Need help finding studies

[Tigger2022]

I’m trying to arm myself as we go to see my husband’s MO on 10/12, so hoping for a little help. I’ve tried to search this site, but I don’t really know what I’m looking for.

I think I filled out the profile with my husband’s info, and I’m sorry if it is too much information. We have been tossed around a bit, and we’re hoping to find an MO who wants to front load treatment, since that seems like what a lot of the current research recommends. Our first MO was with Northwestern (we live in the western burbs of Chicago) and was really nice and explained a bunch, but told us that 18(-24) months of ADT and doing the radiation was really all we could do. Then wait, and see what the PSA did.

And then the doc’s post-visit notes recommended Zytiga or to consider treatment with Docetaxel, or a bunch of other meds… all the stuff we had asked about but he had said wasn’t appropriate when we were in the office with him. (Argh.) So now we have another appointment coming up with a different MO, and I want to go armed with some papers to discuss. Our feeling is that while we know there is still cancer out there, he has no identifiable mets, and he’s also not likely to be stronger than he is now, going forward.

Thanks in advance.

[tango65]

Discuss having radiation the prostate fossa plus whole pelvis radiation (radiation to the lymph nodes in the pelvis ) and 2 years of ADT plus abiraterone as per the STAMPEDE study.

thelancet.com/article/S0140...

This trial included patients who had positive pelvic lymph nodes which is a difference with other trials of radiotherapy and ADT post prostatectomy.

[Tigger2022 in reply to tango65]

Thank you. I’m fairly certain this is happening. He’s about 1/2-way through radiation at this point, so it’s probably too late to pivot? Thanks for the article!

[tango65 in reply to Tigger2022]

He is already on ADT, they could add Zytiga at any time.

[Tigger2022 in reply to tango65]

It was weird — we went to the Northwestern MO for that reason. But he pretty much said, “no, just ADT for 18-24 months and the radiation, that’s all you can do!” And then called that night to mention Zytiga. I don’t know if he just didn’t want to treat my husband (although he said that wasn’t the case) or what, but it was weird. If he had said that adding on Zytiga and pred was the way to go, we’d have left with an Rx. But the whole thing has been so disjointed. Hoping that this new MO is willing to add in the Zytiga, since he apparently works with hubby’s RO all the time. (Although the RO said nothing could be added while hubby was having RT… but he *could* have the Zytiga, right?)

It’s frustrating. I guess I keep expecting someone to take the lead in his care, and no one is. So does that mean it needs to be us?

[tango65 in reply to Tigger2022]

I think he fits the protocol from the Stampede trial since he does not have distant mets and there was a positive pelvic lymph node.

[Tall_Allen]

It sounds like he is on a curative path. Be sure the RO is treating the expanded area:

prostatecancer.news/2021/05...

The SPPORT-HD trial (not yet published) showed that whole pelvic salvage + 2 years of ADT may be curative:

medpagetoday.com/meetingcov...

Consider signing up for the following clinical trial in the Chicago area:

clinicaltrials.gov/ct2/show...

[Tigger2022 in reply to Tall_Allen]

I really appreciate your input. This is exactly what I’m looking for, and this clinical trial sound like a great option. Will discuss this with my husband and the new oncologist.

[Shooter1]

Stay on top of it and you may get a cure. That would be great. Best of luck, most of us here are way worse off than your hubby, but lots and lots of info here. Best of luckl

[Tigger2022 in reply to Shooter1]

Thanks for your comment! Yes, I read daily on this board and am grateful for the info provided. I’m pretty sure if he hadn’t asked his doctor to run a PSA on him in January, that by the time he was symptomatic he’d have been like lots of you with multiple mets and fewer options.

[Darryl Partner]

Sign up for malecare.org/prostate-cance... Our AI will parse out current articles based on your interests. It's an easy weekly read.

[Tigger2022 in reply to Darryl]

Done. Thank you!

[MateoBeach]

adding abiraterone +p to the adjuvant ADT with curative intent expanded field SRT has not been demonstrated in a clinical trial yet (that I know of). But may be worth considering for the 18-24 Mo of ADT since it shows additional benefit in every other application and has become the SOC both in mHS and mCR. Don’t think benefit from adding docetaxel chemo is there in non metastatic, esp with low PSAs. But who knows given the good results of Triplet Tx in de novo metastatic setting. 🤷🏼‍♂️

[Tigger2022 in reply to MateoBeach]

OK, thanks. We got a little dazzled by the Decipher test that said his tumor is pretty responsive to docetaxel (and pretty much not at all sensitive to ADT) and are really still hopeful that there might be a chance for cure for him. Hoping the next MO is up for discussing all the most recent info with us.

[Tigger2022]

Just did so! Thanks so much!

[Tigger2022]

Thanks for your comment. And very best of luck and continued health to you!

[Darryl Partner]

You can also search scholar.google.com A glass of wine goes well with this.