Maybe we should all get a cholera vac... - Advanced Prostate...

Advanced Prostate Cancer

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Maybe we should all get a cholera vaccine.

George71 profile image
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" Table 1. After a mean age of 7.2 years and accumulated 6033 person-years of follow-up, 29 of them had died due to prostate cancer, giving a mortality rate of 4.8 per 1000 person-years, whereas the rate was 22.5 for those patients who did not use cholera vaccine. Use of cholera vaccine was associated with a decreased mortality rate, as compared to patients without cholera vaccination.."

"Risk of death due to all the causes

"In Table 3, we show the risk of overall mortality among patients with prostate cancer who used cholera vaccine. The overall mortality rate was 9.4 per 1000 person-years for patients using cholera vaccine, whereas the rate was 48.3 for those who do not use cholera vaccine. A decreased overall mortality rate was found among patients using cholera vaccine, as compared with patients without cholera vaccination use, with a crude HR of 0.27 (95% CI 0.21–0.35) and an adjusted HR of 0.53 (95% CI 0.41–0.69). The decreased mortality rate was largely consistent, irrespective of age at diagnosis, clinical stage at diagnosis, and disposable income."

nature.com/articles/s41467-...

I have read elsewhere that the cholera vaccine is one or 2 pills and lasts for 2 to 3 years -- maybe it would be good to renew after 2 or so years to regain the benefit. I was given cholera shots in the Navy decades ago.

I think all one needs to do, is tell their GP they are thinking of traveling to Honduras or somewhere similar for vacation or on a cruise.

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George71 profile image
George71
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George71 profile image
George71

ITCandy,

What is your current PSA and how long on ADT?

I read that the Cholera vaccine lasts about 2 years -- how long ago did you do it and what do you think about retreatment to restore the effect?

George71 profile image
George71

Is the "shot" you are talking about for cholera? and if so, what is the name of it --apparently it is different from the oral Dukoral vaccine --- the test in the article were oral Cholera vaccine -- I wonder if it matters -- shots or oral?

gusgold profile image
gusgold

IT,

where can you buy Dukoral

Gus

Ralph1966 profile image
Ralph1966 in reply to gusgold

Dukoral®

SBL Vaccin AB,

SE-105 21 Stockholm, Sweden

Telephone +46-8-7351000

Website: sblvaccin.se/External

It is not available in USA

gusgold profile image
gusgold

can it be shipped to the U.S.

HOPEFULSPOUSE profile image
HOPEFULSPOUSE in reply to gusgold

Looks like it requires refrigeration so most pharmacies won’t ship it.

George71 profile image
George71 in reply to HOPEFULSPOUSE

yes -- I had to fly to Toronto to get it. over the counter then put it in carry on bag with Ice in 3 ziplock bags surrounding it. made a 4 day mini vacation.

HOPEFULSPOUSE profile image
HOPEFULSPOUSE in reply to George71

oh wow! we will try to get one from his GP

George71 profile image
George71 in reply to HOPEFULSPOUSE

I don't think a Dr. in USA can prescribe it. I couldn't find one. It is only approved in Canada -- Mexico and Europe. No prescription is required -- it is over the counter in Canada. My wife and I flew to Toronto round trip from Houston -- made a 4 day mini vacation -- cost about $1100 total for 2 people round trip air fair and hotel.

HOPEFULSPOUSE profile image
HOPEFULSPOUSE in reply to George71

Oh wow - thanks for the info. I may have to hit up family there.

Tall_Allen profile image
Tall_Allen

Association is NOT causation. There were 89,142 men in the Swedish registry, but only 841 (1%) men who received the vaccine to prevent cholera. The first suspicion is "selection bias" - in what ways were the men who got the vaccine DIFFERENT from most men? I suspect there were more health care workers who are more attentive to catching diseases (including prostate cancer) early, more educated, and may have gotten a wide range of other therapies (e.g., chloroquine, an anti-malarial, has some effect on PC cells in lab studies). These suspicions are borne out in Table 2. Cholera vaccine users were:

- Younger

- Diagnosed earlier

- More educated

- Higher income

- Diagnosed at an earlier stage

- Less likely to have comorbidities (diabetes, heart disease, COPD, hypertension)

Even with statistical adjustment (which assumes significant overlap), the biases are way too large and unmeasured confounding variables (like PSA testing, chloroquine use, lifestyle, diet, smoking, health care workers) too important to draw any useful conclusions.

