Metastatic Prostate Cancer has now spread to multiple sites in my liver. What are my treatment options?

[Allycat2]

Metastatic prostate cancer has now spread to my liver. "Multiple hepatic masses of varying sizes are identified and strongly suggest hepatic metastasis. Most are between few millimeters and 1 cm in size but the largest is in the inferior portion of the right hepatic lobe 4.3 cm. Multiple skeletal sclerotic lesions identified is 3 cm in size right ilium adjacent to the anterior scaroliac joint. Findings are suspicious for sclerotic metastasis. Asymmetric enlargement and irregularity involving the left posterior aspect of the prostate gland. Given the schleroic bony lesions nd heptatic metastasis cannot exclude a primary prostate lesion.

5 months ago my liver was fine. What are my treatment options? Is cryoablation an option? Jevtana?

[Magnus1964]

Ask your MO about Provenge.

[Tall_Allen]

No, cryo is not an option. Your first step is to have a liver biopsy and histological and IHC analysis. Possibly a genomic analysis too, if they can collect enough tissue. That will guide your treatment decision. They will probably start you on Jevtana+Carboplatin soon.

[vandy69]

I was diagnosed in September 2017 with 20+ liver lesions (already had multiple lymph node mets). Immediately had CT guided biopsy of liver which confirmed that lesions were metastatic PCa.

Had chemo port inserted in right upper chest and began chemo with a Docetaxel/Carboplatin combo.

Since then have had 16 infusions of same chemo combo (2 rounds of 6 cycles each and most recent round of 4 cycles). Used Xtandi as a rechallenge after first 2 rounds, but round 3 was chemo combo PLUS Xtandi,

During round 3, PSA has dropped from 48 to .2 and lymph nodes normal and liver lesions greatly reduced. Overall it has worked wonderfully for me. Have a liver MRI every 2 months and blood work prior to each chemo combo infusion.

Best Wishes. Never Give In.

Mark, Atlanta

[Hidden in reply to vandy69]

🙏

[vandy69 in reply to Hidden]

Thank you.

[Hidden in reply to vandy69]

Thank you and take care.🕊

[MelaniePaul in reply to vandy69]

That's amazing, Mark. I am so glad for you. And how are you feeling?

[vandy69 in reply to MelaniePaul]

Hi Melanie,

Thanks for checking on me. I have pain in upper left leg, probably due to 3 spinal surgeries since September 2018. Do not think it is bone mets. So far my cancer seems to be under control, but next week have both a CT and MRI which will give a better view.

I am a miracle and try to treasure each day.

Best Wishes.

Mark

[JLS1 in reply to vandy69]

That's fantastic Mark! Good for you, and I hope you continue to keep this under control for a very long time!!

[tom67inMA in reply to vandy69]

Hi Mark, very glad to hear the carboplatin combo worked for you. I have a fresh tumor in my bladder and just had a liver biopsy yesterday. Currently in a major panic waiting for the results. Guessing stage 4 bladder to go with my stage 4 PCa. Hopefully they find a genetic defect so I can nuke both f'ers with one drug, but also probably have carboplatin in my future too.

[Allycat2 in reply to vandy69]

This is turning pretty ugly pretty fast. I am going to go to Sloan Kettering very soon. I wonder if I will need to go into assisted living.

[Hidden in reply to Allycat2]

Hello Allycat , I like the picture. If we could just run like a cheetah away from APC . Do you live alone? Is that why assisted is in view? Better not to be alone if that’s needed.. you might just have to throw the kitchen sink at this tenacious pc . Knock it with chemo !!! I’m pulling for you 🙏

[Caring7 in reply to vandy69]

This is great news for you -- and maybe to us. Husband's liver mets have been dramatically increasing. Taxotere alone failed, Carbo alone failed and Jevtana alone failed -- so now we are trying Jevtana + Carbo. I hope he has as good of a response as you! The Xtandi addition is interesting.

Did you have reduction in PSA and/or Liver mets size during the first 2 rounds? I couldn't quite tell from your post if there was good response earlier or only with the added Xtandi.

Thanks, And keep going!

[vandy69 in reply to Caring7]

Hi Caring7,

I did get both a reduction in PSA and reduced size and number of liver lesions from each of the first 2 rounds of 6 cycles each with Docetaxel/Carboplatin chemo combo.

Also rechallenged with Xtandi between these first 2 rounds as it had earlier failed me.

This treatment plan gave me about 5-6 months between chemo rounds.

Of course, after each chemo break, PSA started to rise and liver lesions began to grow larger per MRI.

Best Wishes. Never Give In.

Mark, Atlanta

[MyWifeMyLife in reply to Caring7]

Hi Caring7, not sure yet how to work this whole blog posting..but I wanted to know how the combo went for you? I’m supposed to start it this coming Tuesday..thanks a lot!

[MyWifeMyLife in reply to MyWifeMyLife]

For your husband I mean..

[MelaniePaul]

I am sorry to hear this. I am not an expert but would suggest platinum-based chemotherapy as soon as possible. Good luck.