the canals of his skull that houses one of the nerves to his tongue. He was diagnosed last Feb. with Stage 4 PC with numerous bone mets (pelvis, spine, skull, femur...) , which was surprising given his psa was only 5.8. fwiw, doctors were at first thinking he had multiple myeloma, "MM", because all of his other tests indicated he was otherwise very healthy. It wasn't until they did the bone biopsy that we got the shocking diagnosis. His gleason scores are: 7 (4 + 3) & 8 (4 +4), and he does have the BRCA gene. His first oncologist (at a top hospital in the country!) was horrific (another story) -and he should have started hormone treatment IMMEDIATELY, to prevent the totally incapacitating pain he developed soon afterward!! Fortunately we found a wonderful prostate cancer specialist team who got him in quickly and started him on the hormone treatment. Amazing how quickly the bone pain improved after taking the casodex! A few weeks later he started chemo and had 6 rounds of Docetaxel, every 3 weeks, with tolerable side effects (extreme fatigue being the worst). This brought his PSA to below 1. I think the lowest was 0.09, and when he went in for his 3rd lupron shot 2 months ago, his PSA was 0.10. So we were very happy!! -and he was really looking forward to working harder on his exercise program which he just started earlier in the fall, with the help of a personal trainer. All was good until.......
About 3-1/2 weeks ago he suddenly developed what he thought was sciatica pain, which he assumed was from something he was doing at the gym. (supposedly common after being on chemo). The pain was in his R butt cheek and was/is worst, excruciating, when he stands up after sitting or laying down. PT wasn't helping, so he had an MRI last Friday. On Sat. morning the orthopedic oncologist called to tell us the MRI revealed a tumor growing in his spine at the L2-L3 area. (fwiw, sciatica originates at the L4-L5 area) He suggested radiation. Given my husband had a bone met at the L2-L3 area before he was diagnosed, we're hoping this isn't something 'new', and maybe this area was more 'stubborn', and didn't respond as well to the Docetaxel chemo and hormone therapy. My husband can now barely walk. This morning he woke up with numbness in his shin. The only way to get relief is to lay in bed on his L side. He has pain meds, NSAIDs, but the only thing that seems to really help is tramadol. However the tramadol knocks him out. This afternoon he got an e-mail from his oncologist agreeing with the orthopedic oncologist (who called 2 days ago), and said to schedule an appt with him asap. He said there are "numerous" other treatments to consider, in addition to radiation. I wonder what the other treatments might be? Any idea? TIA.
I assumed my husband's PC is hormone sensitive given he responded so quickly to the Casodex alone, weeks before starting chemo. (he went from being unable to walk - bedridden in pain, to being able to walk the dog again, within days after starting the casodex!!) I also remember the oncologist implying this at one of our first appointments. Does that make sense, or do you still need the blood test to be certain?
Also, do you know if this 'flare up' of the bone met/tumor usually means it's time to switch from casodex to the next drug, or could this be an isolated 'stubborn' bone met that needs additional treatment and after that, he can stay on the daily casodex pills + lupron shots every 3 months until a rising PSA indicates otherwise?
Thank you so much for all the information. A bit overwhelming, but VERY helpful while deciding what to do next.
HI, my husband has stage 4 prostrate cancer, he did go through the chemo this past year. Plus six weeks of radiation on a tumor that had blocked his kidney tubes. PSA started to rise again ,after chemo.put on Zitaga, did not work, now cat scan found one lymph node. Going to surgeon this Friday to schedule a biopsy. Than see what the next course of treatment.?? I've heard of the treatment you are speaking of , where would you get this treatment , nano patricians ? Is this a clinical trial ?? We live in Pa.
He's with the U of Chicago prostate cancer team. We also went to Johns Hopkins late last winter for a 3rd opinion, and saw Dr. Eisenberger. He personally knows our oncologist at U of C and said we're in good hands, so we didn't gain much by going there, except that they ran the AR-V7 test, and my husband does not have it. Still, I agree, esp at this point, that it may be helpful to get more opinions, to compare notes, esp if they offer more treatment options- ie., as you say Dana Farber has with Oliparib.
