Questions, for Med/Onc

[Carp1707]

I have a tele/appt with my med/onc Friday.

My PSADT is 2.1 months, now it just crested the 1.0 area. I was hoping to get into Flu-BLAST study there at UWMC, SCCA; but in reading fine print I'm ineligible. They require DT of >3 months. They have Axumin ability as that is what is used in this trial. I would opt for a Gal scan at UCSF, bearing the costs myself if necessary. Tried to get an idea from scheduler at SF but wouldn't talk as I have no orders from Dr. I've been through over 3 years of ADT some with Abirateron, 37 sessions of radiation and RP. I think I'm still hormone sensitive and am wondering what path there is and what questions I can pose.

[Tall_Allen]

I'm trying to understand your situation. You had RP, and then SRT with short-term ADT for N1 PC. Then you had a single course of ADT+Zytiga, but then stopped it? Is this correct? Now your PSA is doubling rapidly with no systemic therapy? I don't really understand your lack of systemic therapy. Maybe that's what you want to discuss with your MO.

[Carp1707 in reply to Tall_Allen]

In Dec. 2020 my PSA was 0.59 and I think he was wanting a bit higher so he could get an image of it to determine localities of mets. The best they have at SCCA is F18 PET/CT. as that is what they are using in a study. The spread of specificity, sensitivity between F18 and Ga68 is astounding. But that a carpenter's opinion.

[Tall_Allen in reply to Carp1707]

I've heard several patients say that they stopped ADT to increase detection. IMO, that is a self-fulfilling prophecy and is always a mistake. I don't think it is ever a good idea to let the cancer grow on purpose.

[Carp1707 in reply to Tall_Allen]

Did not make sense to me either. Nice to have a vacation but when the PSA returned I think that would have been a good time to act.

Looking at some chemo components to act in concert with ADT. I'm not comfortable with just denying 'food source' for it but rather attack it head on.

[Tall_Allen in reply to Carp1707]

Here's some info on the optimal timing of various therapies:

prostatecancer.news/2019/02...

[RVALuna]

I would suggest you to try Avodart to lower dihydrotestosterone to lower/control PSA if you are hormone sensitive . it can slow it for short while 1 1/2 years for PSA slightly above 1 above one . it controlled /slowed my PSA after BCR for 15 years when started at PSA =0.3 before it got above 1.0 and started grow rapidly. This is recommended by research from a paper by Dr. Gerald Androile (U. of St. Louis Urologist) 1995-96 best Luna

[Carp1707]

I much appreciate the replies.

Had my conference this a.m. and it went well.

We decided on:

(Looking into immunotherapy

(Axumin scan with inclusion into middle are of Flu-BLAST study, as SOC, since I'm ineligible for the study itself, this would include spot radiotherapy to known tumors.

Hoping for the immunotherapy as it would systemic. About 20% of patients are sensitive to this. So here's hoping I'm one of five.

Thanks again for the support.