Battling two cancers on two fronts, simultaneously

[CharlieBC]

Has anyone fought PCa and NEPc simultaneously? I have had PCa-classic since 2011. After lupron/lusinipril for years, I began Casodex . Bad reaction, switched to Zytiga. That affected my liver enzymes, so on to Xtandi. It worked well. So, this last August a lump was found under my jaw at the lymph node. This was confirmed as Neuroendocrine PCa. (possibly caused by androgen receptor pathway inhibitors- Zytiga, Xtandi, Erleada). So, we stopped worrying about the PCa-classic- stopped Xtandi. Went through Chemotherapy, and presently getting immunotherapy and returning to Xtandi. So.....my questions are:

Why go back on Xtandi if that is what possibly forced the transformation of the cancer to begin with?

Has anyone here battled two cancers on two fronts, simultaneously? Did the mix of therapies cause any reactions/consequences?

Side issue- extremely dry mouth, probably due to immunotherapy (atezoluimab)? Any recommendations are appreciated.

Every one have a great weekend and GO 9ers!

[Tall_Allen]

"Why go back on Xtandi if that is what possibly forced the transformation of the cancer to begin with?"

Because you have a mixed type, which is probably the most common. The adenocarcinoma cancer cells are still responsive to hormone therapy. Metastatic cancer mutates rapidly and some of those mutations will be resistant to whatever gets thrown at it - that's why it is incurable (so far). Most of your cancer cells were killed by Xtandi, which is why you have lived so long with it. But some cells have become impervious to it by differentiating to a neuroendocrine form.

There are some clinical trials you can discuss with your oncologist:

prostatecancer.news/2016/12...

[CharlieBC in reply to Tall_Allen]

TA, thank you very much

[Ian99]

Hi Charlie. Re dry mouth.. I got this from RT to head and neck 10 years ago. During the day I just adapt eating habits (more sauces etc). Sleeping is more problematic.. it wakes me up. I use a mouthwash called Biotene, tends to work 2-3 hours then repeat and go back to sleep. Not ideal but best I have found. Hope this helps.

Agree.. go 9ers.

[CharlieBC in reply to Ian99]

Ian, thank you. Right now I'm tethered to a water bottle and just am constantly sipping all day. I've heard of biotene. I'll probably grab some of that.

[Bethpage in reply to CharlieBC]

I have Sjogren's, no saliva. Both Biotene and Act help. Good luck!

[j-o-h-n]

Fighting two also. Pca and Lung Ca. Pca fighting with Lupron and Nubeqa and Lung (metastasis from melanoma) was fought with Keytruda (immunotherapy) and it apparently worked.

Good Luck, Good Health and Good Humor.

j-o-h-n

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

Thank you j-o-h-n. As long as they play well together!!

[old64horn]

Charlie, I'm currently battling two cancers as well. I had prostate surgery back in2009 and and salvage radiation in 2021. Unfortunately, I was diagnosed with bladder cancer in 2022 and had my bladder removed in Jan of 2023 followed by one year of Immunotherapy which I just completed. So far there is no evidence of any bladder cancer spread so, now I can refocus on my PC. My PSA is 0.65 so my MO will start me on ADT once my PSA gets to 1 or if doubling time is less than 10 months.

[CharlieBC in reply to old64horn]

Old64horn, I just resumed Xtandi after taking a 5 month break to focus on my NEPC. The down side is my PSA is up to 2.96 as I re-start it. Two front battle it is.

[Grandpa4]

there is a new agent HPN238 that is active in neuroendocrine disease. Might try to get in a trial.