My father (63) just got diagnosed with “high risk (low volume) locally advanced” Grade 5 prostate cancer. He has been fortunate to quickly seek two opinions, one of which was at a COE with a group of radiation oncologist, medical oncologists and urologist. They confirmed through PSMA PET, and PET/CT scan there are no visible metastasis at this time, but suspect possible micro metastasis.
Based on his case and being otherwise very healthy they have recommended triplet therapy. Can anyone help explain the benefit of choosing triplet therapy compared to doublet therapy? I am not able to find too much research on outcomes.
Thank you all for any advice or support!
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Bluedog13
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What Tall Allen is recommending is exactly what I had done. Without more specifics on his diagnosis, it appears that your dad has curative options available. Which is great news!
I choose Pelvic and prostrate radiation and short term ADT. It appears to have worked so far.
The rationale for the pelvic area radiation was to eradicate any cancer that was not visible on the scans. So I went for the cure rather than wait to see if there was cancer there.
So happy to hear of your success so far! Thank you so much for both of your replies. From my understanding it seems that due to the Gleason 10 diagnosis is why they suggested the chemotherapy. As RodofGod mentioned below as “round up” for the body. I think these have brought up good points for further discussion with his doctor!
I am not medical advisor and I will explain you base on my knowledge. Clinical trials already approved that triplet therapy is best in the class.
triplet therapy Include reduce testosterone using ADT + blockers like Xtandi or Nubeqa that block cancer cells to connect with testosterone and docetaxel kill the cancer cells.
This video will either be over your head (in which case, look up trials CHAARTED, LATITUDE, PEACE-1, etc) or help give you talking points to go into the MO/RO with.
Do not mistake any of us as authoritative on the subject. I would hope your medical team knows what is best as a treatment plan for his diagnosis.
That said, I liken Chemotherapy to ROUNDUP for the body. It goes around and kills those little bastards wherever they are hiding... The trick is to be stronger than the treatment...
I was at the tail end of 68 when I started Triplet Therapy. For me, it proved successful... Thus far <0.1 PSA
That changes a lot of options and increases the chance of cancer cells outside of the prostrate. So maybe triple therapy is now on the table as a curative hope or even a extension of survival time.
My initial biopsy showed four of twelve core findings cancerous with one very close to a duct. Gleason score 7. I had a bone scan done, no metastatic bone spread.
I opted for RP surgery. In less than six months I had a chemical resurgence. A second bone scan showed no metastatic bone spread. A PSMA PET scan was ordered and revealed abdominal lymph node involvement.
I was referred to oncology. Oncology revised my diagnosis as Prostate Cancer, Ductal Variant, Stage IV. Gleason Gleason score 8.
He felt the area was to broad and my type was too aggressive for radiation to be effective.
He gave me three options with potential statistical longevity outcomes.
Lupron alone, two years
Doublet treatment, three to four years.
Tripplet treatment, Six plus years.
I elected Triplet therapy.
The desire to live exceeded the potential side effects of the Taxotere treatments.
He was up front and honest about it. But stated hitting it hard up front was the best chance for longevity and barring major side effects, I would be back to myself in time after the Taxotere treatments.
In my case, this proved true...
I did lose my hair (it's back) and I would have chemo dips as I called them, that being a tiredness that did not resolve with rest for a day or two that would hit about three days post treatment... Yes diarrhea became a constant companion which is now cleared up. The medicine they provide pre and post treatment day kept other symptoms at bay.
Actually as weird and antithetical as this may sound... I came out of treatment charged up and ready to go... and continued on as if nothing could stand in my way...and it didn't..
I called my treatments getting "Juiced" 🤣
I bounced in and out.
Blood work was done and processed right before treatment to insure my platelets and all that stuff made me good to go for juicing.
i was routinely queried about signs of neuropathy. None of which I had...
Im a controlled type II diabetic for some twenty plus years. I had a medium heart attack with no damage and underwent a quadruple bypass back in 2010.
You can give chemo a shot and remember you can take each treatment as your last if circumstances require. You are not obligated to stay the whole course.
My point in telling my story is in hopes of alleviating some of the fear inherent in the idea of doing chemotherapy. It is not a panacea. It is a tool in the cancer treatment arsenal.
Perhaps Nietzsche was right "what doesn't kill me, makes me stronger"
I wish to inform you about using the combined word MOTHERFUCKER here . It's only acceptable to use the words MOTHERFUCKER if you are describing those little MOTHERFUCKERS that are eating us alive. Otherwise save MOTHERFUCKER for your occasional road rage incidents. Thank you MF (and that stands for My Friend).
Given the context in which it was used and placed at the end of my reply I thought that was implied. Of course it was used in reference to the Little MOTHERFUCKERS eating us alive as you do quote.
Sorry if you were in some way offended.
p.s. I don't road rage... And I was unaware that you are in charge of policing members publicly and what was the point of that nonsensical private message you sent me?
I have been snooping around in this forum long enough to appreciate the sarcasm and humor needed in these times! My dad always appreciates a sense of humor ☺️
Let’s let it rest there. Thank you both for your insight!
If you have the details from his biopsy to confirm and expand the "locally advanced" and "low volume" features a recommendation would be more tailored to his condition. The biopsy has much critical information and your synopsis is too brief. I wish him well.
Thanks Tarhoosier. Besides the fact that he was graded Gleason 9/10 with 13/13 cores positive I don’t have many other specifics. The locally advanced low volume were taken from the notes with the MO when discussing treatment options. I do know his PSA doubled in about 3 months so it is very aggressive and we are lucky to have even caught this when we did it seems! Trying to remain positive that it was found before distant metastasis with the Gleason 10 score, all doctors were rather shocked.
Review a copy of the biopsy report. It will calm you about some of the issues at the edge of his diagnosis. You have the prominent particulars. Every patient should have a personal copy or easy access to his biopsy report. It guides the oncologist and other treatment professionals. He will likely have a series of treatments that will last for many years.
The best advice I gave myself was to find the best prostate (urologic) oncologist, no matter how far or how much it cost. I was and am in the U. S. With that relationship established i later had a local doctor as my consulting to carry out items recommended by my managing oncologist. Time and money were involved and this all came 12-18 months after diagnosis when I knew nothing.
note:
I am 18 years out from diagnosis with G9. My response is not normal. No one here provides medical advice.
check ARASENS trial online, it gives great results to high burden patients (or high volume) but not with low volume or micro metastasis. It could also be curative but I would follow TA’s advice, or at least ask them why triplet therapy ( with me it worked greatly so far)
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