PTH and aggressive PCa? I need guidance

[K-xo]

Hello, everyone! I can really use some guidance. My husband’s PTH (Parathyroid hormone) has been elevated since his Dx (pre & post treatments) Being that his blood calcium is at normal levels, his MO ruled out Secondary Hyperparathyroidism, and moved on. But that never sat right with me. Why the elevated PTH?

Recently, I revisited this in a google search. To my surprise, I found a lot of research linking elevated PTH & aggressive PCa. None of which is very encouraging. Here’s just one example….…

Prostate cancer, serum parathyroid hormone, and the progression of skeletal metastases.

pubmed.ncbi.nlm.nih.gov/183...

Correct me if I’m wrong, but wouldn’t it make sense to treat the elevated PTH? How does one go about “suppressing serum PTH”?………

“PTH promotes the growth and invasiveness of prostate cancer cells in bones….we propose that suppressing serum PTH in advanced prostate cancer may reduce morbidity by decreasing fractures and pain caused by bone resorption and may reduce mortality by retarding the progression of metastatic disease”

He hasn’t had a Vit D test in a few months, calcium fluctuates from a solid normal, to low normal. Kidneys appear to be good.

If his blood calcium remains normal, what’s causing the high PTH?

More importantly, is there a successful method to treating this?

Should he have a urine calcium test instead? Is there a solution, if he were to have low calcium?

Wouldn’t adding D & calcium supplements be counterproductive to PCa bone mets?

As you can see, Im on PTH information overload. Im hoping you smart medical researchers can break this down for me in layman’s terms. Or, maybe some of you can share your experience with this. Any info I can present to his MO, would be greatly appreciated. MO is usually open to suggestions.

Meanwhile, he’s having a PSMA scan tomorrow. Chemo may not be working out for him. As soon as we know more, I’ll add another post. Ugh

Grateful for all you incredible people. I look forward to your thoughts

Ps. Hubs in his 50’s & mCRPC. Lucky us

[Tall_Allen]

It may be a result of Zometa? Is his serum Vitamin D adequate?

[K-xo in reply to Tall_Allen]

Thanks for your reply, TA! I also read about PTH & Bisphosphonates , but his PTH was elevated at Dx, prior to any treatments. That said, it did rise from 88 to 105, sometime after treatments began. No idea if that was a result of Zometa. Vit D will be checked in a couple weeks. If it’s low, would you recommend supplements?

[Tall_Allen in reply to K-xo]

Of course, supplement Vitamin D if it is low.

[dockam]

aacrjournals.org/cebp/artic...

[dockam]

link.springer.com/article/1...

Previous studies reported an association between chronic parathyroid hormone (PTH) excess and breast, gastrointestinal, kidney, and thyroid cancers [13,14,15,16] and PTH in excess was shown to favor tumor invasiveness with increase in bone metastatic burden [17]. PTH increases the availability of cytokines, such as interleukin-6, tumor necrosis factor-α, and growth factors (transforming growth factor-β) in the bone microenvironment [18], possibly influencing the growth and survival of disseminated cells from tumors (e.g., breast cancer and PC) frequently homing the bone marrow [19] and even potentially favoring the resistance to chemotherapy and hormone deprivation therapies [20, 21].

[K-xo in reply to dockam]

Ugh, great! Leave it to my hubs to make this PCa Dx, even more complicated. Here’s what doesn’t make sense…

Apparently, an elevated PTH is NOT uncommon in PCa. So why isn’t there an SOC or at the very least, more research? The Hubs went to a PCP upon Dx. This doc happened to give him every blood test known to man. Otherwise, we never would have known about his PTH. Which begs the question, should PTH automatically be tested upon a PC Dx?

Your attached link also reads………

“calcitriol and analogues that suppress PTH without inducing hypocalcemia could play a complimentary or alternative role to bisphosphonates in fracture reduction in prostate cancer, as has recently been proposed for the combination of calcitriol analogues and bisphosphonates in osteoporosis”

My brain wants to explode reading all of this. Can you or anyone explain what a possible treatment is in Layman's terms? Is this just in mouse models or people? Can this be controlled?

