What I'm doing to boost my immune system and to fight cancer and also the covid 19 coronavirus. I've had aggressive prostate cancer and survived so far for 6 years but I've been really concerned about this covid 19 virus because my zytiga does get rid of all my cortisol which is crucial to keep your immune system strong. Plus, I also have high blood pressure. So what I've been doing and will continue to do, is exercise regularly, which is the best way to strengthen your immune system and lower my blood pressure and I also stopped my zytiga at least temporarily to keep my immune system stronger. And I'll be watching my PSA but I hope that it won't climb too fast and force me to go back on the zytiga or maybe change to zaludtimide. Everyone keep well and keep safe. And God bless us all.
How I'm boosting my immune system - Advanced Prostate...
How I'm boosting my immune system
The prednisone replaces the cortisol that Zytiga takes away - that's exactly why you have to take them together at those doses. Too much prednisone dampens immune response as does too little.
I took eplerenone 50 mg, while I was on zytiga instead of prednisone because it's much better and safer. I don't have to be as concerned about osteoporosis or a weakened immune system and the added benefits are that the eplerenone got rid of my swelling ankles and calves and I no longer have severe leg cramps at night time while I'm asleep. If you read the literature you will find that zytiga was first patented back in 1994 without prednisone because most people did not need it but the prednisone was added so that they could get the patent renewed.
You don't have to be concerned about osteoporosis or a weakened immune system with a REPLACEMENT dose of prednisone either. Low dose prednisone was added because men taking Zytiga without it suffered from a syndrome of secondary mineralocorticoid excess. The FDA has ONLY approved Zytiga with a corticosteroid replacement.The right dose is very individual:
pcnrv.blogspot.com/2019/06/...
Corticosteroids have a secondary benefit in controling the cancer.
I appreciate what you're saying Tall Allen, but my experience tells me otherwise. Most men really don't need to worry about excess mineralocorticoids but if the labs show that they are having an issue, then they can get on eplerenone which is a potassium sparing diuretic that was used in the original study for comparison to prednisone. Eplerenone controls excess mineralocorticoids. It was found to be just as effective as prednisone and safer because the effect of prednisone is subjective to the individual. It can cause weakened immunity and weakened bones. And prednisone is a very poor substitute for the cortisol hormone.
But you have no reason to believe that a replacement dose of prednisone "can cause weakened immunity and weakened bones. And prednisone is a very poor substitute for the cortisol hormone." I'm glad that eplenerone is preventing the effects of mineralocortoid excess in you. But I would be very careful about NOT replacing corticosteroids that are inhibited by Zytiga. We need corticosteroids at the right level - not too much, not too little. Corticosteroids suppress prostate cancer.
You don't seem to realize that prednisone is not really a replacement of anything your body produces. It's a substitute and a very poor and dangerous one at that. It is nothing like cortisol and does not act like a cortisol does in your body. A 5mg dose of prednisone daily might seem like a small dose, but over time it accumulates and accumulates and accumulates until it's no longer a small dose in your body. That's why you have to gradually reduce the dose over time, once you stop taking it. I know this from experience as you may also know. And all the literature out there tells you that prednisone does weaken your bone structure causing osteoporosis and steroids do weaken your immune system. I didn't just make that up. Here's a link to a drugs.com with a very good article explaining the pros and cons of prednisone. drugs.com/slideshow/prednis...
Trust me - I understand the biochemistry very well. Prednisone is metabolized to prednisolone. Prednisolone differs from cortisol by just a double bond in the 1,2 position. This change makes it more active at activating the glucocorticoid receptor. You would need 20 mg of cortisol to have the power of 5 mg of prednisone. Glucocorticoid receptors are found on every cell of your body, so removing cortisol, as Zytiga does, will eventually have far-ranging deleterious effects if it is not effectively replaced.
