Hi All,
My fathers have completed all does of LU177 and PSA is under control and the body pain is severe . After pet CT. doctor is suspecting Neuroendrocrine prostate cancer and asking us for biopsy again.
Can anyone tell us what is it and what's the next treatment option can be .
He already had undergone firmagon abiraterone , lu177 .
Thanks
Neuroendocrine PCa is rare. It is an aggressive variant, difficult to treat. Let's hope the biopsy shows no neuroendocrine tumor.
You could get the bones radiated to mitigate the pain.
Thanks for the response GP24 .
Can I ask if chemo may work upon it?? Isn't it an option
I think a combination of two different chemos work on it for a while. Hopefully TA or GP24 can give you some guidance. Hoping for the best for your Dad.
Usually this is treated with Chemo + Carboplatin. Please wait for the biopsy results, so far you just have the opinion of your doctor that it may be worthwhile to check for neuroendocrine PCa.
Chemo is the best treatment, usually a combination of a Taxane and a Platinum such as: Docetaxel or Cabazitaxel+ Carboplatin or Cisplatin. Other combinations are possible depending on what they see in the biopsy.
Thanks EdBacon GP24 NickJoy for your advice . Appreciate you have consider me and grant me your valuable time in replying .
A biopsy can confirm. Here are some clinical trials.
prostatecancer.news/2016/12...
Thanks Tall_Allen as always you are there for us to revert
Neuroendocrine PCa is when the the cells begin to look like a neuron with long tendrils. My cancer is in an intermediate state where the biopsy shows genetic mutations indicating neuroendocrine differentiation but the cells still look like prostate adenocarcinoma. This state is being labeled “amphicrine.” Today I am going in for my 6th and last docetaxel + carboplatin infusion and it has worked well for me. I am still asymptomatic. The treatment has put my ski season on hold because of the low hemoglobin caused by the tx. Hoping I can get out in the spring!
Thanks TeleGuy
I had a biopsy that showed Small Cell cancer in tumors on the lining of my left lung 5 years ago. The mistake I made was assuming that all of the adenocarcinoma had morphed into SCC. I was treated with Carboplatin and Etoposide and the Neuroendocrine cancer stopped growing. A massive amount of fluid that kept accumulating in my chest also stopped forming.
Now, 5 years later it is my adenocarcinoma which has become active spreading to bones. My pleural tumors have not changed at all.
Thanks DenDoc for you advice and wish you a happy new year to you and your loved ones
I just read your report about the Etopside and small-cell. Five years ago! I think this is the road I will travel as LU177 has failed and PSA has spiked.
Wish you a very Happy new year to you and your loved ones . I pray to God for a great year ahead .thanks GP24 Tall_Allen TeleGuy EdBacon NickJoy
You may want to check out 177Lu-DOTATATE Peptide Receptor Radionuclide Therapy, which is used specifically for neuroendocrine cancers. Here is a link to one of the studies. Dr. Sen at Fortis Hospital in New Delhi works with this therapy. pubmed.ncbi.nlm.nih.gov/315...
Pet ct report attached . Also biopsy
Got the biospy report and pet ct scan report..Dr said nothing is there and now there are putting it on Docetexal. He suggested to start 1 cycle of Docetexal on 17th.
Hi Abhishek , but biopsy didnt show us anything....now doctor suggested to start his chemo session. Docetexal 1st was given on 17/01 and 2nd was given on 08/02.
Hi All,
My father was given Docetaxal after this , but no benefits looks like...his pain is increasing after 3rd chemo...he is getting pain even after he is coughing ...any advise pls..
Tall_Allen GP24 any suggestion...pain in severe in his case
You wrote: "After pet CT. doctor is suspecting Neuroendrocrine prostate cancer and asking us for biopsy again." This biopsy did not show any tumor so it is still unclear if there is neuroendocrine tumor. Bone biopsy is difficult and often unsuccessful.
I think he should get pain meds now for mitigating pain and then plan the further treatment with his doctor.
Hi GP24 , as my father is not able to stand up as his lower part is unable to work.
Dr. said this is majorly due to spinal cord compression. Due to which he is not unable to stand up and walk properly .
He gave Dexa 4 mg today and asked us for pet ct again , so that he can give radiation at that point...we are in tension as this is the same condition which was in 2019 while cancer detection first time.
Hi GP24 and Tall_Allen ,
My dr. Was very negative today about his health. He clearly said that he don't have much treatment after this . He is not able to walk /stand up. Dr. Said this is a critical situation and time is not so good.
Although he is trying and giving me with Dexa and radiation(5 day) and D3 D4 .
Can you please suggest me anything in this situation. I understand ,m regularly poking you guys , but thanks to you and this group in which we can share our feeling .
It is possible to mitigate spinal cord compression with surgery. There are doctors who specialise in this type of surgery.
Hi GP24 , thanks for your support.
Will appreciate ,if you can please suggest me any name of any Indian doctor who can perform this surgery. Thanks
I tried for surgery with neurosurgeon but he said there is nothing like spinal cord compression so surgery is not suitable in this case.
My question is if there is no spinal cord compression why he is not able to stand up.
Also ,pet ct showed that there is a compression on D3 ,D4 .
GP24 can you help me here to understand this and any solution if possible . Attached MRI and Pet ct.
The new PSMA PET/CT concludes: "extending into the spinal canal with compression of the cal sac". This will be the reason why he cannot walk. You wrote: "I tried for surgery with neurosurgeon but he said there is nothing like spinal cord compression". Apparently he did not read the report of the PSMA PET/CT. Get a second opinion! After surgery a Lu177 Lutetium therapy would make good sense for your father to attack the metastases all over the body.
Hi GP24 Tall_Allen thanks you were always with me till his end.
A life so beautifully lived deserves to be beautifully remembered.
With great sadness, I announce the loss of my beloved father on last 02/06.
He fought well , but everything is planned by God.
🙏 Thanks
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