The hits just keep on coming. - Advanced Prostate...

Advanced Prostate Cancer

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The hits just keep on coming.

Costarica1961
Costarica1961

Hey fellow warriors, some of you may know from previous posts some of my history with P.C I am currently in my 5th week of a phase 1 clinical trial for my CRPC . gleason 9. and 4.5 yrs into the battle. Recently on week 3, I had a horrific reaction to the drug being administered, ast numbers were all up 2154 , all phos and all the critical liver numbers. Well since then a lower dose regimen and a couple weeks has passed, everything is back to normal except alk phos at 128. And PSA has surged from 17 to a eye popping 191. This is my big concern at this point. Could it legitimately be a inflammatory response, or in 5 weeks is that a grim progression of a out control freight train, or is this a possible shedding effect of tumor Mets. The two optimistic scenarios or is this just a sign of a disease showing its dominates over a tier one immuotherapy treatment. I realize this is complex and difficult question to pinpoint, although perhaps some of you have knowledge and experience beyond mine. The doc wants another PSA done. Check, and bone scan next week. Any thoughts thankyou.

11 Replies

Is this the Harpoon trial? Some immune responses do not show on PSA. Provenge, for example, does not necessarily elicit a PSA response - but it does increase survival. If the PSA increase is coming from immune annihilation of cancer cells, that is certainly a good thing. You have to look at metastases on scans.

Thankyou. I will know more when the scans arrive. I am always hopeful, although its difficult after montering my PSA for years to see such a increase. Good things to come based on your insight. Thankyou.

The only way to determine what is happening is to see if there is radiological progression of the cancer.

The responses to immunotherapy are variable. One may think it is a binary process. The cancer responds to the therapy or it doesn't. However, there is also the situation where the immunotherapy treatment accelerates the progression of the cancer It is called Hyper Progression under immunotherapy and it may happen when checkpoint inhibitors are used.

Some info here:

ncbi.nlm.nih.gov/pmc/articl...

Best of luck on this journey,

Interesting. I think I understand. What does one do if they believe, based on the scan and the disease progression, stop immuotherapy and take a different course. Or is there any benefit, or is it all a turn for the worst.

They need to determine if the cancer has progressed. If it did, I assume they will advise to stop the experimental therapy.

Although it may be hard to do, mentally, you might want to think more in terms of radiological progression than in just PSA test results which may be in ranges that you may not have seen before.

Anecdotally, I was alive and still treatable when at my original diagnosis I had a PSA of 5,006. Several men here once had PSAs in the 400-900 range and were/are still walking around as they have done various treatments. I've known a couple of men whose PSAs had risen into the 2,000 range while they were still able to get out to attend some Support Groups while they were doing some of their later treatments.

What you actually do with your medical options, and especially what you actually do with your daily internal life and interactions with those around you, is not totally defined by a number like a PSA test result. I hope you have good results and peace and balance in the months ahead.

Thankyou.

Dr Charles E Myers gave me URSODIOL in 2008 to help me protect the liver from toxicity of ketoconazole.

I will ask tommorro about what you were given. Thankyou

Follow up.... with everyone one...

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 09/27/2020 6:01 PM DST

Thank you john

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