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- Опубликовано: 27 авг 2024
- In this video, PCRI's Alex asks Dr. Scholz about recent changes in the management of advanced prostate cancer patients. They discuss new treatments that are becoming available and how the validation of early, aggressive combination treatment protocols have achieved substantially better outcomes for metastatic patients in large Phase III clinical trials when compared to the previous standard of care which put men on hormone therapy indefinitely and then reserved stronger treatments like chemotherapy and second generation anti-androgens until the development of hormone resistance.
Dr. Scholz also presents a case study of a man who was diagnosed with low-volume metastatic prostate cancer to the bone in 1996. He was treated with an early variation of those aggressive protocols and is still alive today in 2023. While it is unclear the extent to which these new methods will improve survival and quality of life for each and every patient, patients who are faced with a diagnosis of metastatic prostate cancer can at least feel optimistic that their chance of achieving favorable outcomes (remission, durable remission, and possibly even cure) are better than what contemporarily available statistics may suggest (since they are based on patients who were treated with older protocols).
0:07 Can you give a survey of the treatments available for bone metastases?
1:05 -- A Case study of a man diagnosed with limited bone metastasis in 1996. He was treated with an early version of the new aggressive protocols that are just now being validated by Phase III clinical trial. Despite less effective treatments available at the time, the patient is still alive today, in 2023.
3:15 How commonly do men with metastatic disease achieve remission?
4:53 How do the older chemotherapies used in the case study compare to contemporary chemotherapy like Taxotere?
7:44 Can a patient redo chemotherapy or radiation again if the cancer returns?
9:07 How accessible are these systematic treatments?
10:21 Are there any situations in which you would not want to use aggressive treatment on a metastatic patient?
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The Prostate Cancer Research Institute (PCRI) is a 501(c)(3) not-for-profit organization that is dedicated to helping you research your treatment options. We understand that you have many questions, and we can help you find the answers that are specific to your case. All of our resources are designed by a multidisciplinary team of advocates and expert physicians, for patients. We believe that by educating yourself about the disease, you will have more productive interactions with your medical professionals and receive better individualized care. Feel free to explore our website at pcri.org or contact our free helpline with any questions that you have at pcri.org/helpline. Our Federal Tax ID # is 95-4617875 and qualifies for maximum charitable gift deductions by individual donors.
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Hi, my husband was diagnosed with aggressive pc in Feb. 2022, with a Gleason score of 8 (4+4). In April 2022 his urologist preformed a prostatectomy. Because lesions were detected in his pelvis we went to an oncologist who said the pc had metastasized, still had a PSA level of 23. She started him on Lupron in June 2022 and sent him to a radiologist oncologist who ordered a PSMA Pet Scan, which revealed oligometastasis (4 areas, 3 in pelvis and one on rib.). In Aug. 2022 SBRT was given to only one area of the pelvic where the bone was fractured, and by the end of August his PSA was 0.014, undetectable. In November 2022 his oncologist added Xtandi to his treatment and as of April 10, 2023 his PSA continues to be 0.014, undetectable. We pray that his Lupron & Xtandi treatments continue to keep him in remission. I want you to know that today’s video was so much my husband’s situation. There is definitely hope, even with an aggressive cancer like his. Other than feeling tired at times, he is doing great. I will keep you in my prayers for a good outcome. 🙏🏼
Fact that your husband has PSA 0.014 means that the cancer is still in his body. In my case I had the PSA value less than 0.001 for three years and I thought that I was free of cancer. After 4 years my cancer came back and in November , 1.5 year since last PSA measurement my PSA went to 0.75. In December 5h I had PSMA test and report says that I have very small amounts of cancer on 3 ribs and possibly also in my left arm pit lymph nodes. Good luck to your husband.
Your results o& therapy sounds very good! I was on all of those hormone ablation therapies until the expected happened, they stopped working. Now I’m on Plavicto radiation and my PSA has gone from 36 to 15 with one more of the 5 tx’s to go. They tell me that this is not a cure. Your body doesn’t get cancer free because you don’t have enough radiation or chemotherapy! The only thing that will cure your cancer is to change the lifestyle that caused it in the first place. I went to a wellness center for two weeks to learn how to do that and saw my psa that was doubling every 6 weeks stop increasing and start to drop with out any of the allopathic treatments that I was on before. I had stopped them for Two months waiting for Insurance OK to start a new drug my oncologist said might work, and did only the lifestyle plan to achieve those results so I was convinced that changing my lifestyle was the real key. During the two weeks of learning and practice of the program I heard several testimonies of patients who got cancer free verdicts by their MD’s.
@@4truth69 And what were these lifestyle changes?
