After a year of numerous scans (CT, MRI, Choline, Gallium 68 and x-rays), it has finally shown up. The biopsy results were: multiple pale tan-red soft tissue cores
and fragments, ranging from 0.1-0.7 cm in length.InterpretationA. Lung, Positive for malignancy. Metastatic adenocarcinoma consistent with patient's known prostate primary.
It must be unusual for the first metastasis to be lungs, but that appears to be what has happened. PSA is 2.1 now and next week a scheduled appt to discuss treatment options.
I have little to offer others in experiences or advice but would love to know what might ahead for treatment. I believe there are multiple nodules in both lungs, not sure that means anything, they biopsied the largest one that had shown growth from June.
So far no treatment under taken. Probably good that radiation wasn't done, with the Dr. even saying chances very low it would work anyway, and very expensive.
Thank you!
Written by
Buddy1950
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I had numerous lung nodules when I was first diagnosed. I chose to do early Docetaxel chemotherapy with ADT. After my chemotherapy, I got imaging and they said the lung nodules were gone.
I remember my doctor saying they don't know whether they are prostate cancer or possibly lung cancer. I pointed out that I was doing chemotherapy and she said "OK, for lung cancer it's not first-line chemotherapy, but it is second-line so that's good." Whatever it was, it's gone now as far as I know.
He has metastatic adenocarcinoma of the prostate according to the biopsy. The cancer should be castration sensitive.
The treatments are ADT (lupron, or Firmagon) plus Abiraterone (Zytiga) and prednisone or ADT plus Chemo with docetaxel. There is not difference in overall survival using one therapy or the other.
There is also the possibility of treatment with ADT plus apalutamide (Erleada) which has been recently approved for metastatic castration sensitive cancer.
Thank you... the comments from the real expert are really relavent. Have ideopathic perphireal neuropathy which might really be important to bring up, even though it is in charts. Thank you!
I have a peripheral neuropathy. All the neurologists and oncologists I have consulted with considered that I should not have chemo. If a peripheral neuropathy becomes worse it could ruin whatever life one has left. Oncologists are very cavalier about peripheral neuropathies.
Thank you. It is already a big issue in my life. Mayo told me they have nothing too offer in help for neuropathy, so I really appreciate being warned not to add to the problem.
Unless the biopsy shows something strange, it will probably be ADT plus Docetaxel - 6 infusions, 3 weeks apart. Maybe followed by Zytiga or Erleada. (I think this sequence is preferable for logistical reasons.) Here's a discussion of options - understanding that you are high-volume recurrent rather than newly diagnosed.
My first mets were to my lung and the covering (pleura) of the left lung only. That was 12 years ago. You can read my story in my profile on this site. Not hopeless but you need a good oncologist to guide the way.
A positive attitude is also important and there will be some challenges. Build a good support system and be able to share your concerns.
Don't know where you're being treated. My late dad had advanced PC; he had also been a heavy smoker for years. He had an isolated lung lesion, biopsied as adenocarc. lung; he had a mediastinoscopy which showed involved nodes between his lungs. He was scheduled for chemo based on the spread of lung cancer to regional nodes, but became a surgical case when the mediastinal nodes turned out to be PC. Repeat immunologic testing of lung biopsy showed it was indeed lung cancer. Because it was localized, he had surgery instead of chemo.
I should say that it took 4 months to sort all this out, and only a very on-the-ball pathologist saved him from chemo. Of course I have no idea if your nodules are PC or NSCLC, but obviously the treatments will be different.
I am one who has, and still don't have any other metastasis but in my lungs. Found by PSMA GA 68 scan at UCSF a year ago. Between my local oncologist and my other at UCSF both state its pretty rare just lungs. More then 10 nodules on both lungs. Being held (no growth and very little shrinkage) currently. Didn't do chemo. I am on Lupron and Zytiga and its my only treatment so far. With low PSA always my marker can't be PSA. Blood work and scans every 2 months to follow/track.
I was totally devastated when I heard this news last year. I have a very well-known oncologist at UCSF. He told me he plans on having me around for a number of years not months. Thats all I needed. Best to you keep us posted...
Husband and son on the way to Mayo .. thank you so much for taking the time to post this. Thank you.. maybe can take a breath again and see what they say tomorrow.
Appears to be Firmagon for 18 months, and see the local oncologist to get Chemotherapy for 6 months. They have seen good results doing this for lung nodules. They want ice used on extremities for expected neuropathy, and he already has it. Overall, this isn't as bad as we might have imagined. Thank you for all of the advice. Back to Mayo twice during treatment they said. We are so grateful for all of the information everyone provided. I better eat Wheaties as this it looks like I'll be in charge Susan They even used the word "curative" .. and I know that is only a possibilty, but at least gives us hope.
Should say they said to only go to get chemotherapy at places where they ice hands, feet and head to prevent nerve damage. Probably common knowledge, but guess we will ask the clinic.
I believe there are not data showing that icing the hands and feet prevents anything. In the interview with Dr. Tanya Dorff, she indicated that she does not know anyway to prevent the development of neuropathy.
If you think about it , it takes 48 hours to eliminate 80% of the docetaxel from the body. Difficult to understand that icing hands and feet during infusion will protect the nerves of the hands and feet from the action of the docetaxel circulating in the body for more than 48 hours.
Thank you again! Ice extremely painful for him with neuropathy. Bad enough we have really cold weather already and winter isn't even here. He is on his way home and just relaying what they said he was to do. Only three oncologists .. Grand Forks, N. St Paul and Duluth that they wanted to do this... Grand Forks the only realistic place to go every 28 days and how to tell them they need to use ice... Appreciate the thought... if this does no good, he shouldn't suffer from the pain of the ice packs.
I meant to say 48 hours to eliminate 80% of the docetaxel. Few hours of icing the hands may not do anything. A neurologist consultation should be done if possible to determine if he can risk chemo in his situation.
My treatment for IIIA lung cancer was cisplatin and taxidere , maximum lung radiation , and thoracic removal of top right lung lobe . Somehow I beat the odds and am still vertical ( well, mostly anyway) eight years after diagnosis.
I think that is what is listed as next if Fermagon and taxidere (or something similar) don't work. Cisplatin sounds awful? I think I'm the same stage. Wonderful to hear you are doing so well so many years later, hope this continues for you for many more.
Buddy, the biggest part of any cancer treatment though is in your head. It is essential that you remain positive , forward looking , and get on on with your life. I am rooting for you!, judg69
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Susan They even used the word "curative" .. and I know that is only a possibilty, but at least gives us hope.
CT scan for possible spread to lungs:bad cough with no signs of infection or virus
Is now the time to be writing you representatives about 177-Lutetium pricing?
Advance prostate cancer metastasis to lung and lymph nodes
better options
MD
