CR Advanced Prostrate Ca, and start of chemotherapy after PSMA

[Ij2023]

Dear All, I am posting my message with a hope to have better insight into my father's condition of Castrate resistant Advanced Prostrate Cancer and also seek the help of your experience.My father has had his cadaveric liver transplantation from Mayo Clinic, Jacksonville, Fl in 2001. We went from India for his treatment. His surgery had gone well, however, he had a drug reaction from an immuno-suppressive agent, thought to be from Mycophil mylate and Lansoprazole, from which he was weaned off and his inflamed lymph nodes subsided after sometime. His liver numbers and blood works came back to normal. We came back to India.However, in 2007, his PSA started rising and it reached 32. We consulted an Onco-Urologist. His Gleason score was 7 ( I remember it was one which is better, either 4+3 or 3+4 ). In March 2007, his Orchiectomy was done, and he was put on Bicalutamide 50, for 2 months. His PSA went down to 0.02 and later to 0.01 for almost 14 to 15 years.In early 2022, his PSA started rising again, though slowly.In 2023, we consulted our Urologist again, who has put him on Bicalutamide 50 OD again for two months. However, this med did not work this time. Next in the line, my father has been put on Abieraterone + Wysalone 10 mg daily for three months. However, this med also did not work and his PSA kept rising during this period. He was asked to stop taking the medicine, and our doctor considered for putting him on Docetaxal and Enzulamide, after doing a PSMA study. His PSMA has been done on November, 6 and the study results have shown 'PSMA avid extensive sclerotic lesions involving almost entire skeletal system including skull bones. PSMA avid enlarged abdominopelvic and right inguinal lymph nodes largest 2.3 x1.8 cm. No other significant PSMA lesion in the body surveyed.' He does not have any bone pain in the body as of now.He has been given Docetaxal 120 infusion alongwith Denosumab 120 injection for bones. He has not been put on Enzulamide, as the doctor considered his immunosuppression status post liver transplantation and has put him only on Docetaxal and Wysolone 10 mg OD. He has already developed mouth sores and feeling very low on energy. He has been asked to take more n more of proteins.In the hospital lab, his PSA has shown down from 10.5 to 7.79In view of above, please have a look at my father's case/ condition and request for your guidance and considered thoughts please.thanks and regards, IJ Singh

[Tall_Allen]

After docetaxel, he may be a good candidate for 177LuPSMA.

[Ij2023 in reply to Tall_Allen]

Thanks Allen, though I expected more of your wisdom on his condition , thanks a lot!

[Ij2023 in reply to Tall_Allen]

Sir, my father has been asked to put the second dosage of docetaxal on the hold, due to his low WBC and Hb numbers..It is due on Novemebr 27. His bone mets are quite diffuse. He has not been tried for Enzalutamide or any other like drug. Our hands all crossed, what lies Next...as my father is a liver transplant recipient and having low immunity or immunity issues.

thanks,

[Benkaymel]

It's probably a bit late now but sucking ice cubes/ice chips during chemo can stop/reduce mouth problems. Also, icing feet and hands to help prevent peripheral neuropathy. Difficult to deal with low energy but try to keep active (walking, swimming, cycling?) and do some light weights. Good nutrition is also important of course. Importantly practicing mindfulness and meditation is very beneficial. Good luck.

[Ij2023 in reply to Benkaymel]

Thanks , we are doing every bit to counter the effects of Docetaxal. Since this is the first dosage and first few days only , we hope to cope up better. Thanks!

[j-o-h-n]

Mr. Singh, Would you be kind enough to tell us your Dear Father's age? Excluding your detailed post as shown above, any other pertinent information would be helpful and should be added to his bio page. All information is voluntary. Thank you and please give you Father our sincere best wishes.

BTW Tall_Allen is a very busy member.

Good Luck, Good Health and Good Humor.

j-o-h-n Saturday 11/11/2023 10:02 PM EST - Honor our Veterans.

[Ij2023 in reply to j-o-h-n]

Hi John, he is 76 yrs of age...in 2007, the bone Mets were not diffused as in the PSMA study now..He appears to be resilient and ready to withstand the chemo effects.. Hopefully he does so, Amen !!

[j-o-h-n in reply to Ij2023]

Thank you for your response and we are confident that your dear Father will indeed "withstand any chemotherapy effects". Our prayers are with him.

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 11/12/2023 1:27 PM EST