Chemo (taxotere) was not so easy for me and symptoms became worse with each infusion. The 5th and 6th (final) infusions were the worst. My scalp hair thinned out and color went all white. Also I lost all of my pubic hair, underarm hair and eyebrows also thinned out. Eyelashes also disappeared and this caused me to have constant watery eyes. It looked like I was crying all the time. Oncologist told me to just buy a box of tissues whereas the oncology nurses told me to use "natural" tears eye drops from the chemist. I also suffered peripheral neuropathy particularly in the soles of my feet. It felt like walking on stones all the time. Finger nails also became distorted and each infusion showed up as a line on each nail. The most difficult aspect of chemo was the fatigue. At the start of chemo I would swim 1000m as a warm up in the pool 3 to 4 times a week. By the 5 th and 6 th infusion I was struggling to swim 50-75m and would be struggling for air at the end for 2-3 minutes. However following the advice of Dr Scholz I persisted and still swam the 1000m by just doing 20 x 50m short swims. I am now 8 months post chemo and I have recovered well. I am now back to swimming 1000m non stop although I am a little slower than before chemo. The oncologist told me it takes 6 to 12 months to fully recover from chemo. Would I do this all again? YES as I wanted to hit my cancer hard. 3 levels of attack - ADT, Chemo and radiation. Original PSA was 38. After chemo it was 0.06. Past 6 months PSA levels have been
Wow! You are a inspiration.
Are you off of the ADT now?
@@schmingusss Yes, last 3 monthly injection was 12 Dec 2023. No further injections since.
@@crankyneanderthal6784 That's good to hear. I hope you are doing well.
Had a PSA of 137 with Gleason 10 in all 12 cores. PSMA Pet scan showed some localized pelvic lymph node involvement, but no bone Mets. Was put on Lupron and Xtandi for 2 months. PSA went down to 1.5. Now starting 9 weeks of IMRT. Very hopeful to see PSA become undetectable.
That's an excellent result, Gary. I had a PSA of 500+, Gleason 8, now down to 341 after just 12 days of hormones (Orgovyx), and expecting this to continue. Doctor very happy with initial result.
@@carladerenzy3674 That’s good news. Let all of us keep up the fight and remain positive and hopeful.
These is so hopeful for my husband, he was 132 PSA and had testicles removed, lymph nodes one bone met, PSA down to 5 6 months ago august for another PSA test god is good all the time . Best of luck guys ❤
@@carladerenzy3674 Update, as of July 19, after 9 weeks of IMRT my PSA is undetectable. Hope it stays that way for a while.
@@Rockinrn Fantastic news! Hope this continues.
My dad has psa of 16,3...He is in his 70's and for me it's gut-wrenching. Diagnosis will be next week and he has a little back pain, but i must add he did had an infection around his blatter so lets just hope for the best. Fingers crossed guys.
Thanks a lot guys. I am a prostate cancer patient with mets in bones and my good oncologist has put me on hormone therapy and Enzalutamide. My PSA has gone down to 0. 07. I find your video extremely important because it gives people like me HOPE! That all is not lost, and that there is life to be had even with mets!! God bless you both!!
Side-effects?
None!
Hope you are doing well!
How much time it takes to down ur psa level plz tell me
Thank you for another great video! I am 47 and diagnosed with stage 4 oligometastatic disease (lymph nodes only, no bone mets). Over the past year, your videos have educated me so I can have the best possible discussions with my Dr and feel like I have some control in my treatment plan. Your advice about diet and exercise is so important to follow. Please keep the videos coming! They inspire me and give me hope.
47???
Thank you, superb information, this is what we need
Great information. Prostate cancer seems to be not much different from mosquito or weed control in that early and aggressive treatment can keep the problem from growing exponentially. During the dryest times of the year when mosquito numbers would fall, I would redouble my hunt for their watery breeding places. As these places become rarer my treatments had more impact. Kick'em when they are down was my motto, seems to work well with prostate cancer. .
Thank you for this. Thank you for the much needed education and hope (and asking questions I'm afraid to ask but need to know)
Thank you Dr. Scholz and Alex ..That debate is very beneficial ..we appreciate your efforts.
Excellent information! Always positive, and this is what we need!
Gleason 10 with 6 spots on bones pelvis and spine and lymph nodes , I was lucky to get PSMA pet scans ,I had Taxotere plus double hormone therapies like they say here , plus radiotherapy to the prostate after that ! Had a PSMA pet scan in march to check , all gone ! I am in remission-) got to stay on hormone therapy for 2 years though-) well pleased ! The aggressive therapy that they talk about here is a good choice ! Also the chemotherapy is not too bad , I did a session every 3 weeks for 6 sessions!
My father has also prostate bone mets and diagnosed 1 month ago plzzzz give me some info about it I m so worried I keep crying all the time for my father and too much panic in my mind I don't want to lose my father plzzz tell me can my father live
@@glamup2013 I also have stage 4-b metastatic prostate cancer, diagnosed in May 2020, believed I was going to die that summer, but the treatment seemed to improve my condition. Yes, your father can and will live with proper therapy, although it will be a fight. You must encourage him with positive energy/vibes. Prayers for your father and praise for you, he will need your grace, bless you. Thomas.
We can chat here if you like to or need to.
🙏
@@tommuttera3730 thanx dear my prayers also with u 🙏 ❤️
Thank you Dr. Scholz and Alex! You are doing amazing work!! To: Anyone who may be able to help, I am a 65 y/o, (active and otherwise very healthy male) who had a radical prostatectomy 12 years ago- and after being undetectable for years I had a PSA of 1.44 in 2022 and then measuring 8.53 on 1/4/24 and6.97 on 01/12/24.
