Just trying to educate myself.
I have read posts that when any organ met like bladder or lung etc are detected , chemo is immediately begun.
Would the hormone therapy not shrink those too just like it does in bones ?
If ADT helps tame all Prostate tumour... - Advanced Prostate...
If ADT helps tame all Prostate tumours , why is Chemo given as soon as some organ met detected ?
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Tinkudi
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It is then a CRPC
First off, ADT does not shrink tumors. ADT, androgen deprivation therapy, stops your body from making testosterone. The reason for that is testosterone is the “food” for prostate cancer cells. So, if you deprive your body from making testosterone, it will assist in lowering the probability of metastasis keeping your PSA low.
You are on Lupron which stops your body from making testosterone. You have reached the point where Lupron is not working effectively. Normally, you would be placed what I call second line ADT. There are a number of drugs in this class: Erleada, Nubeqa, Xtandi and Zytiga. They may also want to place you on radiation to hopefully stop the current metastasis. I believe you not at the point where you need chemotherapy. That’s just my opinion. I saw your bio, I do not know what else is going on. Please keep us posted and best of luck!
No no. I was just educating myself. Dad is on orgovyx and xtandi and doing ok Has bone mets
So what DID you want? This is merely a support group. If you wish to educate yourself Google whatever it is you wish to know. We can only share our own experiences. I took a lot of time and effort to answer you. Plus NO WHERE is it stated this your father.
My bio does say it’s for my dear dad 😊
I am just trying to understand so I am on top of things before they may happen and personal experiences are much more useful than just google I feel.
I appreciate your time and thanks for trying to help 🤗
My apologies if I came off well, like an A-hole. Obviously, I must have not read the bio very carefully. Over the past few days I experienced some very unexpected life events which obviously affected my ability to read carefully and to respond nicely. Please accept my apologies. If your Dad only has bone mets (and there are not many), radiation could be a solution. Normally PCa will metastasize to the bones and lymph nodes first. Radiation may work on an organ, depending on the organ. I tried to avoid chemo as long as I could. You may wish to see if there are any clinical trials. I know India is a huge country, but there may be a clinical trial that your could participate in. If you have a chance, please read my bio. I’ve experienced a lot in the 19 years I have had this disease. Your Dad is lucky having someone looking out for his best interests. Again, I apologize that external issues affected my ability to just answer your questions in an effective and positive manner.
No need to apologise please. I am sorry you are going through a tough time and unexpected events. My best wishes and prayers for your journey 🤗🙏🏻
I'm glad you posted this. I like this response much better.
I think many of us do use this forum to educate ourselves about the course of treatment, alternative ways (different from alternative medicine) of dealing with PCa at any given stage, and so forth.
TA alone is worth the price of admission, but there are others.
Anyway, this response was spot on.
No one forced you to reply to his question...he didn't say he or his Dad have organ metastasis.
Steady on. No one forced you to reply.
You are right. And obviously my response was not needed. I have sent another reply.
He didn’t read your bio.
A very rude response to his questions.
You are correct. I am normally not that way. I have replied again. Sorry you had to read that.
She’s just trying to help her dad. We would all be blessed to have such a daughter.
You are definitely correct! I have tried to patch things up with with another response. I apologize for that response.
Good going. I wish I had a nickel for every retraction I’ve ever had to make.
let’s let it go he apologized. We’re not walking in his shoes right now. We don’t know what he’s going through.❤️
Thank you.
Yes this is a support group. Part of the support is education, lessons learned, education and experience. Members have posted their thoughts and research about PCa that may help others in their journey of understanding. I have learned a lot from this thread in my ongoing experience/battle with PCa. Fortunately, I am currently undetectable but when that changes (and I full suspect it will) I want to be prepared to talk to my urologist and understand the situation.
I just found an article posted by a member that does a good job of talking about AFib (another thread, another condition) that helps me understand what is going on and to be able to understand my cardio support team.
The poster could be helping their father, husband, partner, neighbor, it really does not matter. We are here to help, learn and educate.
You are 100% correct. I was not very nice. I have apologized and offered some information I hope may be useful.
Imagine the unbridled temerity of someone coming here looking for answers!
My apologies. Your vocabulary is more extensive than mine. I had to look up “temerity”.
adt does actually shrink tumors to some extent. Giving adt before prostectomy has been shown to reduce tumor size. Obviously not endless as it is not a cure, but to some extent.
That is what I thought. Or what explains pains in bones vanishing on starting ADT
I, personally have not experienced that. From a logical viewpoint ADT may assist in reducing tumors. My apologies for not being very reasonable nor polite.
