Oligometastasic Prostate Cancer

[NYB91]

Hi everyone,

I am writting here from Spain. First, I would like to apologized for my English.

I always read you but this is the first time I write as I always find relief in this site so thank you very much for all the support and Knowledge you provide.

My father was diagnosed with Advanced Prostate Cancer on December after his usual urologist ignored his PSA increase. Age 61 Gleason 9, two bone mets one in sacrum , and other illiac, two nodes involment . PSA at diagnosed was 10.

After surgery PSA 0,06

Microsurgery and node removal in February.

Recent PSA 0.002

Our oncologist recomended radiotheraphy first in the surgery area as she said there are remainders of the surgery.

After reading you we asked for a second opinion and they recommended us adding docetaxel.

I have read that where there is low burden of metastasis there is not significant difference between ADT and ADT+ docetaxel but there is some difference,

Are there anyone who is in the same situation as my father? Is it possible to reach the cure?

Thank you very much!

[Tall_Allen]

As far as we know, it is impossible to cure PCa that has already metastasized. But there is a lot of hope of managing it for a very long time. A lot of patients understandably think that what they can detect with imaging is all there is. That is, unfortunately, not how it works. Most metastases are too small to be detected by any kind of imaging available now or that will be available in the foreseeable future. So it is important to treat what we can't see as well as what we can see.

CHAARTED was the clinical trial that first proved the effectiveness of docetaxel in men newly diagnosed with metastases. But they found that it only increased survival in men with multiple metastases. Another clinical trial, STAMPEDE, proved that Zytiga + prednisone significantly added to survival over ADT alone. So that might be a better therapy to start with.

[leo2634]

I agree with Nalakrats, I would look into the Zytiga,Prednisone route it seems to be working for a lot of men I'm one of them. In our cases we look for a comfortable quality of life because a cure isn't offered to us yet. Best of lick.

[mcp1941]

I am now in my 21st year with prostate cancer. Original PSA 95, Had many second opinions from urologists and none recommended surgery. I had EBRT and seeds. Went 14 years with cancer in remission and the next 7 beating back recurrent prostate cancer. I am still looking to survive for many more years.

[cfrees1 in reply to mcp1941]

Wow, that's fantastic really. Twenty one years? I pray for that type of journey. Best of luck as you continue.

[NYB91]

Thank you very much for all your comments.I also suposed docetxactel can also be use in the future so I will search it.

won't you recommend in any case Radiation in Bone Mets while he is Hormo naive?

thank you!

[Hidden]

While the tumor burden is minimal and your body is strong, take the chemo. It is what I did 14 years ago and I have not looked back. Nothing to treat metastatic prostrate cancer since February 2010. Still undetectable. Add low dose of testosterone in 2012 and besides an undetectable PSA, my T ranges between 350 to 650. Google Gourd Dancer advanced prostate cancer or check my previous posts. Google Dr Robert H Amato and chemotherapy and hormone trial. Read and talk to your MOs again. Good luck in fighting this bastard.

Gourd Dancer

[NYB91 in reply to Hidden]

Thank you very much for sharing!

When you talk about Chemo, are you refering to Docetxatel or another one?

[Hidden]

I understand that is the standard. The trial in which I took used two different infusion drugs along with several ideals. Paclitaxel (Taxol) and Docetaxel (Taxotere) are both taxanes. Both attack cells that rapidly divide; like cancer, hair, and toe/finger nails; interfering with growth and slows down cancer growth. Doxorubicin (Adriamycin) commonly called Doxy is a anthracycline which kills an enzyme that is needed by cancer cells to grow.

"Each course of chemotherapy lasts for 8 weeks. Patients were treated in weeks 1, 3, and 5 with doxorubicin 20 mg/m2 as a 24-hour intravenous infusion on the first day of every week in combination with ketoconazole 400 mg orally 3 times a day daily for 7 days. In weeks 2, 4, and 6, treatment consisted of paclitaxel 100 mg/m2 intravenously on the first day of every week in combination with estramustine 280 mg orally 3 times a day for 7 days. 30 mg of Prednisone everyday through the three courses of chemotherapy."

Note. I was told by a MO on staff in a local hospital that doxy would never work. My comment is that just because it was an early generation of available chemotherapy, doesn't mean that in combination that it would not work..... I have a non-medical personal opinion. There is a big difference in slowing down growth and killing cancer. Targeted cell apoptosis of cancer cells is what we want and both types of chemo do the job. Yet, happens if the tumor burden goes to school and adapts itself in self survival mode? At its fundamental cancer cells are mutated cells. If a cell can mutate why can it not also mutate in an effort to survive? End result, I had a combination of chemotherapy agents to fight thus bastard.

GD