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Treatment-Emergent Neuroendocrine Prostate Cancer: Frontiers in Oncology

Balsam01 profile image
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frontiersin.org/articles/10...

citation:

Frontiers in Oncology

Treatment-Emergent Neuroendocrine Prostate Cancer: A Clinicopathological and Immunohistochemical Analysis of 94 Cases

Front Oncol 2020 Feb 01;[EPub Ahead of Print], Q Zhang, Y Han, Y Zhang, D Liu, J Ming, B Huang, X Qiu

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Balsam01
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pjoshea13 profile image
pjoshea13

Thanks Balsam!

The term "Treatment-Emergent" is not popular among those who promote heavy-duty treatments.

17 years ago, when I read study papers describing the androgen receptor [AR] as 'wild type' at diagnosis, & reporting on the common AR alterations after ADT failure, I realized that I had to delay Lupron initiation as long as possible. After all, ADT is never offered with curative intent. Why do many feel they must "hit it hard" with ADT, sooner rather than later, when the treatment is merely palliative? The downside is rarely discussed.

"Treatment-emergent neuroendocrine prostate cancer (T-NEPC) mainly occurs in the advanced castration-resistant prostate cancer (CRPC), which is caused by the transformation of ordinary prostate adenocarcinoma after androgen-deprivation therapy (ADT). The main clinical manifestations of T-NEPC include low PSA level, high tumor metastasis load, and rapid resistance to ADT. T-NEPC is an aggressive variant of CRPC, with a poor prognosis. Most T-NEPC patients die within 1 to 2 years after diagnosis, accounting for approximately 25% of CRPC deaths."

It may well be my fate, but I have tried my best to avoid it.

{Victorian fairground expression: "What you gain on the roundabouts you lose on the swings?"}

-Patrick

Danielgreer profile image
Danielgreer

Thank Balsam! Has anybody out there had treatment emergent NE that was first found in swollen lymph nodes?

V10fanatic profile image
V10fanatic

After using Lupron + Casodex initially, and now Lupron + Zytiga, I can only hope that I have not unintentionally accelerated my own demise.

🤨

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