Best to ask TA directly about this, but I believe he has written that ADT like Lupron actually kills many PCa cells. I have to admit I haven't read that anywhere else, so best to check with him. Of course, ADT doesn't last forever.
"ADT does not shrink tumors."
I would disagree with that part. ADT is used to shrink a prostate tumor before radiation. And in my case, I am told ADT is shrinking my prostate tumor that recurred after radiation, keeping it from closing the urethera. ADT is also being used to slow my lymph node mets.
"Hormone therapy is often used to treat advanced prostate cancer to shrink the cancer and slow its growth. Hormone therapy is sometimes used before radiation therapy to treat cancer that hasn't spread beyond the prostate. It helps shrink the cancer and increases the effectiveness of radiation therapy." mayoclinic.org/diseases-con...
"Hormone therapy can keep prostate cancer under control for several years by shrinking it, delaying its growth and reducing symptoms." betterhealth.vic.gov.au/hea...
Because more, sooner is better. The goal is to slow progression and live longer, not to just "tame" the cancer temporarily.
prostatecancer.news/2021/05...
Thanks Allen 😊
Good answer
So, prostate radiation a good thing for already metastatic men?
" prostate radiation cut radiographic progression-free mortality in half."
I thought we usually talk about radiographic progression-free survival?
I am sorry but I see no rudeness and in the first line I did mention I am just trying to understand.
Have a happy day 😊
I don't think it was rude at all.
Chemotherapy is an interesting approach which is designed to kill off dividing cells while leaving other cells intact. So it works best the faster cells divide. If a tumor is slow growing, chemotherapy won't do much but you still get all the side effects (e.g. intestinal issues as intestinal tissue is dividing/replacing fairly quickly or problems with blood counts (platelets, red blood cells, white blood cells/immune system)).
Prostate cancer is usually very slow growing and hormone sensitive at the beginning, until the remaining tumor cells, after sometimes years of hormone deprivation, have mutated to not need male hormones to kick off the cell division cycle (it's not a food but it's a trigger for cell division). ADT causes sensitive tumor cells to not divide and eventually age out to the point of cell death.
The prevalent chemotherapy for prostate cancer is Taxane based. Chemicals that mess with microtubules that are necessary for mitosis (the cell division process). If a man has visceral metastases, like in the lung or liver, chances are it's a super aggressive (=fast spreading, quickly dividing) tumor where chemotherapy will actually have a benefit besides the (sometimes debilitating) side effects. Hence it's given "when the time is right".
That’s absurd. He can ask all the questions he wants. Answers here may come from a member’s knowledge or from his personal experience. if not they may range from pure conjecture to relevant information not known even to the patient’s doctor.
You’re right. I apologize for my reply and my behavior.
You don't need to apology again, or feel bad about your reply. You tried to help another person. Your irritability was a flash, a very human reaction that suggests how you were in the moment, not who you are.
Thank you for response. I really appreciate it.
We need more people like MJCA in this world. It's easy to make a rash decision and then try to cover it up or sweep it under the rug, but not MJCA. He took full responsibility and went above and beyond to make things right. If more people had his integrity, the world would undoubtedly be a better place.
I had only one chemo before being forced to stop due to infection. Several months later tumors had shrunk 50 percent or more. 20 months later tumors continued to shrink for a total reduction of about 70 percent from the original size. My gas tank is filled solely with Lupron and abiraterone. Next imaging is in ten days and we will see if all those pumpkin seeds, walnuts, pistachios, macadamia nuts, Brazil nuts are making any headway, therefore arising to my handle, and I’ve survived many infection battles one Tuff Nut.. A diet extremely rich in nuts and a few blueberries, Flax seed, strawberries and elderberry are all I have to work with.
I suggest the chemo if your body will tolerate it as the clinical trials say triplet therapy is the most effective. Imagine if I had been able to continue the chemo. What reductions would have been obtained! I posed this question several years ago and nobody answered as far as a metric in terms of tumor size reduction that they had obtained under triplet therapy. Did your tumors shrink 90 percent, 100 percent?
one chemo being so effective ! Did you have it at the start of your treatment ? Best of luck for your imaging 🙏🏻
yes. In Gods hands as my cancer was so rare, so aggressive that it even responded to the the standard treatments. Best to you Tinkudi.
You had genetic testing ?
Yes. Was not passed on from my father who had prostate cancer 20 years before it metastasized. I don’t know where I put the results
Mr Tuff - I'm sure you are aware of this, but for anybody reading this it's important not to eat too many Brazil nuts. It's very very very very easy to get selenium overdose or even poisoning from eating Brazil nuts everyday.
