I was referred to a urologist who specializes in Prostate, Kidney and Bladder Cancers (whom I shall call Dr. U) by my original urologist. Dr. U subsequently sent me for a second bone scan and CT and then determined I should go in for the Provenge treatment. He also told me to quit going to my original urologist (who provided my Eligard injections) and quit seeing my oncologist (who provided my Xgeva injections) and come to him for everything.
At first I thought this would be good since it cut down visits to multiple docs, but I have since begun to wonder why he did that. So tomorrow I am going to talk to my oncologist and get his opinion of the situation, including whether Provenge is the best way to go.
The problems are that (a) I don't know what the alternatives to Provenge are and (b) the cost of the Provenge routine is going to put a serious crimp in my budget.
Comments? Advice? Concerns?
Provenge is the only FDA-approved immunotherapy. Medicare covers it for men with metastatic castration-resistant prostate cancer. There are other immunotherapies in clinical trials. If you have had distant metastases, you should be seeing a medical oncologist rather than a urologist.
Would all metastases not be distant metastases, I'm asking because during my RP several lymph nodes were tested for prostate cancer and one showed traces of cancer.
I'm sorry I know what I am asking is very elementary, but trying to understand all I can, thanks for reading.
It's a good question. Metastases to pelvic lymph nodes are considered to be REGIONAL, not distant. They are staged N1. Metastases to distant sites are staged M1a (if in distant lymph nodes), M1b (if in bone), or M1c (if in visceral organs).
We are very fortunate to have a person with your ability and knowledge to help us, I thank you.
So can I assume stage N1 is stage 4 prostate cancer.
According to the AJCC Prognostic Stage Group, N1 M0 is Stage IVA. Some argue that it should be demoted to Stage III because it is often curable.
Great info!