Att: Tall Allen

[JolleySprings]

Would you please review my husband’s profile …. And now that “c” has shown up in Abdominal peritoneum … In a couple of “at present” visible spots on Auxium scan… Recommendation is to biopsy … and one Doc wants to do SBRT … the other wants Proton Bean…

Would you consider Dr. Onik’s protocol at this point b4 radiation?

Dr Onik had reviewed the scan and feels comfortable and 40% 😩😳 confident he can help!

I’d love your thoughts!!

Thank you!

[Tall_Allen]

There are no clear conclusions yet about metastasis-directed therapy (MDT) aimed at oligometastases (1-5). That is not to say that it does not help, it just means there are no clear conclusions yet. IMO, if safe, why not go for it?

I know Dr Onik believes in his combination of cryotherapy and immunotherapy. He has not published the data, and I'm skeptical that cryo can completely clear the cancer. But he relies on the abscopal effect - immunotherapy to clear up any cancer missed by the cryo. Maybe- the tumor antigens exposed by the cryo can activate T cells?

SBRT and protons have more data, and may do a more thorough job of initially clearing the tumors. One possibility is to use it with Provenge to promote more of that abscopal effect.

prostatecancer.news/2016/08...

If there is enough tissue, peritoneum tumors are rare enough that you may want to biopsy it for histology, IHC, and genomics.