ADT’s effectiveness and reason for limited success of chemo on prostrate cancer

[Samrecan]

I was wondering why they don’t just give chemo for Prostrate cancer irrespective of hormone sensitivity. Chemotherapy drugs destroy all rapidly dividing cells (even hair) so why would prostrate cancer cells be spared?

I was trying to understand if ADT really kills PC cells or just makes them hibernate because if it doesn’t kill them then it is just making matters worse by allowing these cells to go undetected by chemo.

I found this article which provides an explanation as follows:

Most chemotherapy drugs destroy rapidly dividing cells - so there is nothing to kill when cells don’t divide during chemo cycles. This is especially true for hormone sensitive prostrate cancer cells which divide “very” slowly, making chemotherapy ineffective against them.

ADT however does activate “programmed death” of such hormone sensitive PC cells as it can be administered for long durations. This is the reason that ADT is started immediately and continued. It does “kill” these cells by kind of making them commit suicide.

Metastatic CRPC cells divide much faster (like 50-100 days timeframe) and can therefore be targetted by chemo.

The article is quite technical and this is what I understood - please point out if I missed anything.

sciencedirect.com/science/a...

[Hotrod65]

Chemo is a hit or miss for most cancer treatments and the important thing to note is we all have cancer but none of us responds to it the same..I had 4 cycles for MPC4 and did nothing for me, ADT or HDT as its known " Lupron" does not directly " kill" PC cells, it works by shutting down the bodies ability to produce male T, the path from Pituitary to Testes is how it's produced..lack of this hormone T for PC Adenocarcinoma will starve the cells into hibernation or sleep mode and become inactive, , problems start again when becoming castration Resistant, these cells have the ability to change form and adapt/ mutate under their new microenvironment and start spreading again, looking for PSA doubling times, the kidney adrenals produce a small amount of PSA so fluctuations , but consecutive rises will be monitored to then get into Anti Androgens, Radiation or whatever doctors will prescribe next...it's a journey my friend...take every day we are blessed to have.

[gsun]

Chemio is used at the beginning before ADT. It’s called triplet therapy.

[Maxone73]

triplet is ADT and then within 8 weeks (if I remember correctly) you add ARSi (daro, enza,...) and 6 cycles of chemo, and it is used in hormone sensitive metastatic PC