The interaction between radiation therapy and immunotherapy for PCa.

[pjoshea13]

The following is from Dr. Myers' blurb for what looks to be an interesting topic:

"This issue focuses on the interaction between radiation therapy and immunotherapy for prostate cancer. This interaction has been extensively documented in laboratory models where the combined treatment can show benefit even in metastatic prostate cancer.

"In the laboratory models, it appears that cancer cells damaged or killed by radiation trigger an immune response. This response can be enhanced by additional agents.

"The most promising situation to test this approach is in patients with oligometastatic prostate cancer. These patients have 5 or fewer metastatic lesions that can be targeted by radiation therapy. In this setting, all detectable prostate metastases receive a radiation dose sufficient to treat the cancer.

"The hope is that triggering an immune response will enhance the ability of radiation to kill all cancer in the irradiated lesions. There is also a hope that this immune response might suppress the growth of cancer metastases that are present but not radiated because the lesions are too small to be detected. This would act to delay the appearance of new metastatic lesions and possibly extend survival.

"There are several unresolved issues in this area of research. First and foremost, immunotherapeutic agents with activity against prostate cancer are of limited effectiveness currently. For example, while the Provenge (sipuleucel-T) vaccine is FDAapproved to treat prostate cancer, it extends survival by only months. Immune checkpoint inhibitors, such as those that target PD1/PD1L, can cause dramatic responses, but they do so in only a small proportion of patients. Nevertheless, prostate cancer immunotherapy is a very active area of investigation with a number of promising concepts at various stages of testing.

"Another unresolved issue is when is the best time to administer immunotherapy with regard to radiation treatment—before, during, or after. Radiation dose may also be critical as extensive radiation can dramatically suppress immune system function.

"Despite these limitations, this is a research area worthy of investigation. The ultimate goal of cancer treatment is a durable complete remission. As it is unlikely that patients with metastatic cancer will ever be cancer-free, a more reasonable goal is to place remaining cancer cells in a state of dormancy. In laboratory models, immunotherapy is one of the most successful approaches to achieve cancer dormancy."

-Patrick

[kenner]

Look my dear friends...this is the way I see it. With all due to respect to all of our contributors . I have been blessed with a PSA of 0.29 after 18 years.I will not subject myself to pain that my dear Brotheren have been through just to live a couple years longer. I have no pain & can still golf. When the the good Lord comes to take me I'm ready. I am really fed up with our dear Brothers suffering to beat the "Beast"In closing the only thing I miss is INTIMACY.No sex,no cuddling...nothing. YES I Should be happy but my manself died years ago.

[Bluebird11]

Nalakrats.. can you tell me what 7X gator blood is? I thought at first when I saw it mentioned, it may have been a joke.. Now, I see it isn't.. thanks

[Grumpyswife]

It seems dormant is the buzzword in prostate cancer rather than remission. Definitely not “curable” but treat it as a chronic disease was advice we received last January. Dr. Myers felt his own pCa has been dormant for ~18 years.

[Bluebird11]

Nalakrats, I so appreciate your response. I'm going to copy your post, reread and do some research on it. We see a Prostate Oncologist, not local, then 2 local oncologists, an alternative person, qiqong fellow, plus. We have a team where my husband and I can confer and decide what is right for our situation. I'm going to talk to our more alternative people about this.

We are in an information gathering time, once AGAIN...

When we stabilize, we do set up what we call vacations, though I'm always looking for things to put in our back pocket. An old retired urologist gave me advice when we first started this journey .. always look to the horizon. I never forgot that advice.

At this point we do need some help getting stable. It's interesting because each time we delve back in, over almost 12 years now, diagnosed Stage IV, young 55, ... we seem to reach another understanding which helps us to not only cope, but to also let go and enjoy the moments.

I will certainly look into this. Thanks very much.

When I entered this world, I knew nothing about it, I didn't know a PSA or ADT or anything except..... metastatic stage IV prostate cancer.... I received so much help that I made a vow I would always try to give back. I am so grateful for the unseen faces (not yours anymore <smile>) who have shared their experiences.

Choices.. so important to us.

Thanks....

[Bluebird11]

I will certainly stay tuned...