The half-life of prednisone in plasma is 60 minutes, so it is gone in about 7 hours. It does not, as you imagine, accumulate. The reason you ramp down when coming off it is to prevent paradoxical overproduction by the adrenals. The amount of cortisol your adrenals produce is tightly controled by negative feedback. A sudden lack of cortisol results in a surge of corticotropin-releasing hormone by the pituitary. So it is necessary to come off prednisone slowly to prevent that excess.
The literature you've seen does not address replacement doses of prednisone, which is entirely different from extra doses given for other purposes. I hope you are starting to understand the difference.
I'm sorry, but you're stating facts that are incorrect. Even though prednisone has a very short half-life of four to five hours, you've got to keep dividing that half life over and over and over and as you add prednisone each day, even though the half life is miniscule, over months and months of taking the 5 mg of Prednisone it will accumulate. There's no way of avoiding that. And as for your pituitary gland kicking in to signal the adrenal glands to produce cortisol or its derivatives, that doesn't happen suddenly once you stop taking zytiga. It takes quite a while for your pituitary to recover to the lack of androgens. You also have to realize that most people who are on zytiga, are also administered lupron at the same time, which really messes with your pituitary gland. And in fact no one really knows how these anti-androgens affect the body. And I can tell you it isn't good. So my advice is to be on the safe side, and stop the zytiga for a while, at least until this Covid-19 virus passes or switch to something that is not as detrimental to your cortisol levels. But the best thing is to stop all androgen deprivation therapy, if you can and just do the intermittent therapy, like I've been doing, even with aggressive prostate cancer.
I said the plasma half-life of prednisone is 60 minutes, not 4-5 hours.
nadf.us/downloads/adrenalho...
So, by the next day, there is none in your system. It does not accumulate.
Zytiga strongly inhibits cytochrome P450 17α−hydroxy/17,20-lyase (CYP17) enzymes which are needed by the adrenals to synthesize androgens as well as cortisol. Inhibiting the enzymes stops cortisol production as quickly as it stops androgen production.
Negative feedback from your pituitary is immediate and large. In early trials without prednisone, a sixfold increase in adrenocorticotropic hormone (ACTH) was observed,
Since ADT enhances immune response, your imaginings are backwards. It is also incorrect that intermittent ADT has any long-term benefit over continuous ADT.
I was correcting you because you're wrong about the plasma Half-Life being 60 minutes. I've read both studies for long term therapy and intermittent and there is no conclusive evidence that one of the other is better. If you have some clinical trial study proving otherwise please send me a link to it.
I supplied the link.
Interesting discussion by two persons that have done much research and the subject matter is over my head but since at this time I am taking both Zytiga and Prednisone, and I am worried about my increased blood pressure and also my bones, I was hoping that maybe there is an alternate for prednisone. I previously had asked my Onc if I could stop the prednisone and she said NO. For now I will continue using both.
Exercise is good. I've been going to the fitness club three times a week. I went on Sunday. It was closed by government decree the next day, which was yesterday. Today would have been my day to go again. I am now challenged to figure out how to replicate that exercise routine at home. I hope this dang disease peters out soon.
Exercise is INDEED WONDERFUL. Unlike most here and elsewhere ;0), I was fortunate to be on my bicycle yesterday (actually night) at midnight beginning a 121 mile ride that took me from a star studded sky to the rising moon at 4:12AM followed by sunrise at 7:39AM in a tension free/stress free state of physical exertion constantly experiencing the pains this soon to be 70yo body has become so accustomed too. If a curfew should be put in place I will simply resign myself to using the equipment I have at home. IMO, maintaining my physical fitness can only help as I proceed with this uninvited passenger within.
I just turned 70 last month. I wonder if I can access the local high school track / football field -- I could walk or jog up and down the bleachers.
i wouldn't STOP the zytiga. my husband weathered many a flu and infection while continuing his Zytiga.
