lesions on liver and neoplasm mass i... - Advanced Prostate...

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lesions on liver and neoplasm mass in bladder

Muffin2019 profile image
38 Replies

just had results in scan shows multiple ill defined low attenuation lesions in the liver of varying sizes with the largest measuring about 13 mm highly suggestive of metastatic disease. Enlargement of fungating mass in the base of the urinary bladder compatible with neoplasm,either prostate or bladder. Not good news, how do you treat both of these, I have had on occasions passing of blood and once blood clots ? How do they treat the liver lesions and can you have bladder cancer as well as prostate cancer ? It looks like chemo is on the table again and how effective is chemo on liver lesions ? Do they biopsy the bladder mass and how do they cure if it is bladder cancer or could it be prostate cancer that has gone into the bladder ? Any information will help plus what type of chemo do they use ? Can the lesions in the liver be destroyed with chemo ?

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Muffin2019
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Tall_Allen profile image
Tall_Allen

It is most likely prostate cancer that has spread to the base of the bladder. They can biopsy (histology, IHC and genomics), which should provide some clues about the type of PCa you have and the clinical trials that might help.

Discuss the combination of carboplatin and Jevtana for your next chemo:

ncbi.nlm.nih.gov/pmc/articl...

Muffin2019 profile image
Muffin2019 in reply toTall_Allen

That is what he plans on then do a PET scan then pluvico after the chemo, how tolerable is that combo and will it eliminate the liver lesions ? Do you know of the side effects of that combination, how many weeks apart are the infusions ?

Tall_Allen profile image
Tall_Allen in reply toMuffin2019

All I know is what is published in that study.

Aye chihuahua Muffin ! I’m sorry for this liver involvement? ..it could be pc ? Anytime an organ is involved it’s serious . I had pc tumors blocking my urethra and my bladder . Imrt w/ double adt took it all way for me . It was hell . Tubes and a foley for 18 months . I think that my doing high dose C ivs bi weekly with other natural remedies during that time helped me out also? I pray for you to get better! 🙏😔. Hang in there! 💪

Muffin2019 profile image
Muffin2019 in reply to

Thank you, I am planning on the biopsy, no fun but a necessity, there are no bone lesions so a bright spot, been on xgeva for over a year and lupron since 2018, arbitrone failed after a year and half and xtandi is not working. Want to do chemo as soon as possible to hit it hard early, the liver lesions has shown up since the last scan in May, been 3 months on this scan from that one.

in reply toMuffin2019

Oh boy! Hang in there dude! 🙏❤️

EdBacon profile image
EdBacon

I agree about doing a biospy and IHC on the cancer to see which type of chemotherapy would be appropriate. If there are small cell features, then adding Carboplatin would be indicated. Otherwise Jevtana (second-line chemotherapy) alone.

I'm on Jevtana now, one week after first infusion. The side effects have been fairly mild for me and it reduced my intense hip pain down to nothing in less than a week. Seems to be working for me, but I'll know more when we look at the blood tests and imaging.

Muffin2019 profile image
Muffin2019 in reply toEdBacon

Keep us posted as I will. He plans on using both as you are, my latest PSA is 49.8 from 21, is it going to lower your PSA ? How often are your infusions and how many of them are you doing ?

EdBacon profile image
EdBacon

I'm only doing Jevtana at this time. Infusions are every 3 weeks and my doctor said he would give me up to 10 cycles. He said he doesn't want to beat up my bone marrow too badly so that I could take other treatments after. The typical number of cycles you have before it stops working is somewhere around 5 or 6. Of course, some go much longer so you could always get lucky.

PSA response from a recent clinical trial with Jevtana was:

After four cycles, 34.6% of men achieved a PSA decrease ≥ 50% and 49.6% a decrease ≥ 30%.

PSA response is generally associated with prognosis, but more importantly is the Overall Survival. My doctor likes to say we're chasing the cancer, not the PSA.

Below: Kaplan–Meier plots for progression-free survival (a 50% cut-off; b 30% cut-off) and overall survival (c 50% cut-off; d 30% cut-off) among prostate-specific antigen (PSA) responders and non-responders

Charts
Muffin2019 profile image
Muffin2019 in reply toEdBacon

Thank you, your doctor seems on top of things by chasing the cancer and not tgr PSA, are you still working ? Hopefully the side effects are mild for me also, when I did doxentol in 2018 I had virtually no side effects, only thing I did was to eat a piece of fried chicken but had pills for the nausea.

