My brother -in - law, has primary prostate cancer ,it has spread to liver , kidneys, lymph nodes, bones and pleural cavity. He has had hormone injections but PSA results increased to 1700 , therefore not responding to treatment. Consultant has suggested starting chemo in a few weeks. Has anybody else experienced this misfortune.
Diane
chemo + zytiga are your best options...you have to move fast..your brother-in-law is in a dire situation
I'm sorry to hear about your brother-in-law. That is indeed an advanced case. I hope the chemo goes well for him. I hope he will discuss clinical trials with his oncologist.
My brother -in-law lives in Liverpool England.
He may be able to find appropriate clinical trials there using one of these:
In what part of the world does your brother-in-law live? Perhaps someone here can give you some ideas about finding the best specialists and treatment locations for such advanced prostate cancer, and the matching health care system.
His cancer could have the neuroendocrine type which doesn't have androgen receptors. If that's the case, treatments such as Zytiga or Xtandi that are based on androgen blocking won't work. That's probably why your Oncologist is recommending chemotherapy, most likely Carboplatin and maybe adding something else. Did the doctor say which chemotherapy specifically?
Did the hormone injections ever work for him, even for a short time?
Also, did he ever have a biospy done? He could also get genetic testing to see if he has a mutation that has a targeted treatment available.
I wish the best for treatment, hope he is able to get some good results from the chemo. Please let us know.
Do neuroendocrine cancers produce PSA that high? I thought they were characterized by lower PSA than in the more common forms of PC.
Alan
I'm guessing there is neuroendocrine differentiation because of the poor response to ADT and the metatases to organs and soft tissue. If there's a combination of the two you can have a high PSA. The only way to know for sure is to get a biopsy. Also can check Chromgranin A. Here's an article about it. There's a table that shows median PSA values with PSAs ranging over 5000 although the median was low.
prostatecancer1.mmparchive....
As always with cancer biology, when I imagine that I know something it turns out to be a lot more complicated than I imagined.
Thanks for the info.
Cancer is a very complicated disease, that's why a "cure" is so illusive. I was reading somewhere that there are over 5000 known mutations of PCa alone. This means that in all likelihood, there are no two cancers that are exactly the same. Someone described it as a "race against evolution" with the cancer.
I also read that at the castrate resistance stage, PCa starts producing neuroendocrine-type cells at a fairly quick pace. And of course, that morphology is resistant to androgen-based treatments.
Yes he has had biopsy taken, consultant said it was "an agressive cancer". He is having another hormone injection this week . He has also had a bone scan to see if he will be able to have chemo. Thank you for your advice.
Thank you
One option to investigate is Lutetium 177 available in Germany. High cost but some get very good results. Lu177 is nuclear medicine given by infusion. The drug seeks out prostate cancer cells anywhere in the body and hits them with alpha radiation. Use the search function on this site. I met with Australia's leading doctor this week and he said 60 to 70% have a result, some better than others. 2 to 6 shots are usually given.
Hi, my name is Lynn, my husband and myself are right now waiting to see if my husband qualifies for a new drug that was just recent.y approved bhuge FDA. It's a targeted therapy drug. 🙏🏻 there are so many clincial treatments.
Best wishes for your brother in law and family.
Keep us posted.
Thank you
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