We’ve sustained our first significant pathological fracture (right humerus), and upon X-rays have been told the other humerus and both femurs are of similar status. Ortho oncologist talked about doing preventative measures like plates and rods which seem very extreme to put him through major surgeries like that. Wondering if others have used less invasive measures to prevent breaks successfully? We’re 3 years into this fight, Gleason 9. We’ve done Docetaxel (3 rounds, stopped due to pulmonary edema and PCP pneumonia), Zytiga, Xtandi, Xofigo, and Lynparza . Dr would like him to try Cabazitaxel but husband is not sure given his bad experience with Docetaxel. Dr also considering provenge. We’re literally at a crossroads on a couple fronts. Any advice appreciated.
First major pathological fracture - Advanced Prostate...
First major pathological fracture
- Prostate cancer
- Fractures
- Peripheral neuropathy
- Docetaxel
- Metabolic conditions
- Provenge
- Cabazitaxel
- Zytiga
- Xtandi
- Lynparza
- Xofigo
You can re-do Xofigo too.
I think his Mets are too extensive now, and I was not sure you could do it sgain
I have fought my Pca since diagnosis in 2009, Gleason9, Psa only 6, but inoperable, then ADT, EBRT, salvation IMRT, Cosadex, Zytiga, Docetaxel, Lu177, Xtandi, and I had first Xofigo ( Ra223 ) on 26 Feb 2021 and will have next one on 23 April.Psa rise slowed down, but blood tests indicate continued bone mass loss and doc fears that if the bone mass loss does not reduce after 2 more Ra223 doses, I would not be able to have more Ra223, and I'd have to have more chemo with Cabazataxel, and unlikely to work, because Docetaxel failed badly in 2018. The docs fear is that I would lose too much bone marrow.
Without enough bone marrow we just can't live long.
So the idea of having a second round of Ra223 after having say 6 initial doses seems to be dangerous to me. My doc is wondering if I will withstand only 3 doses of Ra223.
I not had any bone fractures yet, but I guess the pain will tell me if and when a bone breaks due to Pca and I sure don't much like the idea of using metal plates, rods, screws et all if the Pca keeps destroying more bone.
Apart from high blood pressure at 73, I don't have any co-morbidity conditions that I know of. The medication for this has failed completely.
Anyway, it seems that Pca can destroy enough bone marrow to kill us, and the idea of treatment is to kill the cancer at a rate that is faster than rate of bone loss due to Pca. But Ra223 also kills some bone marrow where mets are, so just what happens after beginning Ra223 is anyone's guess, and the aggressiveness of Pca in bones is not the same for all men. So I have no idea if I'll be alive this time next year.
I've read some good things here about Ra223, but that does not mean I will get a good result with much extended lifetime.
BTW, I had 6 doses Lu177 during 2019 and 2020, it did seem to kill all soft tissue mets.
It also killed a lot of bone mets but then new bone mets appeared which could not be killed by Lu177 because these new mets did not generate enough PsMa which is the chemical produced by most Pca that allows Lu177 or Ac225 to be targeted by a ligand chemical that makes Lu177 or AC225 to gather at met sites to kill Pca with beta or alpha particle radiation. Ra223 depends on calcium traffic and radium replaces calcium where there is calcium uptake in bones. There's more calcium uptake at bone met sites, so radium is absorbed, but to do any good, radium has to be made more radioactive in a reactor than it is when found in nature, so it is made into an alpha emitter, and all bone mets may be killed by Ra223.
I'm not sure about bone density drugs being of much help where men don't exercise, and afaik, walking a mile day might be all that's needed, but many men and women have frail old bones because they just will not do any exercise.
During 11 years since diagnosis, I still don't have symptoms of Pca, and despite my Psa now at about 350. I am continuing to cycle a lot on a road bike, but have eased back from 200km+ week to about 150km, and I don't know if arthritis or Pca will stop me staying fit from the exercise.
Patrick Turner.
Thank you for all this info!
Did the doctors prescribe Xgeva or zoledronic acid (Zometa or Reclast)?
We’ve been doing Xometa every month.
You could consider treatment with Lu 177 PSMA and/or AC 225 PSMA. There are clinical trials:
clinicaltrials.gov/ct2/resu...
clinicaltrials.gov/ct2/resu...
Thank you, I’ve been reading about this one!
There also studies with Thorium 227, which is an alpha emitter like Ac 225
clinicaltrials.gov/ct2/resu...
Best of luck!!
How old is the horse.... cause you're the boss.... and what was his gleason score?
Good Luck, Good Health and Good Humor.
j-o-h-n Friday 04/09/2021 8:00 PM DST
He’s 53, Gleason 9
Thank you...Keep fighting.......
Good Luck, Good Health and Good Humor.
j-o-h-n Friday 04/09/2021 8:08 PM DST
Such a man man Johnny!😩
53Dam! Same as I was upon dx. Brutal 😩
I’m taking denosumab, it seems to be helping heal a rib that has been broken for over a year due to a PC bone met.
I M on the prolia myself.. heal up from that break. Ouch!✌️
He’s really in the heat of the battle. Prayers to him and to the twins mama in wv.. This is a fear of mine also from pc treatments .. I’m sorry for this Dammed disease and his suffering .🙏
It’s interesting, had follow up yesterday and got staples out. Dr said pathology report showed no cancer at the break site?! So thinking bones weakened from treatment?? Dr described the bone as porous. Not what we expected to hear
Was you husband engaged in some activity or is it just bone weakness from the treatments he's received?I'm 55 and May will be 2 years since diagnosed G9
Lifting a 12 pack of bottled water and his humerus snapped
That’s is scarey ! 😳
Ohhhh!
Update to Can't treat what we can't see
rising PSA and 'light' advancement of mets in hip bones. Diagnosed stage 4 in March 2021.
Docetaxel 111(2)
Painful Mets to ribs. Radiation or operation.
ADT + Docetaxel
