Information in Bio
Hoping to try a PARP inhibitor or Provenge perhaps, I don’t know much about this, but my medical oncologist keeps mentioning pluvicto, I’m not interested in doing that yet.
Information from Bio below:
Diagnosed 07/01/2022 Diagnosed
By PSA Score 942.40 06/24-2022-07/06/2022
Advance Metastatic Prostate Cancer with Ductal subtype
with focal cribform architecture in carcinoma not large gland
4 cores out of 15 with another questionable core with necrosis and questionable atypical cells
Stage 4 Gleason 8 3 Lytic Lesions (unusual or rare)
CT Scan, Pylarify Pet Scan, Bone Scan,
3T 3D guided MRI with write over
07/15/2022 Transperineal Biopsy
Started Firmagon 7/6/2022
Zytiga with Prednisone 7/20/2022
Started Docetaxel Chemotherapy on 08/11/2022
End Docetaxel Chemotherapy on 12/23//2022
Complete 6 cycles @ every 21 Days
Ductal Prostate Cancer is
aggressive, it cannot be monitored by psa score alone.
As it can still spread by low non existing psa numbers.
However, Medical Oncologists feels my
Prostate Specific Membrane Antigen is high on scans
PSA 942.40 7/6/2022
To 2.87 08/03/2022
To 1.07 08/11/2022
To 0.41 09/01/2022
To 0.34 09/13/2022 Testosterone <7
To 0.24 10/18/2022 Testosterone <7
To 0.20 11/08/2022 Testosterone <7
Up To 0.26 11/29/2022 Testosterone <7
Down To 0.19 12/20/2022 Testosterone <7
Down To 0.07 12/17/2022 Testosterone <7
Last Docetaxel Chemotherapy of 6 cycles
Had Davinci Radical Prostatectomy with Pelvis Lymph Node Removal 03/14/2023
8 Lymph Nodes Removed
I have a small mass on prostate bed and feel this is why my PSA is rising.
Held PSA
Down to 09/07/2023 <0.06ng/mL
I started Taltz for my severe plague psoriasis in 01/2023
The Gastroenterologist feels this was the reason for my severe colitis attacks with blood that went on daily from 07/15/2023 through 01/2024, on colonoscopy and endoscopy found 16 inches of connected ulcers possibly from the Taltz Biologic Medication
My PSA started
rising 10/10/2023 0.09ng/ml
rising 11/07/2023 0.11ng/mL
rising 12/07/2023 0.29ng/mL
rising. 01/04/2023 0.46ng/mL
Stage 4 Advanced Metastatic Prostate Cancer
PSA 942.40
Gleason 8 ductal without large cribform gland,
Gleason 9 4+5
cT3b CN0 cM1b
Gleason 8/9 * 4+5=9
Stage 4
Grade 5 :
ypT3a YPT3a
3 lytic lesions resolved to 1 mild avid lesion
Biopsy 15 samples
4 adenocarcinoma
11 benign
Low volume
High grade
Triplicate Therapy
Firmagon @28 days,
Zytiga with Prednisone Daily,
Metformin 500mg Daily
Docetaxel Chemotherapy @ 6 sessions
Taltz monthly injection for severe plague psoriasis
VIT D2 @6 weeks, once a weeks, 50k units, Temporary
No Prolia or Z Acid for bones,
As my teeth need work
Germline - No Brca but BLM missing copy mutation
The Tumor Genomics were an-
Oncomine targeted panel from transperineal MRI guided biopsy 07/2022
Tier 1
Tier 2 Variants in p53 and CDH1
Tier 3 in DNMT3A, HRAS, WT1, TSO500
I’m burdened with a mutation load
Tumor genomics -
Targeted Oncomine panel from post-treatment prostatectomy
Tier 1 ATM frameshift alteration,
Tier 2 FOXP1-BRAF fusin, PTEN frameshift alteration, FOXA1 frameshift alteration,
FBXW7 missense, SETD2 frameshift alteration.
TMB high (17.4 muts/Mb),
MSI stable; multiple VUS (BLM, CUX1, EML4, EPHB1, FGFR2, FOXA1, GRIN2A, JAK1, SMARCA4).
I’m terrified of Small Cell and Neuroendocrine because of mutation load.
No complaints from radical prostatectomy leakage resolved
CHA test Component Your Value Chromogranin A 117 ng/mL
0 - 103 ng/mL H
My Carcinoembryonic Antigen <0.5 ng/mL this test was very low, good news.
<=3.0 ng/mL Non-Smoker: <= 3.0 Smoker: <= 5.0
My LDH was Component Your Value Standard Range Flag
Lactate Dehydrogenase 168.0 U/L
Rising PSA after starting Zytiga - Prednisone - Eligard
Next step. Some advise please
FIRMAGON LUPRON NOW ZYTIGA PSA
Can i take vacation when already 5 years PSA < 0.01
After Firmagon, what next?
