5 months on from initial diagnosis - Advanced Prostate...

Advanced Prostate Cancer

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5 months on from initial diagnosis

Ianrs profile image
14 Replies

Diagnosed early February 2021.

3 months of "up front" Enzalutamide and 4 months of Zolodox.

No adverse side effects.

Mid June PSA down to 0.19 (20/1/21 = 64.7, 18/5/21 = 0.33) and first testosterone measure <0.5 (normal range 7 - 26).

All other blood indicators in normal range except red cell (4.11 v. 4.5 to 6.5), estimated GFR (69 v 90 to 120 but compares to 61 0n 7/1/19).

Next blood test 15 July

Oncologist appointment early September to discuss local radio therapy (36 gy in 6 factions).

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Ianrs profile image
Ianrs
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LearnAll profile image
LearnAll

Your treatment seems on right trajectory. PSA is falling dramatically...indicating prostate cancer cells are dying en masse. Some decline in red blood cells is a common side effect of Zolodex. It is called "anemia of ADT" Hb can decrease by about 1 point and then, it stabilises.

A good sign in your data is that your Testosterone has gone down very low. Lower T goes with ADT, longer the person lives. Its called Nadir T..lower the better.

Tall_Allen profile image
Tall_Allen

Any metastases?

Ianrs profile image
Ianrs in reply to Tall_Allen

3 - 1 small one right shoulder and two in pelvis - one of which is small. 67 years old.

Tall_Allen profile image
Tall_Allen in reply to Ianrs

so debulking the prostate might be beneficial.Stay on enza until it stops working.

londoncyclist48 profile image
londoncyclist48 in reply to Tall_Allen

One thing that I have always wondered, when the metastases get attacked by the enzalutamide, does new bone grow in its place to replace the tumour? Or is it a lot more complex than that? I also have a patch on my rib (although NHS doctors in the UK tell you little).

Ianrs profile image
Ianrs in reply to londoncyclist48

I am gong to ask a few questions when I meet the oncologist on Sept 1. I do not understand the met process or the treatment e.g will the radiation be directed at them or be limited to prostate, in addition to 3 mets identified ( 2 small) what are the possibilities that there are undetected mets, and what is the prognosis after radiation given my PSA down to 0.07. I am very happy with the oncology department (Newcastle / Carlisle with its brand new cancer centre); I was not too confident with the urology department.

londoncyclist48 profile image
londoncyclist48 in reply to Ianrs

My radiotherapy was purely on the prostate. My guess is yours will be too. Recommended. Nukes the source. How did you manage to get so much information? Private patient? I'm NHS so they tell me little but, I must admit, I prefer it this way. If I knew all my numbers, I would be sitting here worrying about it.

Ianrs profile image
Ianrs in reply to londoncyclist48

NHS in Carlisle. I get a blood test very month before receiving my monthly supply of enzo and they give me the print out. My oncologist described the mets and offered to show me on scan (declined). Did you see article in The Times on talozoparib?

lcfcpolo profile image
lcfcpolo in reply to Ianrs

Hi. It certainly sounds like a great centre. I have to write to Medical Records (Leicester Royal Infirmary) every month to get my monthly blood reports posted out to me.

I think Londoncyclist and yourself have what is called 'low burden' under 5 bone Mets. You both therefore qualify for radiation etc. which hopefully gives you an even longer response 😀. Alas I do not as 8 Mets at least.

Talozoparib. Was it in today's or another days Times? Just googled it. Looks promising, particularly if DNA mutations. Did you get checked for BRCA1 or BRACA2 etc? Sorry for all of the questions.

