I am looking for advice or I guess what to expect from anyone that can help. My dad was diagnosed with stage 4 metastatic prostate cancer in June of 2015, Gleason 10. Since then he has had taxotere, casodex, iliguard, zytiga, xtandi, another round of taxotere and getting ready to have second treatment with jevtana. Oncologist says this is the last of the drugs unless there’s a clinica trial. Is this really the end? There is no bone involvement it is all soft tissue. We know it’s aggressive I guess it’s just hard to come to terms with. God bless you all
Dad stage 4 prostate cancer - Advanced Prostate...
You could consider Lu 177 PSMA treatment. There are clinical trials:
If it is possible to pay for it, the treament is available in Europe, Australia and South Africa.
They could study the genome of the cancer using direct biopsy of metastases or a liquid biopsy looking for Circulating tumor cells or cell free DNA. This study could show mutations which could be treated with specific drugs.
He is a candidate for the vaccine Provenge which could have a survival advantage.
There are clinical trials for niclosamide which could re-sensitize the cancer to abi or enza.
Best of luck.
I'm not a doc or research scientist. Only considering what I would do in your place. Your dad is lucky to have you on his team and whatever you and he do it will be together.
If you have a family bloodline history of cancer get Genetic Testing approved by a Genetic Counselor to find mutated genes that indicate you can be treated with different off label drugs and perhaps qualify for some trials. Time is of the essence.
Consider alternative therapies. What do you have to lose. Research, lots of unsubstantiated stories. Some must be true. Choose what looks like the best shot and give it a try. Work with your MO who will likely poo poo most any alternative treatment but should be helpful in explaining if you want to make a really wrong choice. The med industry SOC in your case has possibly run its course. We are all so very different so what works for you may even be unique. I've found extreme diet and lifestyle change tales of cure or long term remission that are supported by a presenting physician. Excellent books on fighting for a cure with readily available and proven drugs but used "off label" for certain aspects of PCa. Titles like Eat to Live, or Starve Cancer are common and very interesting reading. Cannibus (THC), has been touted as a cure in high doses. Pretty difficult to achieve doses that might work though. Do your own research and be difficult to convince. Choosing an extreme treatment may mean a loss of QOL and not a reasonable choice, but when you find something that seems solid, give it a try.
The "Vision" trial which uses LU-177 / PSMA MIGHT be worthwhile but only if it's being done at a nearby center..Lots of hoops to jump through. Also, look into BAT, a simple testosterone injection that is cheap and has been fairly effective. It has the added benefit of re-setting Zytiga so it works again...Hard to convince MO's to try it. What is his PSA now and how fast is it doubling ?
Thank you all for your advice and good wishes!! He has completed genetic testing and did not find anything. I am researching and suggesting everything I can to him. One of the biggest issues is getting him to understand that just because his oncologist isn’t sure doesn’t mean it’s not worth a try. I have been looking at clinical trials and unfortunately for my dad he also has congestive heart failure and many of them have that listed under exclusion criteria. I will look into both BAT and Lu-177 trials and see what I can find out. His psa is doubling in 3 weeks time.
Do they feel its localized or is it out of the prostate? Has anyone told you anything about tumor size? Has anyone suggested Lupron or ADT? Latest T,DHEA,DHT and PSA?
How old is your Dad and does he have anything else going on in his body?
Ask about Metformin,DES and PCSpes,pomiX10,finasteride,duasteride, Zoladex.
All these are available and may manage the cancer.Cancer drugs should be taken in combination not one at a time. IMHO it can only fail at some point. Treatment you do 24 x 7 is alot more powerful than a drip that lasts a short time. You should consider ingesting every nutrient known to kill cancer. Get to love these nutrients as if they would save your life and they will. These are widely known and should be your primary line of defense.
Has he had any other treatment for PCa?
It’s outside of prostate spread to liver, chest lymph nodes, pelvic lymph nodes, lungs. He’s been on ADT. He has used all the following meds eligurad, casodex, zytiga, xtandi taxtotere twice and now jevtana. He is not a candidate for Provence. My dad had a severe adverse event with zytiga so going back on that isn’t really an option. When he took.xtandi it didn’t work but he also had to stop a lot of his heart medications because they interacted with xtandi. He is 62 and also has congestive heart failure.