My brother has advanced Prostate cancer

[rasher1]

Hi everyone,

I attached previous post about my brother. Since then he had one more PSA test which came back at 17! He has CT scan and bone scan, he had some new mets on his bones(spine) and they are suspected to some lymph nodes of chest. Currently he has hormone therapy every 3 months and Nubeqa. His MO told him at this point we can not do any thing and just clinical trials have left.

I want to ask some of you that are in the same situation that what is the next step? Unfortunately he failed the triplet therapy. We are so worry as he just began this treatment from October 2022 and now we are in this bad situation. Is there any hope?!

I wish all of you the best.

[Tall_Allen]

If he can get on a clinical trial for Pluvicto in Canada, that would be a good choice.

[rasher1 in reply to Tall_Allen]

Thanks for replying. Do you think that he has limited options? and I'm not sure about Pluvicto as he lives in Vancouver and I'm in Toronto. Is there any hope that Pluvicto works for him? It seems that his cancer is very aggressive.

[Tall_Allen in reply to rasher1]

IMO he should have both PSMA and FDG PET scans before Pluvicto.

[MarkBC in reply to rasher1]

I believe there is a Pluvicto trial based in Vancouver. His oncologist at the BC Cancer Agency should be well aware of it. The Chief Medical Officer and the Head of Research at BC Cancer are both prostate cancer experts.

[rasher1 in reply to MarkBC]

Thanks for letting me know. I hope they call him very soon for the next step.

[MiaAmia]

pluvicto is approved in Canada as soc post chemo; HOWEVER, no DIN# has been assigned so outside of clinical trials you have to pay for treatment. Our MO in Ontario has two wealthy patients getting treatment in BC at $27,000 per infusion. For us, it’s out of the question but if your brother has money, he’s in the right province. There is a trial getting underway in London Ontario but it is for those who’ve not had chemo. His MO or the hospital he attends should know what’s available locally and might have a team that oversees trial applications.

[rasher1 in reply to MiaAmia]

You mean in Canada just BC has this trial with Pluvicto? Not in Toronto?

[MiaAmia in reply to rasher1]

sorry to confuse. There are trials in various parts of canada including Toronto and in bc, but if you want to access the post-chemo treatment that you have to pay for, it appears only to be accessible in bc and maybe Quebec right now - sorry about the caps and punctuation - I’m on my phone and my thumbs are stupid 🤣

[rasher1 in reply to MiaAmia]

I got it! Thanks for your time. I talked with him. He has an appointment in the next 10 days. We have to see what is the next plan for him. Hopefully they can control it.

[Woodstock82]

Another option to look into is another chemotherapy drug, cabazitaxel.

I too got good results from Lupron and docetaxel. My PSA dropped to a nadir of about 1.5. Then it started to climb again, despite the continued Lupron. When it doubled after nadir, I was considered castrate-resistant, and that prompted my next set of therapies: daily oral abiraterone (+prednisone), and six infusions of cabazitaxel (each three weeks apart).

I got even better results from that. My last cabazitaxel infusion was in early March 2021. I am still on quarterly Lupron shots and daily abiraterone (+prednisone) pills. CT scans and bone scans show my cancer has not progressed at all. My PSA has been down around 0.01 for two years now.

[rasher1 in reply to Woodstock82]

Thanks for the information. Wish you all the best.

[Leader4077 in reply to Woodstock82]

With a PSA of 0.01, something is working. Maybe consider a daily Orgovyx pill to replace the 3 month Lupron shots……..very few side effects to go along with other treatments. “Early” chemo like Docetaxel is more likel to keep your PSA low.

Mike

Seattle

[bandgeek]

Not to be unkind, but if you are concerned, encourage him to speak with his oncologist!!

[rasher1 in reply to bandgeek]

Thanks.