How about a Foundation One Genomic blood or tumor test; Pending results of my next 06/08 CT/NM bone scan results??

[depotdoug]

My Guardant360 liquid biopsy Sept10, 2019 found no Circulating DNA. Am I done finished with Genomic testing? My Med Onc said I have no BRCA genes to ID yet. Time to confront my Med Onc about

How about a Foundation One Genomic blood or tumor test? I’ve heard that:

Foundation One will test 328 Genes---the last I knew, and you can get the PD-1 and PD-L1 markers determined at the same time. May be able to throw in AR-V7 Gene Splices--which can indicate effectiveness of Xtandi, and Zytiga,

My reasoning is:

I’m having my 2nd set of CT scans Pelvis, Abs, Chest and NM total body bone Scan June 8th one week from Monday. When those results(June 9th) show “tumors” growing rampantly in around my prostate gland, pelvic lymph nodes and abdominal lymph nodes, should not this warrant a Foundation One Genomic blood or tumor test??

Caveat: maybe I should not be so pessimistic in my Scan results that I haven’t even got yet.

Worried, Depotdoug? maybe.

Doug

[Tall_Allen]

Why all the interest in Foundation One if Guardant360 showed nothing? Guardant 360 looks for cell-free DNA, so it does not rely on circulating tumor cells, only the DNA from your cells. The DNA may be from somatic or germline sources. PD-L1 and MSI-hi/dMMR are rare findings - so far your answer is "no."

[depotdoug in reply to Tall_Allen]

Point: Well I'm trying to find more treatment or attack methods for my Adv PCa.

#1 my last PSA 03/10 was 1.032 since on Abiraterone/pred/Lupron 6 months.

#2 March 10th, I asked pointedly my Med Onc. why not another 68Ga-PSAM-11 PET scan next?

#3 He said my PSA was below the limits now. <3.0 I think was cut-off. so no PSMA re-scan.

#4 He did order me CT Pelvis/Abd/chest & NM Bone scans due up in one week,06/08. Results next day 06/09. Ok.

#5 Am I expecting active positive tumor growths(prostate, pelvic lymph or abdominal nodes? That's why we (Adv PCa) guys get tested and re-tested and tested, I keep telling myself.

That's why I was positively thinking of Foundation One Genomic testing to find something in my 'tumors'.

I am openly receptive to:

a) specific tumor biopsies

b) Targeted SBRT radiation at those hot spots, that may take some convincing of my Med Onc team.

Tall_Allen, as you can see I'm trying to overthink my progress or future treatment plans. Am I anxious to get scanned again CT and NM? Yes. It's been 18 months since last scans from my 1st Med Onc. that was before I was tagged Adv S4 Metastatic last fall. That's tiring me out just typing. Time for exercising.

Doug

[Tall_Allen in reply to depotdoug]

There are two questions you have to ask yourself about any testing:

(1) is it possible that it will show anything that will change my treatment decisions?

(2) Are those treatment decisions likely to add to my life or my quality of life?

I can understand how anyone in your position might be flailing around for something that might, even remotely, be useful. At some point, finding more tumors that are large enough to detect and zap is a losing game. I have no idea whether that increases survival - no one does. The bigger reason to detect tumor progression is to know when a treatment is no longer working and it's time to change. PSA and other biomarkers are good first indicators when that time has arrived.

[depotdoug in reply to Tall_Allen]

Excellent advice Tall_Allen.

I just increased my QOL 25 days ago with a 5 hr RF cath cardiac ablation to correct my persistent(constant) AFIB. My daily Kardia and Apple S4 watch EKG's are NSR.

How long will I remain NSR and Not AFIB? I can answer that one either.

Negative note: My current Urologist/oncologist, not my MO, did say I could possibly have my still intact prostate gland removed, still, but that would entail removing my non-functioning neurogenic bladder too. Not a very delightful proposition.

Positive note? # 1I will patiently wait my next PSA & T-Level labs results in 8 days.

#2 Let's see what my CT pelvis/abs/chest and NM bone scans materially find and document one week out. Or don't find.

I just gotta stop making plans for things I do not know yet or my doctors dont.

Doug

[depotdoug]

Sounds so so easy. Yes, I did call Foundation One 1-888# last week. One, I've been resourcing their website a bunch. Two the lady says to talk and ask your Med Onc.

Ok, I'll call again this afternoon, pronto. I'm just discouraged with the idea i do not have any genomic DNA markers. When my CT and NM scan results next Mon show tumor(hot spots) why not do another Genetic DNA liquid blood or tumor biopsy?

[depotdoug]

Thanks Nalakrats,

I’ve been exercising at my Purple Fitness Planet and outside. Picked loaded up 24 bags of Cedar Mulch of course unloading is fun too.

I smell like a hamster or gerbil cage at the moment.

Yes I shall call Foundation One Genetic DNA advocate Tue AM. It’s on my reminder Pri #1 flag.

Depotdoug

[j-o-h-n in reply to depotdoug]

With or without an excercise wheel?

Good Luck, Good Health and Good Humor.

j-o-h-n Tuesday 06/02/2020 10:55 PM DST

[depotdoug in reply to j-o-h-n]

Yeh I’m gonna get Vanna White to spin my Wheel of Fortune exercise wheel. What will I win? An all expense paid trip to my Med ONC office.

[j-o-h-n in reply to depotdoug]

Don't forget you'll have to pay income tax on the cost of the trip in the event you win..... Stay well and stay Funny.....

Good Luck, Good Health and Good Humor.

j-o-h-n Wednesday 06/03/2020 2:52 PM DST

[depotdoug in reply to j-o-h-n]

I’ll ask my CPA about my MO trip gift visit. He may deem it medically necessary, I’ll take Vanna White with me, ok. She can take notes at my MO OV.

[j-o-h-n in reply to depotdoug]

I betcha you're gonna buy all 7 vowels.....

Good Luck, Good Health and Good Humor.

j-o-h-n Wednesday 06/03/2020 7:50 PM DST

[depotdoug in reply to j-o-h-n]

Yep. All vowels that Vanna lets me.

Sky’s the limit. Maybe a trip to Mars from WOF. But that’s a long shot.

[j-o-h-n in reply to depotdoug]

If not her you can take it with Pat Sajak..... but first you must stand on the floor marker while holding his hand.....

7 vowels?

Good Luck, Good Health and Good Humor.

j-o-h-n Wednesday 06/03/2020 8:10 PM DST