Ianrs profile image
Ianrs in reply to lcfcpolo

Hi. Today's Times. Yes .. just (!!) 3 mets. I don't know how much lower PSA can get with hormone treatment. No knowledge of BRCA1 / 2

lcfcpolo profile image
lcfcpolo in reply to Ianrs

Thank you. It's worth asking your Oncologist if they will check for DNA mutations like BRCA2. Mine would not, as not NICE standard of care. However, COLOR in the USA do a saliva test if you wish to be tested. About $350 but DHL do drop off of test kit and pickup. It worked well. Best of luck with your treatments.

londoncyclist48 profile image
londoncyclist48 in reply to Ianrs

sunday august 22 2021

Personalised drug stops spread of prostate cancer

“I was told I had less than two years left”: Peter Isard’s treatment has transformed his life

“I was told I had less than two years left”: Peter Isard’s treatment has transformed his life

Andrew Gregory, Health Editor

Sunday August 22 2021, 12.01am, The Sunday Times

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Thousands of men with prostate cancer could benefit from a revolutionary drug after it was shown to stop the disease from progressing.

In a landmark global study, talazoparib — one of a new wave of precision treatments that target specific weaknesses in tumours — was demonstrated to freeze the progression of advanced prostate cancer.

Experts believe the drug, which is taken as a daily pill and is already proven to be effective in women with advanced breast cancer, could benefit thousands of British men every year.

They said the discovery was an “important step forward” for men with prostate cancer who would otherwise have “run out of options”.

The results of the first “phase two” trial of the drug, led by the Institute of Cancer Research in London and the Royal Marsden NHS Foundation Trust, showed it halted the progression of advanced prostate cancer by an average of 5.6 months — about twice as long as with existing treatments.

The treatment was particularly effective for men who are genetically predisposed to develop prostate cancer due to a mutated BRCA gene — the sort carried by the Hollywood star Angelina Jolie, which increased her risk of ovarian and breast cancer.

Using the drug delayed disease progression by an average of 11.2 months in prostate cancer patients who had faulty BRCA genes.

However, the treatment also worked for men with ten other DNA mutations. In some cases, the treatment stopped tumour growth completely.

The phase two trial is the first to demonstrate the safety and effectiveness of the drug for prostate cancer. It was so successful that a phase three trial is already under way.

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Despite rapid advances in the treatment of other cancer types, the number of men who die from prostate cancer is rising. In Britain, the toll is 11,900 each year — about 32 every day.

Personalised medicine breakthroughs have changed breast and ovarian cancer treatment, and experts hope prostate cancer sufferers can benefit from the same revolution.

This is the second personalised or precision medicine to be proven to work for prostate cancer, after similarly extraordinary results for olaparib.

Both drugs enable doctors to target cancer according to the patient’s genetic makeup, rather than the “one-size-fits-all” approach of chemotherapy and hormone therapy. The new wave of drugs, called PARP inhibitors, exploit a weakness in cancer cells’ defences to kill a tumour without harming healthy tissue.

This weekend Peter Isard, 61, a patient at the Royal Marsden, said he welcomed the talazoparib results.

The married father of three was told four years ago that he had less than two years to live due to his advanced prostate cancer, but has defied that prediction and been able to “live a normal life” with his family as a result of being included in a trial of the similar PARP inhibitor drug, olaparib.

“Six months after finishing chemotherapy in 2017, I was told my chance of living for two years would be quite low. I came to the Royal Marsden for a second opinion, and they found I had a genetic mutation that would make me suitable for an olaparib trial. I was on the drug for just over three years,” he said.

The retired stockbroker said being part of the trial had “allowed me to continue living my normal life, enjoying my hobbies of tennis and karate and spending time with my family.” He added: “I’m so grateful.”

Matthew Hobbs, director of research at Prostate Cancer UK, said: “Talazoparib is now among a handful of precision medicines that have been shown to be safe and effective at controlling advanced prostate cancer. We need to drive progress in this area as quickly as possible.”

The results were published this month in The Lancet Oncology journal. The study’s leader, Professor Johann de Bono, said: “These results are yet another demonstration that PARP inhibitors work well in some men with prostate cancer — delaying the spread of the disease and extending their lives.”

Tall_Allen profile image
Tall_Allen in reply to londoncyclist48

The way bone metastases usually occur with prostate cancer is the opposite of how you are thinking. The cancer causes bone overgrowth (sclerosis) rather than loss of bone tissue (lysis).

londoncyclist48 profile image
londoncyclist48

Interesting. Thanks.

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