Jbooml profile image
Jbooml in reply to Tall_Allen

if you wade through the details of the study one thing stuck out to my reasoning.....some 27 MONTHS from dx to vaccine inoculation....thats highly suggestive of a random selection....i'm very pleased with my choice to self administer......if it helps to lower my chances of coliform dysentery...less harm no foul.

Tall_Allen profile image
Tall_Allen in reply to Jbooml

What do you mean by "that's highly suggestive of a random selection?"

Jbooml profile image
Jbooml in reply to Tall_Allen

Without specific controls ...a lag of 27months between Dx and inoculation has an inferred random concurrance imo....as opposed to one rushing out directly after diagnosis. It’s beside the point anyway those kinds of numbers are too impressive to ignore...and moot in my case...I took it anyway.

Tall_Allen profile image
Tall_Allen in reply to Jbooml

Sorry - I still don't understand. Random concordance with what?

George71 profile image
George71

"A decreased overall mortality rate was found among patients using cholera vaccine, as compared with patients without cholera vaccination use, with a crude HR of 0.27 (95% CI 0.21–0.35) and an adjusted HR of 0.53 (95% CI 0.41–0.69). The decreased mortality rate was largely consistent, irrespective of age at diagnosis, clinical stage at diagnosis, and disposable income."

Tall_Allen profile image
Tall_Allen in reply to George71

Look at the table.

George71 profile image
George71

can you tell from this if it is the drug used is Dukoral?

"Based on the evidence presented above, we hypothesized that the immune function in prostate cancer patients might be altered when they receive cholera vaccination that includes killed whole cells of Vibrio cholera O1 and recombinant cholera toxin B subunit. Cholera vaccine might be repositioned (drug repurposing) and might be used as adjuvant therapy in patients with prostate cancer. Our previous study found that post-diagnostic use of cholera vaccine (including killed Vibrio cholerae O1 whole cells and recombinant CTB) can improve the prognosis in patients with colorectal cancer, which suggests that cholera toxin might have an antineoplastic effect"

here is the link:

nature.com/articles/s41467-...

George71 profile image
George71

I think you are right -- it is the Dukoral which is given in 2 doses a week or so apart and the article said it lasted fro 2 years.

in contrast to Vaxchora - a single dose and only 3 months.

Vaxchora:

(a) 100 mL PO as a single dose a minimum of 10 days before potential exposure to cholera.

(b) Duration of protection conferred by the primary dose beyond the evaluated 3-month period is unknown.

George71 profile image
George71

Do you think I should wait 10 years for a randomized doubleblind clinically controlled trial or try it now? Could the benefits outweigh the risk?

Tall_Allen profile image
Tall_Allen in reply to George71

I never said don't go for it. I just said that this registry data doesn't justify any valid conclusions. I would guess that it was more likely the unrecorded use of antimalarials that the same people got at the same time. At least we know of some plausible reason why an anti-malarial might work. Or, more likely, it was just that the same people who got the cholera vaccine also discovered prostate cancer at a more curable stage by getting earlier PSA testing.

George71 profile image
George71

LOL --- I was joking

j-o-h-n profile image
j-o-h-n

Cholera:

See I knew I was right... Never drink water, cause fish fornicate in it....

Good Luck, Good Health and Good Humor.

j-o-h-n Saturday 02/02/2019 1:15 AM EST

Jbooml profile image
Jbooml

don't drink yellow water?.....unless of course its just the turmeric...my other ace in the hole

George71 profile image
George71

or yellow snow -- LOL

George71 profile image
George71

Every indication is cholera vaccine is VERY beneficial for slowing PCa. It was a meticulous and through study -- I can't can wait 10 years for a RCC Trial to confirm it.

The benefit (at the very least) of not getting cholera -- far outweighs the risk.

Jbooml profile image
Jbooml in reply to George71

No danger there George..the risk is a negative immune reaction....lots of data In that regard....I’ve taken many over the years from way back when a typhus shot really was risking one’s health. Nowadays their using completely hollow shells of virii which are so precise to near eliminate bad reactions....it’s a field of interest of mine...check out novavax and their game changing VLP vaccines. I don’t doubt these guys will be entering the cancer space

George71 profile image
George71 in reply to Jbooml

Jbooml

Thanks for the info on Novavax it sound like the future. Great stuff

Tall_Allen profile image
Tall_Allen in reply to George71

This was just an analysis of available registry data - it was neither "meticulous" nor "thorough." You may wish to react, but don't make unjustifiable claims for the data.

