What does ‘neuroendocrine differentiation' mean in metastatic prostate cancer?

[NikkiJayne]

My 71 year old dad has been diagnosed with metastatic prostate cancer with neuroendocrine differentiation - he had absolutely zero symptoms until a lymph node on his neck swelled up. It’s metastasised to his lower spine and sternum too. He’s just had his oncology appointment today and they’re going to do triplet therapy (docetaxel 6 rounds and darolutamide ongoing). He’s been on the hormones for two months (and had an hormone injection into his stomach) and the lymph node swelling has come down which is good news and he’s handling the hormones well. He’s a very ‘young’ 71 year old, a retired firefighter and keeps himself fit (though he does like his beer).

They will also be doing a BRCA test at some point as we don’t know his mum’s family’s history, but it doesn’t run in his dad’s side.

I understand metastatic prostate cancer but I googled 'neuroendocrine differentiation' and it was all quite jargon-heavy, so any help on explaining what that means would be really helpful. It looks like it usually develops when a patient has been on hormone therapy for a while and the cancer has evolved, but of course that doesn’t apply to my dad. He googles everything and even though his consultant was talking about ‘years’, when he googled that phrase he’s now convinced he’s going to die in the next year. I know he needs time to come to terms with it but any info I could provide him with in the mean time would be very helpful!

[KocoPr]

i plugged in neuroendocrine into this sites search engine. Plenty of posts to read on it including upcoming trial.

healthunlocked.com/search/p...

[NikkiJayne in reply to KocoPr]

Haha I did the same after posting this!

[Tall_Allen]

It means that the cancer has mutated genomics that resemble the genomics of nerve cells and hormone-producing cells. The significance of it is that it is extremely hard to treat - it doesn't respond well to usual therapies, and it is extremely virulent - it spreads quickly. It is usually combined with normal acinar adenocarcinoma, which does respond to conventional prostate cancer therapies. So, he will need extra therapies in addition to the current standard-of-care. For example, he may want to add carboplatin to his current docetaxel.

There are a number of clinical trials, which you can read about here:

clinicaltrials.gov/study/NC...

In the UK, you might try to get to get a consult with Johann de Bono at the Royal Marsden.

[GP24]

A biopsy of the prostate may find neuroendocrine differenciation. This is not necessarily a small-cell neuroendocrine differenciation which would mean a poor prognosis. Therefore I hope it is no small-cell differenciation and you dad does not need carboplatin. I would just observe if the triplet therapy is effective.

[j-o-h-n]

As a retired fireman we all wish he puts out the fire.

Note: Beer goes good with flames..........

Good Luck, Good Health and Good Humor.

j-o-h-n (Happy Birthday America)

[kainasar]

This may help - with more plain language.

mdanderson.org/cancerwise/n...

[NikkiJayne in reply to kainasar]

thank you! We spoke to his nurse and because his PSA is so high and he’s responding to hormones it’s likely he doesn’t have many of these cells which is good news.