With recent Pet/CT and MRI, 2 small lesions were found.(the larger of the 2 is a 0.8 cm restricting and enhancing lesion within the right side of the prostatectomy bed adjacent to the anterolateral aspect of the rectum)
I believe proton therapy would be appropriate treatment as opposed to photon radiation and intermittent hormone therapy (following an initial long period) if the PSA becomes and continues to be undetectable instead of 2 years of continuous hormone therapy.
Is there anything in my situation (All Chart data Below) that would require me to have photon radiation instead of proton or preclude me from intermittent hormone therapy?
-------------------------------------------------------------------------------------------------------------------
Date: Feb 13, 2024
Dx: Prostate CA-Gleason score of 4+3=7 (GG 3) iPSA 4.21 involving 15%of the specimen, negative margins, positive extraprostatic extension.
His final pathologic stage was T3aN0. Current Tx: bi/Pred, Eligard, XRT Prior Tx: Radical prostatectomy May 2012
Oncology History: This is a 65 y.o. caucasian male referred re: rising PSA remote from his radical prostatectomy in 5/2012 at U of C. He underwent a robotic assisted laparoscopic radical prostatectomy in May of 2012. His final pathology revealed prostate adenocarcinoma with a Gleason score of 4+3=7 involving 15%of the specimen, negative margins, positive extraprostatic
extension. His final pathologic stage was T3aN0. No adj XRT or hormone therapy was administered. His PSA since the time of surgery had been undetectable.
Date Value
3/10/2012 4.21
11/29/2012
Hello Sean, we are not able to answer case questions on our comment section but we can help you through our Helpline who can speak with you either by phone or email. Here is the link to contact them: pcri.org/helpline
Thank you. Priceless info as always. 💜
Hi guys . Fantastic information again and bless you for helping in the fight. I was diagnosed in 2019 aged 52 with PSA 3465 and wide spread bone mets. Started with Docetaxel and Prostap. At the end of 2021 PSA was down to 80 but started to double so put on enzalutamide and now down to 35. Is possible to stay in low PSA and enjoy life for a number of years especially due to the initial high PSA at diagnosis and still high PSA relative to the average. I am pain free currently and exercise regularly and on a vegetarian diet. Im in the UK and some treatments like Lutitium-177 are not currently available. Thank you all so much
What is life expectancy of prostate bone mets patients in 2023? My father is 72 and diagnosed one month ago
I was diagnosed 2021 with bone metastatic pc that has spread to my spinal. I was paralysed and on wheelchair for nearly 4 months .I undergone 34 sessions of radiation therapy and daily oral hormone deprivation treatment . My lab test on Feb 2023 for psa is down .006 . I see my oncologist every 3 months for zoledronic acid IV and pamorelin injection every 6 months . I still feel weak and easily get tired after doing small physical activities although there has been generally positive improvement in my pain management.
Wonderful educational video!!! Stay strong everyone. 🙏🏻💙🙏🏻
I was diagnosed in 2019 with 27 psa gleason 9 think God for your talks. Ive had high focused radiation and Nubeqa.
Takes lots of money
Thanks. Good information. Your help is appreciated
Extremely useful videos on this channel.
Three months ago I was diagnosed after biopsy with 18 out of 18 cores, Gleason 10, PSA 7.6 and T3 and put on hormone treatment.
Bone scan showed no metastasis but later (2 weeks ago) the PET scan showed 2 (“small”) spots on pelvic bones. So am now stage 4.
I will soo start chemo and extra dose of hormone treatment.
No mention of radiotherapy.
Is that usual?
🙏
I am Oligometastatic three spots, rib pelvisand backbone high up I have had Lupron and taxatare chemo for 6 treatments..... should i have 2nd generation hormone treatment now? alomg with beam radiation to bone spots? can anybody help me?
informative , tks
My Father has metastatic Prostate Cancer with bone and lung mets Gleason 4+3 psa at time of diagnosis 6 month back was 75 he is on Enzalutamide and Firmagon with 3 month Zoldonate IV. His current psa is 0.06 with clear chest xray. But from a few days he is complaining of severe hip and leg pain. We did bone dexa which was normal. What can be cause of pain. I tried contacting PCRI but couldn't connect. Please guide
My father has also same disease I m so worried
@@glamup2013Does he believe in Afterlife?
@@koof1776 yes
Have done Lupron for 11 years and recently learned I am resistant. PSA started to climb and a pet scan revealed 8 bone lesions. Consequently I just finished 3 of 6 taxotere chemistry. I am 68, what could I expect?
I don’t know myself…but I’m curious how you are doing since you write here?
Is it true that a certain trained dog can detect prostate cancer 99 percent of the time?
This is True~
At 75 they are giving me hormon therapy. My worst PSA was actually 5000,! Now it is .75.
But the hormon therapy make my life misseable. At my age could I stop the therapy and enjoyva better life. I am drownding in my own fluif!
Why miserable?
Just curious how you are doing?
Hai sir my husband pca April 2023 37 with a Gleason 4 +4 how is teatment sir he is age 42years please
42? Prove it~
Yes