U of C did some genetic counseling but I'm not sure if it was "Gene Mapping". This is when we discovered he has the BRCA2 gene. There was some mention of P-10 (doesn't matter with germline tumors???, or something like that?) and VHL (von Hippel-Lindau) which my husband said weren't really important. When we see the oncologist, I'll have to ask if it's possible to get one consolidated 'easier to read' report listing the details of all the test results.
You and my husband have a very similar diagnosis - yes, he is an Ashkenazi Jew.
Thank you for suggesting looking into Keytruda. I've read a few articles regarding possible use in other cancers. My mother may be taking this down the road (she's starting round #2 of chemo, a different chemo, Doxil, after being in remission a few months and her cancer started coming back). She was diagnosed with stage 4 ovarian cancer, just a few weeks after my husband was diagnosed with stage 4 prostate cancer, last winter - both were shocking diagnosis. Totally unexpected.
fwiw, This all began last winter - beginning the night I slipped on ice and broke my R arm (I'm R handed) last Jan, on Friday the 13th! (I ended up having to have an osteotomy 4 months later - Dr's at 1st hospital screwed up) Little did we know that was a sign of what was to come! That night after we returned from the ER my husband started having trouble with his tongue - his first serious symptom that sent him to his Dr and then to the ER. (eventually diagnosed as a bone met in his skull - the story I told you a couple days ago, above) Makes me wonder if the extreme stress my husband was under, getting me to the ER (I went into shock) may have contributed to/worsened the bone met that affected his tongue. Maybe it is true that extreme stress can feed/accelerate cancer - bone mets esp??
Hoping 2018 brings good news with a turn of the tide for all of us!
Nalakrats, yesterday while meeting with the oncologist, I learned my husband's BRCA2 is not germline, it's he's somatic. His PSA test yesterday came back at 1.33 (from .1 a month ago, where it's been since he finished chemo in July, 6 months ago. His oncologist said to stop the Casodex now. His last Lupron shot (which he gets every 3 months) was December 19th, a month ago. He's now on a lot of pain meds with severe pain from the tumor activity in his lower lumbar area. The oncologist said it's wrapping around his spinal column. He started radiation last Tuesday for this area and has so far had 3 of 10 consecutive treatments. (fwiw, he got extremely sick after his 2nd radiation and is now also on anti nausea) His oncologist said we need to finish the radiation treatments before going to a new med. This 'waiting' concerns me!!!!
Oncologist wants us to consider a clinical trial at U of C in which 50% of the patients will receive only olaparib, 25% will receive only Zytiga and 25% will receive both Zytiga and Olaparib. When I brought up the reports of extreme success with Olaparib on patients with BRCA, he said something to the effect that the very high results are only with germline. So now I'm wondering what is the benefit is of this trial vs starting Zytiga NOW, and isn't this trial risky, should my husband be put with the Olaparib only patients if it's known to not work as well with those who have somatic BRCA2? I'd greatly appreciate hearing your thoughts on this. I can't stand seeing my husband suffering so much - this all came on so quickly.
Once again, thank you so much for your input, Nalakrats.
fwiw, Blood test results from last Thursday, Jan 11 came in:
PSA @ 1.33 (from 0.10 on 11/10/17, and 0.09, nadir, on 8/8/17)
glucose - 118 (it's always been high)
alk phos up to 555 (highest was 1141 day of 1st chemo on 3/28/17)
platelet count down to 145 (due to radiation to lower lumbar spine?)
We are currently with the U of Chicago Prostate Cancer team. When we went for a 3rd opinion at Johns Hopkins we saw Dr. Eisenberger who told us we are in good hands with Dr. Stadler at U of C, as they are good friends and talk regularly and are on the same page. That gave us some needed peace of mind. However, Dr. Stadler does not believe in trying to help treat via diet and supplements. I would love to know how many other top CRPC specialists agree with this.
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