EdBacon profile image
EdBacon in reply toMuffin2019

For me, Jevtana has been about 1/3 to 1/2 of the side effects of Docetaxel. I'd guess you'll find it easier. I've been a bit more tired, but no nausea, flu-like symptoms, etc. I don't know about Carboplatin (if you are getting that). Never had that one. My doctor won't give it, unless indicated for NEPc variants. There was a phase 2 trial that showed an improvement for MCRPc wth both Carboplatin and Jevtana vs. Jevtana. As far as I know, there hasn't been any completed phase 3 trials though, and that's what my doctor goes by. He told me that adding Carboplatin is a "tough regimen", but you'll have to see for yourself. One, and only one cycle at a time. To me, if you had no trouble with Docetaxel that's a good sign you'll handle it OK.

I'm not working.

Muffin2019 profile image
Muffin2019 in reply toEdBacon

Just found an article on liver lesions, very bad and if it cannot be stopped it is life threatening, bad luck again. Do not know if anybody on this site has posted their experience and are they still alive. Good thing I got my affairs in order years ago.

in reply toMuffin2019

Shit! 😳

tallguy2 profile image
tallguy2 in reply toMuffin2019

I developed liver, lung tumors in March. Two brain tumors were resolved with GammaKnife. I also have a 2” tumor on my L3 vertebrae. Indeed life threatening but I am taking everything that MD Anderson Cancer Center can infuse into me.

Muffin2019 profile image
Muffin2019 in reply toEdBacon

I think I am getting both , will know more on tuesday.

leebeth profile image
leebeth

My husband had 8 cycles of Jevtana/carboplatin from January to June this year. His PSA went from 41.3 to 2.7 during that time, and fell to 2.1 by this week. He tolerated it extremely well, except for one short episode of neutropenic fever. No other side effects at all. He worked throughout the entire time. In prep for Pluvicto, he was put on Xtandi to increase PSMA expression, and his scan this week did show some liver mets. I figure it was there and ten days of Xtandi just made it light up. He had his first Pluvicto today, with post treatment scan in the morning.

Muffin2019 profile image
Muffin2019 in reply toleebeth

I hope all goes well, very encouaging that I need now. Did he stay on xtandi trough the treatments ? Good luck with the pluvicto , keep posting on his progress. If these treatments fail what next and will be on xtandi from now on ? Hopefully I will tolerate it well,, what is Neutropenic fever and how did he get that ?

leebeth profile image
leebeth

Glad I can help by sharing our experience. This was his first treatment. Right now, the plan is to stay on Xtandi throughout this time, at least. I imagine he will stay on, if his response is good. Next on his treatment options would be Keytruda, as he does have a high mutational tumor burden according to the Guardant 360 test he had before chemo in January. He had another drawn before starting Pluvicto, and it will be checked after every 2 treatments, as well as a PSMA scan. After each treatment, he receives a post treatment scan to see where the Pluvicto attached and make sure it is going where it needs to go. (That is my understanding, anyway.) Not sure this will affect his treatment, or is giving them info for future dosing adjustments, but personally I think all data is helpful.

Other than Keytruda, in a short 16 months he has pretty much run the gamut, so we would be looking at clinical trials. AMG 509 interests me. He retired July 1, so now we can go wherever we need to go, as long as we are healthy enough to travel.

I was just diagnosed with breast cancer, and will begin chemo next week. (Already had surgery.) Balancing our treatments and squeezing in fun is challenging! However, my husband feels better than he has in months. He is getting daily hyperbaric oxygen treatments for severe radiation cystitis. They are working great. The hematuria has stopped and his Hgb is going back up. So he has energy, and golfs whenever he can!

Neutropenic fever is a potential complication of chemo, with a fever, and an absolute neutrophil count <400. He was hospitalized, given IV antibiotics, and felt better in no time.

It was scary though! I had taken my brother for his PSMA scan. Came home to find him in bed, with a raging fever. I could hardly get him to wake up enough to walk to the car! He rebounded quickly, though. But it was a good reminder to keep an eye on body temp during chemo!

