Does anyone have access to this article?
It sounds like the chemo, Docetaxel, which my husband finished last July, may not have helped the tumors in his spine and instead were 'feeding' them?!!!
Targeting JAG1 Sensitizes Bone Metastases to Chemotherapy
I suspect this may be why my husband is suddenly having serious pain in his lower spine causing him to be incapacitated. He's scheduled for radiation treatments beginning next week to help shrink the tumor growing in his spine, which is pressing on his sciatic and femoral nerves.
Last Feb, 2017, my husband (age 60), was diagnosed with metastatic prostate cancer with many mets to his bones (spine, skull, ribs, femur). This was a shock as he had no unusual symptoms until a lesion in his skull effected his tongue (beginning Jan 13, 2017) Prior to that, his only other symptoms were bone pain that didn't seem unusual for someone his age who spends hours sitting, working on the computer). A wonderful neurologist had him immediately admitted to the hospital and given a complete work up with MRIs, CT scans, blood tests, etc and except for all the bone mets and slightly elevated alk phosphate levels, Dr's said he appeared to be a very healthy man. His PSA was elevated, but not alarming - 5.8. (it rose to 18.76 on March 7th, before starting chemo) They were stumped and unable to diagnose until a couple weeks later when the bone biopsy revealed the shocking St4 prostate cancer. By mid Feb.,, right before we went to a new oncologist at U of C, he was becoming incapacitated with bone pain. (it was shocking and VERY scary how quickly the bone mets progressed to cause incapacition! -perhaps due to stress from the diagnosis??) That night, Feb 15th, at the advice of his new prostate specialist oncologist, he started the Casodex pills and had almost immediate relief from the bone pain. (so why didn't the 1st oncologist who diagnosed him tell him to start casodex asap!!!!! instead she said he had a "few weeks" to get other opinions if we wanted - GRRR!!!) More testing via U of C showed Gleason scores 7 (4 + 3) & 8 (4 +4), and he has the BRCA2 gene, and at Johns Hopkins (we went for 3rd opinion) not the AR-V7 (if I'm saying that last one correctly).
Casodex started Feb 15th, 1st Lupron shot on March 7th, and started Docetaxel chemo on March 28th - 6 sessions, 3 weeks apart.
(side effects were minimal, mainly exhaustion a for a couple days. To help minimize/prevent side effects, he took L-Glutamine and we iced his hands and feet via zip lock bags filled with ice to help prevent the neuropathy. Interesting that he started getting numbness on his heels where we weren't icing, so then we added an ice bag there too, which helped. Also did the artificial tears, every 10 - 15 minutes, to prevent tear duct problems, from the chemo pooling in his eyes) Last chemo was mid July and, once the exhaustion wore off, he started to feel really good. Well, except for the hot flashes, so added a 37.5mg Venlafaxine (75mg was too strong - it knocked him out).
His PSA went from 5.8 in mid January to 18.76 on March 7th, three weeks before starting chemo on March 28th, then to 3.25 the 1st day of chemo, thanks to almost 6 weeks of Casodex. Day of his last chemo, on July 11th, PSA dropped to 0.11. His last PSA test was Nov 9th (for 3rd Lupron shot), and was just slightly higher. I don't have the exact number handy, but I think it was something like 0.19.
About 3 months ago (late Sept) he started an exercise program and was looking forward to, hopefully, at least a couple years of progression free status - and being able to enjoy life again.
Late Nov/Early Dec (9-10 months after starting Casodex and 4-5 months after ending chemo) that ended maybe a month ago when he started getting pain in his butt which then radiated down to his foot. With no other symptoms of progression, he thought for sure it was sciatica caused from the exercise program. A week ago an MRI of his lumbar spine proved otherwise - tumor activity (osteoblasts) pressing on the nerves in his spine. We saw a neurosurgeon and a radiologist yesterday. The neurologist prescribed the 'Medpak' (think that's what people call it?) - methylprednisolone 4mg dosepak 21's, which he started today, and the radiologist mapped him and scheduled him for his first low radiation next week. This last week he's been in debilitating pain, so he moved from OTC meds to prescription meds:
2 Percocets (the oxy5-325's) every 4-6 hours, and 1 50mg diclofenac every 8 hours. This was working pretty well until this morning, so he's now adding tramadol for the break through pain. Wondering if all the walking around the huge hospital yesterday and all the sitting caused the pain progression today?
His oncologist mentioned getting him into a clinical trial of arbiterone (Zytiga) + Olaparib. Has anyone here tried this? Nalakrats mentioned soemthing about Dana Farber having a similar trial using nanotechnology, to get the drugs into the tumor vs 'hitting' the tumor, if I understand correctly.
Has anyone else with a similar profile been through this route?? Any words of wisdom?? TIA!!