You can't compare Covid-19 coronavirus to the common flu or cold. It is much more dangerous and much more destructive because it actually destroys the alveoli, which is where the transfer of oxygen to the blood occurs. And when those cells are destroyed, you can't breathe and you die.
Which is why this is not the time to deplete your reserves by allowing the cancer to grow.
So are we all taking Lupron, Zytiga and Prednisone a high risk group for this virus? I thought we are not and our immunity should be OK but I just changed hospitals and my zytiga that came from the new pharmacy had a "chemo" medicine warning label, I was surpised to see that.
Zytiga weakens the immune system because it removes all the androgens, including cortisol which is crucially needed by the body to keep your immune system strong and healthy. That's why I discontinued my zytiga. And if you're concerned that you'll die without it, the effects of the zytiga continue on and your PSA should stay lower for quite some time before it starts rising again. I've been doing the intermittent androgen therapy for 6 years now and only start again when my PSA goes up to 2. And I was diagnosed with very aggressive cancer.
Thanks for that clarification, I did see that discussion. I trust TA, when he said prednisone fixes that, which I take.
I asked my doc at UCSF about intermittent androgen therapy, his feeling was that people who take it constantly live longer. He said if you are too tired of the side effects and want a break, sure you can stop it. He said it is a personal choice quality vs quantity. I would love to take a break but given his comments, I am going to stay with it constantly unless I hear something different.
This OP is misinforming you. ADT enhances the immune system response.
ADT May enhance the immune system it actually hasn't been definitively proven to be so. You have to be careful about what you read out there.
There is no empirical evidence out there that emphaticaly says most definitely taking anti-androgens without any breaks leads to living longer. In fact there are studies that say intermittent therapy could be better for longer life because the cancer cells may be mutating and changing faster with continual long-term ADT and becoming resistant to androgen therapy. It's really hard to know which studies are accurate and correct and under what scenarios and condition the patient is in. But, I'm going with intermittent therapy because I believe it causes less damage to my body in the long term. And it's the long-term damage to the body that the anti androgens do that may eventually kill you instead of the cancer.
In fact, there is certainly empirical evidence that men with low burden of metastases live longer with continuous ADT than intermittent. For men with high metastatic burden, it makes no difference.
Can you direct me to clinical trials
studies that actually prove this?
Certainly.
nejm.org/doi/full/10.1056/N...
I read the study you linked to and it says it's inconclusive as to whether long-term therapy is better.
It said many things, but it had nothing to do with "long term therapy" - everyone in the study got long-term therapy. It was a study that randomized mHSPC patients to either intermittent (iADT) or continuous ADT (cADT). They found:
(1) They could not conclude that iADT was not inferior to cADT, because they arbitrarily set a 20% increase in survival as the bar for inferiority. (In other words, it provides some evidence that iADT was inferior.) iADT was 10% inferior to cADT in terms of survival, so it did not meet their preset bar. Median survival was 5.8 yrs for cADT, but only 5.1 yrs for iADT.
(2) In subset analysis, men with a low burden of metastases survived 6.9 years with cADT, but only 5.4 years with iADT. This was over their arbitrary 20% threshold, so iADT was inferior for this subgroup.
(3) "Among men for whom we could identify the cause of death, 73% of deaths in the continuous-therapy group and 80% of deaths in the intermittent-therapy group were related to prostate cancer."
(4) "Intermittent therapy was associated with improved erectile function and mental health at 3 months but not thereafter."
They proved that far from extending survival, intermittent ADT worsened survival at least in the subgroup of men with low burden of metastases. And there was no long-term benefit to QOL.
For my immune system, I take GABA, Astragalus Artemisinin andUbiquinol, hope this is of some Benefit to you gentlemen. The Artemisinin is taken in a cycle, 7 days on then off, then I take the others during the day for 4 days then back on the Artemisinin for 7 days.
Metastatic PC, but I feel pretty good,little to no lethargy,pain or side effects from ADT injections and Enzalutimide......PS plus a huge dose of prayer...God Bless.
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