Need your recommendation for oncologist for pc advanced

[Soumen79]

At 41 started fighting with ca prostrate with bone mets

189 psa, gs 8, spread to pelvis and skeletal. 5th March 2021, I got diagnosed, got castrated March 18th, first chemo with docetaxal on 6th April - psa since then they are in ng/ml

6April21-2.26

27April21-0.465

18May21-0.213

8June21-0.15

29June21-0.074

20July21-0.113

10 docetaxal chemo planned, 3 weekly basis, 6 done, 4 to go.

Currently living in India, I am in search and recommendation for oncologist specialist in pc advanced, as I understand from this forum that oncologist goes a long way to sort out the complex treatment path. Please share your recommendations.

Thanks!!

[Tall_Allen]

Consider combining with abiraterone.

[Soumen79 in reply to Tall_Allen]

I referred peace 1 trial to my doc. He said he is well aware of that but he want to keep abiraterone for later, not sure what he means. Btw I did the castration, the permanent adt. Will abiraterone and other various hormone therapies still be applicable for me?

[Hidden in reply to Soumen79]

I think you need to get a definitive answer from your oncologist regarding his mindset on why he doesn't want to add zytiga. It could be something in you medical history or it could be just personal and legitimate medical decision. One you get that response you can decide if a different oncologist is in your best interest.

[Hidden in reply to Hidden]

I wonder if cost is an issue. Could a pharmaceutical company in India supply this medication?

[Soumen79 in reply to Hidden]

Yes it is very familiar medicine in India and cost is also manageable.

[Tall_Allen in reply to Soumen79]

Yes, abiraterone is ONLY given along with chemical or physical castration. Your doctor is quite wrong to keep anything for later. Medicines work better and have fewer side effects if used earlier.

[Soumen79 in reply to Tall_Allen]

Got the point, will definitely discuss with more stress in my next chemo date which is 10th Aug. Thank you..

[Soumen79 in reply to Tall_Allen]

Hi TA

My doctor, on my 7th chemo and 3 more to go, is offering Abitaterone, psa today is 0.05 - down from 0.11 on 6th chemo and 189.6 at diagonosis

One question to you, given that I am only 41, if i start arbitaterone now, am I not exhausting my second line of defence too early? Can you weigh pros and cons?

[Tall_Allen in reply to Soumen79]

(1) If we have learned anything in the last 10 years, we have learned that for metastatic men, all therapies used earlier have more survival benefit (and lower side effects) than the same therapies used later. So you can take abiraterone now and add maybe over 2 years to your life, or you can save it for later and add about 3 months to your life.

(2) Look at the pace at which new therapies are becoming available. There is no chance of that slowing down.

[Soumen79 in reply to Tall_Allen]

Thank you TA. Your second point suggests that

1. I have other second line of defences already

2. Thay second line of defence should be added with more treatments in next years given to me by this adt+chemo+abiraterone

Am i interpreting you correctly?

[Tall_Allen in reply to Soumen79]

There are other treatments you have not yet had, and many more in clinical trials.

[Soumen79 in reply to Tall_Allen]

Thanks TA, lets hope for the best.

[DarkEnergy]

I've had great success treating my advanced (metastatic) prostate cancer with adding chemo to abiraterone (hormone therapy).

[Soumen79 in reply to DarkEnergy]

Yes I saw your profile. I mentioned abiraterone and peace 1 trial to my doc but he wants to keep it for later. Not much explanation given though.

[Schwah in reply to Soumen79]

He’s dead wrong according to the science. He’s living in the past. Early use proven to extend life. He can point to no legit phase 3 study out there that shows otherwise.

Schwah

[sdnb]

Hello, I can highly recommend a fantastic oncologist if you are able to travel to Atlanta. He is Dr. Omer Kucuk with the Winship Cancer Center at Emory University Hospital. Actually he moved his practice to St. Joseph's Hospital, I believe that occurred in late spring of 2015. You won't find a doctor with more knowledge and compassion than Dr. Kucuk.Best of luck to you. May God bless you with successful results every time.

[Soumen79 in reply to sdnb]

Thank you for the recommendation, will try to connect him.

[Soumen79 in reply to sdnb]

Will you please provide me any contact number and/or email id so that I can reach out to him?

[Rodeoz15]

I have had a good experience with Dr AP Joshi at Tata Memorial Hospital in Mumbai. We have primarily been doing teleconsultation with him. He explains the diagnosis at length and patiently listens to all your questions.

Had a rather poor experience with Dr Talwar (and his team) at Rajiv Gandhi Cancer Institue in Delhi. Won't recommend that place to anyone.

[Soumen79 in reply to Rodeoz15]

Thank you for the reco!

[Cooolone]

Saving Abiraterone for later is not what the PEACE-1 study showed. So if he is aware of it, he would know that adding it to the ADT/Docetaxel basically increased the duration time to progression by twice the time when not using it.

Therefore there is no sound justification for not using it, when aware of the PEACE-1 trial results!

The question is and always should be:. By adding this, is it beneficial to the patient? And here the answer is YES, in a resounding manner!

I would also let the doctor know that it's your choice, not his... It's your life, and your decision! And unless there is some serious reason to deny it, he should support your decisions because there is data behind it as well. This isn't a stab at the dark, something unknown. It is new, yes, but significantly improving a treatment plan from what was done before. Not even a new drug, just a new method with already approved drugs!

Wishing you the best of luck and regards!

[Soumen79 in reply to Cooolone]

Got the point, will definitely discuss with more stress in my next chemo date which is 10th Aug.

[Soumen79 in reply to Cooolone]

Hi Cooolone

My doctor is now offering arbitaterone to add with chemo and going forward. So for last 4 chemo I will be with adt+docetaxel+arbitaterone.

Thank you a lot the pursuance

[Poowater]

Look up Medical Oncologists in your neck of the woods.

[Helllfire]

hi , can please explain why you have taken 10 docetaxel cycle , when the standard are 6 cycles only.

My father is 55, metastatic is given 6 cycle protocol.