My father has started with Enzulatumide since 2 weeks after failing Docataxel. He feels a lot of fatigue throughout the day , the lymphedema has gotten worse and the rib mets are now palpable and painful. Also his appetite has gone down , but weight not affected. Doctor has recommended synthetic progesterone tablets to increase the appetite. I would like to know has anyone taken progesterone? I have read it's been used as a palliative treatment for breast and endometrial cancer.
Will it be useful for killing our cancer? Or will it worsen the side effects?
I don't know what the biological fate of "synthetic progesterone" is, but progesterone itself can convert to testosterone:
... cholesterol->pregnenolone->progesterone->androstenedione->testosterone->etc.
This is a pathway that Zytiga targets.
There was a Norwegian paper in July that examined the role of progesterone in PCa cells [1]:
"This study aimed to examine the distribution of progesterone receptor isoforms (PGRA, PGRB) in PCa tissue and their association with clinical endpoints."
"... a high PGRB expression in tumor tissue was associated with an unfavorable prognosis in both univariate and multivariate analyses: Biochemical failure (HR: 2.0 ...) and clinical failure (HR: 2.5 ...)".
That's not to say that additional progesterone would have any impact on PCa cells. In fact, Zytiga probably increases progesterone levels, since it inhibits downstream conversion of progesterone.
...
"Megestrol Acetate (Megace®): Megace® is a progesterone, or steroid hormone, that improves appetite in patients with advanced cancer. Megace® is FDA-approved for the palliative treatment of advanced breast and endometrial cancer." [2]
From a 2013 paper [3]:
"There are concerns whether megestrol acetate (MA) stimulates the growth of prostate cancer in castration-resistant prostate cancer (CRPC). We evaluated the effect of cumulative doses of MA on the disease-specific survival (DSS) in patients with CRPC who were receiving Docetaxel-based chemotherapy."
"Cumulative doses of MA as adjuvant treatment for patients with CRPC and who are receiving docetaxel-based chemotherapy, did not affect their DSS. Therefore, MA can be safely administered in cachexic patients with CRPC."
-Patrick
[1] ncbi.nlm.nih.gov/pmc/articl...
[2] cancer.unm.edu/cancer/cance...
[3] ncbi.nlm.nih.gov/pubmed/236...
Excellent response. Thanks
Very informative. Thank you