Muffin2019 profile image
Muffin2019 in reply toleebeth

Thank you fir your information, so sorry for your diagnoses of breast cancer, I pray and hope you beat it. An ex boss a couple of years ago went through her 3rd run with it and is doing good, another worker I know has gone through chemo for her bout with cancer, she has had 3 different cancers the last one cervical. Glad your husband is doing good despite this terrible disease and I pray for both of you continued success with the fight against this beast of cancer. God bless both of you.

leebeth profile image
leebeth in reply toMuffin2019

Thank you for your prayers. My prognosis is great; this is just a hurdle to get through. And a scheduling nightmare! We can compare ports, soon. 😊

Muffin2019 profile image
Muffin2019 in reply toleebeth

Never had a port but will probably have to have one now, the woman I mentioned has a dual port and will stay with her fir awhile. At first the port seemed a little scary but I read an article on it and she told me of her experience with it, just wondering if I can drive myself home after it is done as my roommate of over 24 years does not drive, he is also my support buddy. I understand that the local cancer society have people that can take you places in this situation and if nit there is uber.

leebeth profile image
leebeth in reply toMuffin2019

A great question! My husband did indeed drive himself home. I usually met him there to spoon feed him ice, since his hands were in gel mitts, and then he drove back to the office. Occasionally he took the day off and we went together, but that was a rarity. He felt fine. It’s reassuring to know you can Uber home if you don’t feel up to it.

leebeth profile image
leebeth in reply toMuffin2019

You will not, most likely, be able to drive home after port placement as they usually use a twilight sleep. They will insist someone be with you. So maybe you and your roommate can Uber together.

EdBacon profile image
EdBacon in reply toMuffin2019

I just had a port placed and then right over to chemo for my infusion, only enough time in between for some food . I had a bit of anxiety over the whole thing, felt like we were rushing, but it wasn't difficult. Meanwhile my cancer was growing and bone pain was still getting worse, the day after infusion was the worst. So glad I didn't wait even a day more because the Tuesday after infusion my pain was gone.

And yes you do need a driver that day.

Muffin2019 profile image
Muffin2019 in reply toleebeth

Luckly i do not need a port yet, 3rd treatment this past week, 3 day crash not fun, finally retiring the end of this month after working part time, life begins.

leebeth profile image
leebeth in reply toMuffin2019

Congratulations on retirement! My husband retired July 1. It’s quite an adjustment!

Muffin2019 profile image
Muffin2019 in reply toleebeth

How is he doing, the third day of body aches in the joints is not good, tynenol does not make it, cannot take nsaids, any suggestions. An adjustment that i am looking forward to, had enough of work and the company.

leebeth profile image
leebeth in reply toMuffin2019

Did you receive Neulasta or one of the other growth factors? Claritin helps a great deal. My husband never experienced it, but I did after my first dose. I was more careful to start the Claritin a few days ahead this time and no problems.

Muffin2019 profile image
Muffin2019 in reply toleebeth

Will try that and will ask about the meds for the body aches for the 3 days after chemo.

leebeth profile image
leebeth in reply toMuffin2019

the Claritin is the med for the body aches. Good luck!

Doseydoe profile image
Doseydoe

9 bags of Chemo (docetaxel) and ADT ( Casodex and Eligard) had little effect on the PCa tumors growing inside my Bladder. What eventually got it under control and allowed the Uretural stent to be permanently removed was a TURBT and 20 sessions of VMAT radiation. All the best, DD 😎

Muffin2019 profile image
Muffin2019 in reply toDoseydoe

Wow, if they have to do radiation to get it under control then so be it, did the radiation get rid of it permentaly ?

Doseydoe profile image
Doseydoe in reply toMuffin2019

Yes it did when combined with a TURBT procedure.

Bacana profile image
Bacana in reply toDoseydoe

What is a TURBT?

Doseydoe profile image
Doseydoe in reply toBacana

A Tran Uretural Resection of Bladder Tumor. They go into the bladder via a cystoscopy and do some house keeping, cheers 😎👍 DD

Muffin2019 profile image
Muffin2019 in reply toDoseydoe

Will keep that in mind, thanks

tallguy2 profile image
tallguy2

I too have a (growing) tumor in my bladder. I was provided with palliative radiation treatment (15 weekdays) to eliminate the bleeding and passing of blood clots. I got three months of relief and back came the bleeding. I wish I had a plan of attack but any surgery would take me off my trial drug for many months. Plus full bladder removal doesn’t sound like fun.

"So I'm not going to pre-worry. You just have to deal with life as it comes”. Great advice from a fellow cancer patient!

Muffin2019 profile image
Muffin2019 in reply totallguy2

He is going to start me on javenta this week, he will discuss the bladder issue tomorrow. I have had 4 times blood in urine but drinking alot of water went back to normal, only passed 2 small blood clots a couple of months ago. He wants to get the liver Mets first I think. More questions to him but the survival time with treatment when looking at articles is 1 year 4 months, nit a good outlook.

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