I now have 2 MO's. PCa MO and MM MO. Just to refresh, I had my annual scans about 5 weeks ago to check for PCa mets. What was found was MM. Saw my MM MO yesterday and will start treatment on July 15th. i was floored by how much more complicated MM is than PCa. The number of different blood test was amazing. I start my 10 month treatment plan in 9 days.
thank everyone,
Mike P.
It seems like there is a relationship between these two cancers, although the literature mostly references MM first, followed by prostate. I hope you get some answers and support from your new MO.
I seen that relationship also. I was already DX with CLL about 15 years ago and never needed treatment for it. I am hoping treatment for MM also knocks out any remaining CLL cells.
I think the layman's answer is that the first cancer creates a hospitable environment, so the second cancer accepts the invitation and also takes up residence. The sobering part is how many men apparently have circulating prostate cells, like dandelion seeds just looking for fertile soil.
You are in uncharted territory. Sometimes people find treasure that way. Hope you are one of the lucky ones!
I did get a chuckle, thinking about your two high-powered MO personalities deciding which gets to call the shots 
MM MO said that his treatment plan will not have any effect on any PCa treatment my PCa MO uses. but do I want to do 2 separate chemos at the same time. I think not! Will see this Wed. when I meet with PCa MO and get an update on treatment plan.
Mike P.
Hi Mike,
I know quite a bit about MM because my wife has been treated for it since 2015.
She was diagnosed with a solitary plasmacytoma. Received radiation for that but a second solitary plasmacytoma appeared. Her oncologist lied (said there were several & that radiation wasn't an option) & insisted that she have stem cell replacement after Velcade. The stem cell team at Wake Forest told her she was crazy to consider it for a solitary plasmacytoma. (A 2.5% chance of death during the procedure.) & so she declined treatment.
For the past 15 months she has been on Revlimid (15 mg). Her new oncologist is less aggressive (my sister in England was on 25 mg.) In fact, he has just lowered her dose to 10 mg & stopped her Dexamethasone.
Neither Velcade nor Revlimid are curative, so why give a patient more than the minimum required to control the proteins? She tolerates low-dose Revlimid very well, but had a tough time with Velcade.
My sister has had more serious MM for over 10 years. Velcade has made a huge difference in survival rates. & Revlimid has turned out to be a miracle drug too.
But dealing with two cancers seems like such an unfair burden. I will be thinking of you.
Best, -Patrick
I will get 23 infusions of Darzalex and also take Revlimid, Dexa and Zometa.
Darzalex was not mentioned as an option to my wife. I will mention it to my sister. Thanks.
My wife had a problem with her 5th Zometa shot. She was switched to Xgeva (Denosumab), which is not a bisphosphonate, but is non-inferior. It has the same dental issue. One must delay serious dental work for three months while the drug is cleared. (Actually, the drug hangs around for a very long time.) After the dental work - when everything has healed - one must wait a furthur 3 months before resuming.
Both my sister & my wife had the same problem with Dexamathasone - sleeplessness on the night after taking it. Have a good book at hand. LOL. But you might be different.
Best, -Patrick
I was aware of possibility of ONJ but not the clearing time. also will keep in mind about switching to Xgeva. Thanks for the tips.
Mike P.
Mike,
Re: Zometa (Zoledronic Acid):
"Its high affinity to and long half-life in bone, and long duration of action, allow for once-yearly administration"
ncbi.nlm.nih.gov/pubmed/278...
Re: Xgeva (Denosumab):
"Because of its long half-life in the body, subcutaneous denosumab administrations every 6 months are sufficient to obtain inhibitory effects on bone resorption"
ncbi.nlm.nih.gov/pubmed/238...
-Patrick
Patrick, this is probably an uninformed question, but do hormone treatments affect MM? Or is the mechanism totally different?
PCa hormone treatments target the androgen receptor [AR] either directly or be depriving AR of androgen. I don't believe there is conflict with MM treatments.
But could MM drugs work with PCa?
Mike will be on Revlimid [Lenalidomide]. From Wikipedia, below, "inhibition of angiogenesis" could be useful. In fact, there are 45 PubMed hits for: <prostate Lenalidomide> [2].
"Lenalidomide has been used to successfully treat both inflammatory disorders and cancers in the past 10 years. There are multiple mechanisms of action, and they can be simplified by organizing them as mechanisms of action in vitro and in vivo.[29] In vitro, lenalidomide has three main activities: direct anti-tumor effect, inhibition of angiogenesis, and immunomodulation. In vivo, lenalidomide induces tumor cell apoptosis directly and indirectly by inhibition of bone marrow stromal cell support, by anti-angiogenic and anti-osteoclastogenic effects, and by immunomodulatory activity. Lenalidomide has a broad range of activities that can be exploited to treat many hematologic and solid cancers.
On a molecular level, lenalidomide has been shown to interact with the ubiquitin E3 ligase cereblon[30] and target this enzyme to degrade the Ikaros transcription factors IKZF1 and IKZF3.[31] This mechanism was unexpected as it suggests that the major action of lenalidomide is to re-target the activity of an enzyme rather than block the activity of an enzyme or signaling process, and thereby represents a novel mode of drug action. A more specific implication of this mechanism is that the teratogenic and anti-neoplastic properties of lenalidomide, and perhaps other thalidomide derivatives, could be disassociated.] [1]
-Patrick
Damn. That’s not fair. Sorry my friend.
Schwah
There is a lot of unfairness in this world and I just got my share. I have the attitude that you deal with it and move on.
"Have you considered my servant Job?"
My husband and I are not religious, but we've both read that particular book of the Bible a few times.
job had far more to handle I do.
We lived in a house that was struck by lightning 3 times and had a car drive through the front window...
I shouldn't be laughing. Have you considered moving?
Oh, we definitely moved! I pounded the "For Sale" sign in myself.
The tree in our current house was hit last spring. ☁️⚡
I think your family should wear lighting rod underwear.
Good Luck, Good Health and Good Humor.
j-o-h-n Sunday 07/07/2019 7:18 PM DST
Best wishes to you, mcp. As if it isn’t difficult enough to deal with PCa, you have the challenge of fighting a two front war. Coincidentally, I was on the phone yesterday with a good friend from my boyhood days who just had a bone marrow transplant for MM done on 7/1. He’s now in the waiting period to see if it did the trick. Like Stage 4 PCa MM is currently incurable, but patients can have very long term remissions. My prayers will be with you today for a speedy recovery and a long remission on BOTH cancers. Hopefully, in our lifetime the evolution of treatment protocols for both PCa and MM will turn them both into chronic and manageable diseases. God bless you!
Two words only 'HOLY SHIT'
Good Luck, Good Health and Good Humor.
j-o-h-n Sunday 07/07/2019 7:21 PM DST
I am taking this new challenge in stride but my wife is going off the deep end and driving me nuts!
Remember what you swore to:
"I take this woman to be my lawful wife, for Better or Worse and for Driving me nuts".
Keep on Keeping on!!!
Good Luck, Good Health and Good Humor.
j-o-h-n Monday 07/08/2019 11:58 AM DST
we celebrated our 50th anniversary this past Dec. 7th. another day of infamy.
Blood count concerns 
How to find a MO Specializing in PCa
PSMAddition Phase 1/2 Results?
I am still struggling with treatment decisions - Help please.
Zometa for bone strength to be given only with multiple bone Mets or to all stage 4 patients ? Even stage 4 with multiple lymph node Mets ?
