UPDATE August 2024 and Opinion Question

[APCFighter]

Update:

Traveled to Jacksonville, FL to get a second opinion from the Mayo Clinic.

Got all of my IU Health Doctors agree to consult with my Mayo Doctors when they need some guidance and when I ask. Beginning valuable connections.

Restarted started a Lupron shot every 3 months.

Started Enzalutamide (160Mg daily) and

Another CT scan to help RO design a stereotactic body radiotherapy (SBRT) program

Start SBRT in August 2024

Opinions request: Should I be pushing for Triplet Therapy?

[dhccpa]

I saw Dr. Winston Tan at Mayo JAX about five years ago, but wound up sticking with local MO. Recently, I called them about Provenge immunotherapy but they quit using it at some point.

I like the facility there, though. I accompany a friend who had major colon cancer treatment there beginning in 2017. Always a pleasant environment, easy to park (but getting harder!).

[APCFighter in reply to dhccpa]

Yes - we really liked it there.

[E2-Guy]

I refused to subject myself to the nasty Lupron injections 20 years ago for my prostate cancer. All I ever did was to apply Oestrogel which I buy OTC here in Thailand. Haven't done anything for over 10 years. and my PSA is undetectable. I'm now 81. I believe my cancer has been asleep for a number of years?

My email address is: [e-mail]

[mperloe in reply to E2-Guy]

Yet there is research showing that estrogen may promote growth of the cancer. You are lucky.

[dhccpa in reply to mperloe]

Some on here have said the PATCH trial supported estrogen use as an alternative to Lupron/Firmagan, etc.

What's your take on the PATCH trial?

[dhccpa in reply to E2-Guy]

Sounds like you're doing great. I was wondering how you were doing. Carry on!

[mperloe]

Triplet would be useful for high volume metastatic disease. Have you done genetic and genomic somatic testing?

[APCFighter in reply to mperloe]

Thank you for your reply. I had a full genetic analysis and they didn't find anything that associates with Prostate Cancer and have any treatment for. I certainly would not call my "high volume metastatic" as I only have 3 small spots.

[E2-Guy in reply to mperloe]

No! I'm 81, and my PSA has been undetectable for a number of years , so I'm not even concerned about PCa anymore. I stopped using E2 for about three years. If my PSA ever starts rising, I may consider your suggestion.

[mperloe in reply to E2-Guy]

It's always great to meet people in the been there done that club.

[mperloe]

Then doublet therapy plus RT seem to be what most MDs would recommend. Perhaps a clinical trial would be more aggressive.

[APCFighter in reply to mperloe]

Thanks. Good to know.

[DLimey]

I’ve read a few medical journal articles that suggest doublet, not triplet is the best approach for ductal subtype. I will try to find those references for you. And we see the MO in 10 days and will report back what we learn.