Any suggestion for treatment with P53 is much appreciated?

My SO is 84 years old. He was diagnosed with PC stage 4, Gleason 8 October 2018. He is currently on Lupron and Xygeva, radium 223 and Jevtana. He had tried Zytiga, Docataxel and now is on his 5th treatment of Radium 223 and 2nd treatment of Jetvana.

He recently took a genetic test and was told he has a very bad cancer, P53, and doc said he doesn't know how well Jevtana will work. SO has been very exhausted, has pain on his back bone and not eating well. His doctor suggested he could cash in or continue with side effects but not sure how well treatment will work for him. Oncologist gave him about a year left. doc said PSA reading would not matter.

Is there anything else he can try that may work on P53? Is it more damage on his system should he continue with going through his 6th and final radium 223 and 3rd jevtana treatment in 4 weeks? SO does not want to "cash in". He is very positive.

Worse part of this is his daughter, the caretaker, has never been positive about his dad taking any treatment, especially jetvana and docataxel. She rather had him NOT take any treatment in the very beginning even with PSA of 946 at diagnosis.

[Hidden]

forgot to add he already tried provenge which he finished about a month ago

[cesanon]

1. Here is what James Watson, the discoverer of DNA, has to say about the TP53/P53 mutation.

royalsocietypublishing.org/...

2. Very interesting what Nalakrats has to say about Gendicine and Adexin.

If you find anyone in the US who is using either of them to treat or to clinical trial on prostate cancer, please post what you find.

[Tall_Allen]

Mutant P53 is probably the most common genetic mutation with advanced prostate cancer. There is nothing available to repair the gene. Was there a histology and IHC analysis? Those may be more useful than a genomic analysis. Does his metastasis express the AR and PSMA?

[Hidden in reply to Tall_Allen]

Not sure what a histology and IHC ( what is this ) analysis is ? How is this done ? What is AR and PSMA ? Would this be found on lab work? His MDOC is Dr . Vogelzang.

[Tall_Allen in reply to Hidden]

They are the more basic tumor analyses. Ask Dr Vogelzang - I'm sure they were done.

[Hidden in reply to Tall_Allen]

May or may not be done as DR Vogelzang was not his initial MDOC . Dr Pinsky from. Keck in Los Angeles was his mdoc. till he moved to Las Vegas.

[Hidden in reply to Tall_Allen]

Dr Vogelzang did not do any tumor analysis as far as I know . At initial diagnosis for PC tumor was analysized and was Gleason 8

[Tall_Allen in reply to Hidden]

Not at diagnosis. Someone (a pathologist) looked at the metastatic tissue. Ask whomever your MO was.

[Hidden in reply to Tall_Allen]

Okay thanks . Then the tumor would be old , dated October 2018 . I have the written report . Would it indicate PSMA , AR and histology?

[Tall_Allen in reply to Hidden]

When did they biopsy the metastasis that found the mutant p53? There should be a path report from that.

[Hidden in reply to Tall_Allen]

test was done about a week ago and Dr Vogelzang said he has p53 at doc appointment yesterday . I thought it was a blood test but maybe it was a biopsy .

[Tall_Allen in reply to Hidden]

Email Vogelzang with this question: Does his metastasis express the AR and PSMA? If he doesn't know, perhaps you can get a biopsy stained for those.

[Hidden in reply to Tall_Allen]

Is it good or bad if has AR and PSMA? Do you know if jevtana helps his situation with TP53? He has a doc appointment on July 8th

[Tall_Allen in reply to Hidden]

It means different kinds of therapy might work. As I said, p53 mutations are the most common and there is no known therapy that specifically addresses it. It is best to forget about it for now.

[Hidden in reply to Tall_Allen]

Thank you for your time. Much appreciation for you replies

[Hidden in reply to Tall_Allen]

Quite honestly I wonder if his daughter ( caretaker) has any influence on MDOC because she is against any treatment for her dad . She claims her grandfather lasted 8 years with PC and no treatment but she could never answer whether her grandfather had PC stage 4 or not and what the Gleason was Or the PSA number.

[Hidden in reply to Tall_Allen]

Do you mean AVR 7 or something like that . Awhile back it was done when he was on zytiga in January 2019 and it was negative

[Tall_Allen in reply to Hidden]

No- thhat's not what I mean.

[Hidden]

Thanks Nalakrats and Cesanon for your response .

Based on now knowing that he has the TP53 mutation , do you know if radium and / or jevtana would help with PC?

He used to be about 190 lbs and about a month to two is down to 175 lbs . He doesn’t eat a lot , is exhausted and tired. Not sure if it is the constant drugs in his body or the problem with TP53 ( had genetic testing done about a week ago). Right after Docataxel, he had 2 weeks break , then radium for one session than followed by radium plus Provenge . Shortly after Provenge MDOC added jevtana . Now he is on radium and jevtana .

His PSA doubling time I think is monthly . MDOC said that since he is TP53 PSA numbers wouldn’t matter.

[ctarleton]

Both Xofigo and Jevtana have potential adverse effects on basic blood counts. Taking them at the same time is even more of a reason to stay on top of blood test results. Details about dosing, dose modifications, cautions and warnings, etc. are in these documents. Dr. V's staff may have already given you something similar, but here are links to extra copies, just in case.

accessdata.fda.gov/drugsatf...

accessdata.fda.gov/drugsatf...

With the significant recent weight loss, you might also want to discuss with Dr. V whether or not a modification to the Xofigo dosing might be in order, since it is based in part upon body weight.

[Hidden]

Conflict in a family is common . Mine wrote me off upon dx.. I don’t like that the dr said “ he can cash it in” that’s really not a nice thing to say . I don’t know how much of treatments he can take at 84 ? . They are all so diminishing . I think that the good news is that he has you . You’ll do what’s best for him .I am concerned about your well being . This disease is brutal for the spouses and caretakers . We can’t take to heart the off the cuff comments by our Docs. They sometimes shouldn’t give life expectancy predictions ..I forced mine to do so . The uro said that I’d be dead a year ago . My pc specialist told me I’d never see 80 , I was 53 then , then I went into remission and he said” you’ve got 30 more yrs” Either way with my deteriorating status he’s right .But I won’t ever see 80 or even 70.. I’m shooting for 60 next year . After a long life spent together it’s a crying shame for anyone to suffer so towards the end . I pray for mercy for us all ..God Bless!🙏

[Hidden in reply to Hidden]

Sorry to hear about your family writing you off . I hope you stay positive . Enjoy each day - try to meditate , listen to music and exercise .

I have donated to cancer organization and also for Alzheimer’s disease (. My dad passed away from Picks disease , kinda like Alzheimer)

I hope that there will be more treatments for you and everyone here .

[Hidden in reply to Hidden]

I hope that I never get more treatments. But Its most likely with time. Many things come with age. I’ve adapted to my family and have gained a new one with my wife’s. Mental illness usually gets worse with age like everything else. Have a nice weekend. Peace to papa!

[Nfler]

how are you guys doing this far