Researchers, do you see this? Seems like there could be a solution to potentially prolong lives, give QoL and maybe prevent PC from becoming advanced. No? I’m just a mere mortal, but it appears, I may have been on to something w/ his elevated PTH all along. Am I off base?

I’ll show this to his MO, but anyone feel free to chime in. I’m even more confused and discouraged.

Ugh Randy, now what?

[dockam in reply to K-xo]

mayoclinic.org/diseases-con...

[dockam in reply to K-xo]

hyperparathyroidmd.com/can-...

[dockam]

stlukes-stl.com/health-cont...

[K-xo in reply to dockam]

Haha way to dumb it down by giving me more reaseach to read, doc! Although I don’t know for sure, I don’t believe his calcium will be elevated. If not nomocalcimic, it will prob be low. His blood calcium is now running at the lowest of normal. You know I’ll be calling you this weekend. Thank you!!!

[Carlosbach]

Sorry to hear about your hubs complications. The two of you are already facing way too many challenges.

Don't have any advice, Randy already strained my pea brain with his links, but good luck with the scans today.

[K-xo in reply to Carlosbach]

Awe thanks, CB! Just trying to hang on to this PCa rollercoaster, like everyone else here. Psma scan done & hubs doing well. He’s enjoying the morning outside working on his vegetable garden. We should have radio active tomatoes in no time. 🤔

[j-o-h-n]

It's miles above my pay grade....... but I'd like to quote Leo Buscaglia “Worry never robs tomorrow of its sorrow, it only saps today of its joy.”

Good Luck, Good Health and Good Humor.

j-o-h-n Friday 07/07/2023 7:17 PM DST

[K-xo in reply to j-o-h-n]

Thank you for this, John. Everything you say brings me joy.…

Now go clean yourself up and take your wife out for a nice dinner tonight

[j-o-h-n in reply to K-xo]

Thanks, good idea.....and Costco is open late tonight............

Good Luck, Good Health and Good Humor.

j-o-h-n Saturday 07/08/2023 12:58 PM DST

[K-xo in reply to j-o-h-n]

Lol… While you’re at Costco, you can pick up some fresh bedding. I suspect you’ll be sleeping on the couch again tonight You’re always two steps ahead, John 🤔

[j-o-h-n in reply to K-xo]

couch? cage!!! with one hotdog!

Good Luck, Good Health and Good Humor.

j-o-h-n Saturday 07/08/2023 3:43 PM DST

[j-o-h-n]

Good Luck, Good Health and Good Humor.

j-o-h-n Saturday 07/08/2023 10:40 PM DST

Chocolate chip ice cream (two scoops)

[K-xo in reply to j-o-h-n]

Two spoons! I love that you two share your ice cream. What a great photo of everyone.

[j-o-h-n in reply to K-xo]

Fooled you again.......both spoons are mine......

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 07/09/2023 1:32 PM DST

[dockam in reply to j-o-h-n]

I use chopsticks when I eat ice cream youtu.be/zoYY-vzj2Do(Not working as expected?) JK

[j-o-h-n in reply to dockam]

Required when you're eating chocolate chopped ice cream (two scoops)..

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 07/09/2023 5:43 PM DST

[K-xo in reply to j-o-h-n]

Two scoops, one spoon. Unless you’re sharing 😜

[j-o-h-n]

That's a picture from H U posted 4 years ago. The wonderful couple to our left is Vikkie and her dear recent departed husband Dondee.

j-o-h-n Saturday 07/08/2023 10:48 PM DST

[j-o-h-n]

TO K-xo

Like breasts............ one spoon to lick.... the other to bite......

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 07/09/2023 6:36 PM DST

[K-xo in reply to j-o-h-n]

Here’s Johnny 🪓

[j-o-h-n]

Here's Ed Ames 🪓

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 07/09/2023 6:48 PM DST