Two a day is the way or at least the limit from my understanding! Thanks for reminding everyone, don’t overdose! They once did a blood test on me and found I was off the charts with oxalates which tend to form kidney stones. Drink lots of water if you decide to go nutty. I think one of our members J-o-h-n was bemoaning kidney stones from eating tons of walnuts. Don’t bash me John, be nice!
To be reminded of oxalates! Some years before I was diagnosed with PCa I was an enthusiast for almonds. Handfuls everyday. And irresponsibly ignorant of oxalates.
I begin to have these pains mostly in my right hand side. Episodic and mild to severe. And sometimes extreme nausea and a pallor that caused people to ask me if I needed to see a doctor. Eventually diagnosed as a kidney stone (the cause of the pain, not me). From eating all the almonds. It eventually passed after a prescription for "Flomax". Instant recovery!
And not to bash anyone for eating too many nuts. Now it's walnuts for me. Especially for the ellagitannins which are metabolized to ellagic acid, and thence to urolithins A and B. There seems to be some indication that they are good for us. But I just enjoy walnuts anyway and apparently there's not the amount of oxalates.
From my own experience, my lymph node mets were a certain size; then after a course of ADT, they were smaller. So, it appears to me, and as I recall from this forum and my MO, that ADT kills a certain percentage of tumor cells (thereby shrinking it). As mentioned here, it doesn't kill them all, unfortunately. It's a management technique, not a cure.
I can't speak to your question about chemo. I do believe organ mets are considered more serious and call for an escalation of some kind.
Regardless, kudos to you for taking care of your dad, and pls feel free to ask all the questions you wish on our forum.
Same here, I had a noticeably large tumor popping out in my left groin (lymph node) at the time of my diagnosis. After 2 weeks of preparatory Casodex (50mg) and 4 weeks of Zoladex (similar to Lupron), it was completely gone and my lymph node was symmetrical to the one on the right. This was 3 weeks before chemo and a week before Nubeqa, so it was the ADT.
yeah that reminds me, I had some mets show up that then also disappeared completely after ADT. So, in some cases it seems to kill the mets, but somehow I doubt it. More likely mets just get reduced in size to undetectable by PSMA.
I've heard it described like this: ADT does not kill cancer cells. Only chemo and radiation kill them.
"Apoptosis typically occurs early after ADT within the first 72 h [15]. In addition to apoptosis, other cell death mechanisms induced with ADT include autophagy, necrosis, and necroptosis"
Because you really want to hammer advanced cancer from the start for best results. To use a war analogy, think about starting treatment for metastatic cancer as a counterattack. As a commanding general, what would you rather do: Send small units to poke at a huge invading enemy force, or marshall all your forces together in a massive counteroffensive?
1) ADT is used to shrink tumors and can actually can KILL cancer cells quickly (this is called an "apoptotic" effect). This is short-lived though (realistically within 96 hours or less after testosterone is shut down). I need to slightly correct something in some replies in that testosterone isn't food for prostate cancer, food is food for prostate cancer! Testosterone is just a "trigger" to PCa cells to eat nutrients, grow, and multiply. When ADT cuts off this trigger, some of the cells go dormant/senescent, some die (apoptosis), and some just carry on (these last are called "castrate-resistant" cells).
2) Chemotherapy kills the cancer cells that are still active. Cancer cells are fast-replicating, and the drug is designed to poison them. Unfortunately hair cells and stomach cells are also fast-replicating, hence the unfortunate side effect of hair loss and nausea while on chemo as those "innocent" cells are caught in the crossfire.
3) A drug used to block testosterone and other androgens can be given too. These can be Casodex, or Zytiga, or newer ones in this class like Xtandi or Nubeqa. Even on ADT meds like Lupron or Orgovyx, the adrenal glands can still produce some testosterone, and some PCa cells can even be cunning little bastards and start producing their own testosterone to trigger themselves and survive! These androgen blockers take care of this.
The combo of 1+2+3 is known as "triplet therapy", and research so far is showing that using all three at once, "marshalling all your forces", is better at keeping your dad around longer than each drug used alone. To finally answer your question, this is the reason why chemo's given too.
Best of luck to your father in this fight!
This is a great short narrative 32%! And focuses on and up-to-date understanding, which we don't always get in terms of advice.
I had several Mets in my lungs and Psa of 5664. Scan after being on Lupron for a year showed lungs clear. I had no chemo. I think that is a personal decision. I look at quality of life. My QOL is good at present so I won’t even consider chemo until QOL deteriorates. My cancer is non curable so it is all QOL for me. At 74 years old I get around great with minimal side effects so I’ll continue this path for now. God bless.
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