MRI report shows enhancing bone lesio... - Advanced Prostate...

Advanced Prostate Cancer

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MRI report shows enhancing bone lesion is noted involving the left sphenoid bone.

Gl448 profile image
11 Replies

That’s from an MRI taken six weeks after 10 sessions of IMRT were completed for a surgically inoperable metastasis in my skull.

Apparently this means the contrast agent shows increased blood flow or activity in the tumor.

Does that sound normal to still have increased blood flow or activity six weeks after IMRT is finished? Or could it mean the IMRT was not successful?

Coincidentally I had an infusion of Pluvicto the day after my last IMRT session.

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Gl448 profile image
Gl448
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Tall_Allen profile image
Tall_Allen

Radiation causes inflammation of bone lesions.

Gl448 profile image
Gl448 in reply toTall_Allen

Okay. Thanks!

Alicat1 profile image
Alicat1

Do you have any problems from the lesion such as loss of vision, hearing, headaches etc? Did they say how large it is? Asking as I have similar case.

spencoid2 profile image
spencoid2 in reply toAlicat1

I also have a bone lesion in my skull which was just treated with 5 doses of EBRT . I had three infusions of Pluvicto but my blood levels got too out of range to continue safely so I was switched to EBRT. I was lead to believe that in spite of being in my skull, the change of making it to the brain is remote. At least that is what I am believing for now :)

Alicat1 profile image
Alicat1 in reply tospencoid2

It sounds like it is outside the Dura of the brain in the skull base somewhere. Can you describe where it is in the skull base? Mine is on the clivia and about 2 by 2 by 2 cm. It's compressing the 3rd optical nerve causing double vision. I'm concerned if it grows it will compress more nerves. Normally they do endoscopic surgery to remove the tumor. It's a tricky surgery. It is the same type of surgery they do to remove a chordoma. I have decided to try do something about it.

j-o-h-n profile image
j-o-h-n

I hate to admit this..... but I'm about to fucking pass out........

Good Luck, Good Health and Good Humor.

j-o-h-n

Seasid profile image
Seasid

Did you ask them why didn't they give you PARP inhibitors during the radiation therapy?

Seasid profile image
Seasid in reply toSeasid

PARP inhibitors (poly ADP-ribose polymerase inhibitors) are a class of drugs used in cancer treatment, particularly effective in cancers with specific genetic mutations such as BRCA1 or BRCA2. They work by inhibiting the PARP enzyme, which is involved in DNA repair, leading to increased DNA damage and cancer cell death.

In the context of metastatic prostate cancer, there is ongoing research and some clinical evidence suggesting that PARP inhibitors can enhance the effects of radiation therapy. This is because both PARP inhibitors and radiation cause DNA damage, and inhibiting DNA repair mechanisms with PARP inhibitors can potentiate the DNA-damaging effects of radiation, potentially leading to better tumor control.

For skull metastases specifically, the combination of PARP inhibitors and radiation therapy may have the following benefits:

1. **Enhanced Radiosensitivity**: PARP inhibitors can make cancer cells more sensitive to radiation by preventing them from repairing radiation-induced DNA damage.

2. **Improved Local Control**: The combination may lead to better control of the metastatic lesions in the skull, potentially reducing symptoms and preventing further spread.

3. **Potential Survival Benefit**: While the primary goal of treating skull metastases is often palliation and symptom control, improving local control may have an impact on overall survival, although this is still an area of active research.

However, the use of PARP inhibitors with radiation therapy also comes with potential risks, such as increased toxicity to normal tissues. The decision to use this combination therapy should be made on a case-by-case basis, considering the patient’s overall health, genetic profile of the tumor, and the potential benefits versus risks. Consulting with an oncologist who specializes in metastatic prostate cancer and radiation therapy is crucial to determine the most appropriate treatment plan.

Seasid profile image
Seasid

Can PARP inhibitors pass the blood brain barrier?

PARP inhibitors have varying abilities to cross the blood-brain barrier (BBB), and their effectiveness in treating brain metastases or tumors within the central nervous system (CNS) depends on this capability. Some PARP inhibitors are better at penetrating the BBB than others. Here's a brief overview of a few commonly used PARP inhibitors:

1. **Olaparib (Lynparza)**: There is some evidence that olaparib can cross the BBB, but its penetration is limited. It has shown activity in preclinical models of brain metastases, but its effectiveness in clinical settings for brain metastases is still being evaluated.

2. **Rucaparib (Rubraca)**: Similar to olaparib, rucaparib has limited ability to penetrate the BBB. Its primary use has been in cancers outside the CNS.

3. **Niraparib (Zejula)**: Niraparib has shown some ability to cross the BBB in preclinical studies, but more research is needed to establish its effectiveness in treating brain metastases in clinical settings.

4. **Talazoparib (Talzenna)**: Talazoparib has demonstrated the ability to cross the BBB in preclinical studies, and there is ongoing research to determine its effectiveness in treating brain metastases.

Overall, while some PARP inhibitors do have limited ability to penetrate the BBB, their effectiveness in treating brain metastases from prostate cancer specifically is still under investigation. Combining PARP inhibitors with other treatments, such as radiation therapy, might help improve their efficacy against CNS metastases. For the most current and personalized treatment options, it is best to consult with a medical oncologist specializing in metastatic prostate cancer and CNS metastases.

Gl448 profile image
Gl448 in reply toSeasid

You can only get prescribed a PARP inhibitor if you have a BRCA mutation, which at the time my genetic testing said I didn't.

I'm going to post a new thread about this soon.

Seasid profile image
Seasid in reply toGl448

Can you try with Silymarin, a natural PARP inhibitor? Just find one which was made exclusively from seeds of the plant only therefore no phytoestrogens.

I believed that you could get prescription off label for professional PARP inhibitor. I believe some people with brain cancer could get it prescribed?

Could you please visit my post?

I am using the following product from NZ. It works well with mebendazole, chemotherapy or radiation. It is made 100% from seeds of the plant. You could send it to the laboratory if you wish or phone the nutritionist hotline on this product for more information.

chemistwarehouse.com.au/buy...

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