ADT and Docetaxel worked for treating the Prostrate and Pelvic Mets, but 2 out of 3 ain't bad

[Doseydoe]

Recap: I'm a 61 baby who was DX in Dec 2019 with Stage IV APCa, GS9, PSA 50, with 3 mets found on my pelvis and a metastasis in my bladder which is preventing flow from the left kidney as the mass it's constricting the urerter.

So, my PSA is now 0. 05 (Hurray!! 👏👏) Casodex and Eligard (my ADT) combined with Docetaxel (6 shots) worked wonders on the prostrate and bone mets, but the bladdder metastasis is not responding (2 out of 3 ain't bad.... ). I had a cystoscopy, ureter stent change, TURBT and biopsy 6 weeks ago, and tomorrow I go in for chemo shot #8. The plan is to have one more chemo shot, #9, then when my stent is due for a change in about 7 weeks, determine then during the cystoscopy the effectiveness of the 3 additional infusions. The specialist don't seem very confident that the additional chemo will do much. Anyway, I figured it was worth a shot, pun intended 😁, as the urologist did remark that the mass had shrunk a bit which allowed him to change the stent. My first stent was put in place using the antegrade method as the mass obscured the ureter entrance. It's interesting that both the CT and PSMA PET Scans can't reveal what's going on in the bladder.

My urologist and oncologist are now suggesting we talk to a radiologist to see if my situation makes me a candidate for radiation to trigone area of the bladder. I was wondering what the brains trust here thinks of the idea?

Thanks for reading about what's going on with me, keep up the fight, cheers 😎 DD.

[Tall_Allen]

Have they ever biopsied the bladder met? Are they sure it's prostate cancer and not urethelial cancer of some kind? It is not unknown for there to be two primary cancers. Have you had a germline genomic test?

[Doseydoe in reply to Tall_Allen]

G'day Allen, the biopsy from the bladder stated : This prostatic acinar carcinoma is Gleason pattern 4+5 Gleason score 9/10 and Grade group 5. I have not had a germ line genomic test, thanks for your interest, cheers 😎DD.

[Tall_Allen in reply to Doseydoe]

So it is not a metastasis. Maybe find a specialist in high dose rate brachytherapy who can treat it focally.

[Doseydoe in reply to Tall_Allen]

Allen, what leads you conclude that it's not a PCa metastasis?

[Tall_Allen in reply to Doseydoe]

That's what you just told me - it's prostate tissue with a Gleason score. Gleason patterns reflect the disruption of prostate tissue architecture. Metastases don't have Gleason scores because there are no glands whose function is to produce semen. It sounds like it just grew out of the prostate. Metastases form when cells leave the prostate environment and plant themselves in foreign tissue.

[Doseydoe in reply to Tall_Allen]

OK, I'm confused.

So as the biopsy reported it with a Gleason score, it cannot be a Matastasis. But it originated from the prostate.

Sounds like I need a lesson.

[Tall_Allen in reply to Doseydoe]

When it grows into a surrounding organ (Stage T4) it is not a metastasis. Metastases from prostate cancer may be found in pelvic lymph nodes (Stage N1), remote lymph nodes (Stage M1a), bones (Stage M1b), or remote visceral organs (Stage M1c).

[Doseydoe in reply to Tall_Allen]

Thanks for the clarification Allen, there sure is a lot to get your head around, cheers 😎 DD.

[Hidden]

That tough met on the bladder needs to go . I had tubes and stints for almost two years.. Hopefully with more time that met will fade from adt and chemo,if not zap that puppy with Rt. I’m no expert. I’ll wait to see what others say to you? I think you will conquer this . Getting that stent out will be a glorious day . That’s one goal . Good luck Dosey, once in the ring with APC we can’t stop swinging . Good luck finishing chemo. 😎🌵

[Doseydoe in reply to Hidden]

Thanks Wimpy, I appreciate your support, cheers 😎DD.

[Hidden in reply to Doseydoe]

The “ one thing” we can’t do while under the gun is to stop... “ when you’re going through hell , don’t stop”! Winston Churchill

[Gunnershome]

My husband was diagnosed July 2018 with mets to lymph nodes. Gleason 10, age 54....adenocarcinoma with neuroendocrine. Did Lupron, zitega, prednisone. Stopped working Nov 2019.....had mets to liver and hip bone. Doc at MD Anderson said it “switched” to Neuroendocrine. Spread very quickly to a few other bones....rib, knee, spots on back. We tried clinical trial....AZD4635....did not work. Did radiation to the hip. Starting chemo...Etoposide and Carboplatin. Goes for second round tomorrow.

We are looking at what/where/who to go to see next. Sounds like you have a similar PC as my husband.

[Hidden in reply to Gunnershome]

Oh boy! What a battle? 🙏

[Doseydoe in reply to Gunnershome]

Sounds like you've been up against it for a while now. I appreciate how hard it must be on you both. I hope you get some success soon, thoughts and prayers for you, 😎 DD.

[Gunnershome in reply to Doseydoe]

Thank you! It’s been a tough two years. Did they say if yours is Neuroendocrine PC? That’s what my husband’s is. It is tricky and growing fast.