Jbooml profile image
Jbooml

So sorry George...you qualified it as NOT getting cholera...I misread and mistook your point.

George71 profile image
George71

I am reading that the Dukoral vaccine cannot be shipped to USA because it must be kept refrigerated. Does that mean I have to fly to Canada to get it? And if I do, will they sell it to me over the counter?

George71 profile image
George71

Thanks ITCandy,

Does it take a prescription? or just ID proving age?

sammamish profile image
sammamish in reply to George71

I went up to Vancouver 2 weeks ago, waltzed in and asked for the vaccine at the pharmacy counter. She asked if I wanted 1 or 2 doses. I said. 2. She just plucked it from the refer and gave it to me for 100 bucks or so...no I.D. or nothing. She did ask if I had insurance..I said no. that was it.

George71 profile image
George71 in reply to sammamish

sammamish,

Thanks, that is good news -- do you know if that would be the same for a US citizen in Vancouver? Apparently so -- if they didn't ask for an ID ??

sammamish profile image
sammamish in reply to George71

She did not ask for I.D., I honestly don't think they care if you are a U.S. citizen or whatever, as it is a OTC medication..Kinda like buying Tagamet or something.

GeorgeGlass profile image
GeorgeGlass in reply to sammamish

What did you do with the 2nd dose that comes with the vaccine? You have to take 2+ weeks after the first dose. Did you drive back to the US with that? Do the border patrol officers care about that?

George71 profile image
George71 in reply to GeorgeGlass

I brought it back with me in a carry on -- on the plane -- in a small padded insulated cooler with ice from the coke machine in a plastic zip lock bag -- all the way back to Houston -- still had ice in the zip lock when we got home. Also I bought and brought back a second unopened box in the cooler - no problem with customs - Dukoral is good unopened and refrigerated for 2 years.

Ralph1966 profile image
Ralph1966

Hi ITCandy,

Do you recall the price of this oral powder vaccine?

GeorgeGlass profile image
GeorgeGlass

did you use insurance from the U.S.? If my insurance is U.S. based then can I use that for purchase in Canada? Don't you need two doses when you begin? You can just drive it across the border after purchase?

GeorgeGlass profile image
GeorgeGlass

up to 800? Are you on any ADT etc during the rise? Any mets on your bones? I'm trying to decide whether to go back on ADT after a 7 month break because a spot on my spine has been hurting a little for about 3 weeks.

Arnie1970 profile image
Arnie1970

Good day George, my IMRT and SBRT radiation will start on Monday. Tomorrow PSA and T bloodwork, Friday my three monthly Suprefact injection. Would you do the cholera injection before, during or after all of this. I called the travel clinic in Pretoria, and any scary virus ( Cholera, Yellow fever, etc)injection will cost around $70 ( R 1000) no prescription needed.

George71 profile image
George71 in reply to Arnie1970

The Dukoral is a powder you mix with water. Drink one dose then wait 2 weeks and drink the second. If it were me I think I would wait till the radiation is over.

GeorgeGlass profile image
GeorgeGlass

Did you feel any pain when the cancer spread to all those locations? I'm on adt break. No second level meds yet.

GeorgeGlass profile image
GeorgeGlass

wow, that sounds painful. I'm glad to hear it is not hurting now! My bones crack when I swing my arm I sometimes wonder if its because my spine is getting compressed from the cancer. Who knows.

Was your pain continuous or off and on?

I made a mini vacation to seattle and drove into Canada to get Dukoral. The NIH confirms the effective cholera vaccine for prostate cancer is Dukoral (ncbi.nlm.nih.gov/pmc/articl.... It is a schedule 3 drug in Canada. The pharmacist I saw eventually agreed to sell it to me even though I wasn't a Canadian citizen and therefore I wouldn't be in their database. So when I go back in 2 years for a booster (one simple oral dose) I'll make sure to make arrangements with a pharmacy BEFORE I go - I did this time but neglected to tell them I was a U.S. citizen.

Dukoral is oral (hence the name). One I took was a power that is mixed with a buffer in water. Very simple and I had no side effects. Need two doses to start (dose 1 followed in a week by dose 2). Booster every 2 years (NIH reports it's effectiveness is only 57% at the 2 year mark and suggests a booster). Booster is only one dose.

By the way, while it would be nice to have clinical trials, my cancer is here now and, despite my attempts to persuade it, doesn't want to wait for the trials. So when something "might" help with my cancer and has little to no downside (other than a few bucks and a nice vacation) I'm going to do it.

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