Treating Advanced

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0:22 Can patients with extremely high PSA's still achieve remission?
3:34 Do extremely high PSA's always correlate with aggressive disease?
4:52 What is monitoring like for a patient following intensive treatment for high PSA cancer?
6:55 Is triple therapy required for a patient with a PSA of over 1,000?
7:29 How rare is it for a patient with a PSA over 1,000 to achieve remission?
8:23 What are the options for those patients who don't achieve remission?
10:42 Is extremely high PSA cancer inherently more urgent?
12:16 What options are there if Pluvicto fails to control the growth of the disease?
13:12 Is Xofigo often used in combination on oligometastatic patients?
14:03 Can immune treatments like Provenge be used in combination therapy?
15:38 How effective are PARP inhibitors?
16:31 Alex's conclusions
17:57 If you need more help
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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.

Опубликовано:

29 сен 2024

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Комментарии : 78

@sgtbosshog2182 5 месяцев назад

Thank you helpful information my psa was 247 now after 6 months chemo and hormone therapy number at 1.0 still have more work to do stay positive and everything will work don't stop bless

@Mark_Lacey 5 месяцев назад

Nov '23 my initial PSA was 3,500 and heavily metastasized in my upper skeleton. Started 1st & 2nd generation ADT straight away. Feb '24 I had a bilateral orchiectomy. and stopped the Firmagon. March '24 PSA had dropped to 0.7 I asked the Med Onc about triple therapy but he said he wants to keep further treatment in reserve. I get the feeling I'm on the treatment treadmill, simply following a palliative treatment process in stages instead of being aggressive with treatment. His view is I'm incurable. I'm getting a second opinion.

@kawaahangar4570 5 месяцев назад

Triple therapy including chemotherapy was the way to go. That's the standard of care for high burden cases for many years now.

@stitcheruk1150 4 месяца назад

@@kawaahangar4570In September 2023 my PSA was 310, with Skelton metastasis and have just finished 6 sessions of chemotherapy as part of triplet therapy - the last PSA reading was .10. So my treatment was as you advised.

@shannonrogers5648 5 месяцев назад

My husband had high PSA and advanced disease at diagnosis 1 year ago. We asked about chemo upfront and oncologist said no need, so he only did hormone therapy. He is now castrate resistant and starting chemo. Oncologist dropped him when disease worsened. We are in a new system with new doctor, and don't like it. Trying to find a good oncologist that will be aggressive and fight this thing. Every doctor weve talked with seems so hopeless. The wait to get into the Mayo Clinic is also very frustrating. It takes months.

@dcplunkett 5 месяцев назад

Is there an NCI-designated cancer center near you? www.cancer.gov/research/infrastructure/cancer-centers/find

@ga6589 5 месяцев назад

Don't give up trying to find an oncologist who will work with you. My husband was diagnosed stage 4 3 years ago. We were disappointed with local doctors and finally got in to be seen at Mayo in Rochester, MN. He's being treated there and it made all the difference. Every patient's situation is different, but we feel like there is hope. These PCRI videos have also been very helpful.

@FightProstateCancerWorldwide 5 месяцев назад

You may try to ask TallAllen in section Advanced Prostate Cancer on HealthUnlocked forum.

@ThePCRI 5 месяцев назад

Hello Shannon, please reach out to our helpline. They may be able to help you find someone: pcri.org/helpline

@dusanjez2011 4 месяца назад

You only talk about successful cases, never about medical defeat when the patient is going to die in spite of all medicines.

@dusanjez2011 4 месяца назад

To us who have uncurable status is of little help advice to look for new treatments or to listen of cases where disease has dissapeared. To come in paliative status is a hard blow and defeat for patient and for the doctor who couldnt cure the patient too. Its a lost fight for life.

@brandywvstrong9673 5 месяцев назад

Stay strong everyone. Keep fighting and keep informed and updated 🙏🏻💙🙏🏻

@ThePCRI 5 месяцев назад

Thank you Brandy! You are the best.

@barbaraabbott8254 5 месяцев назад

Sadly, my son has been treated with every treatment available in PC metastatic disease without remission. He is currently at MD Anderson starting a phase 2 clinical trial. He has been fighting aggressively since day one of diagnosis…with the best care at Sloan Kettering, Detroit Michigan when PSMA was brand new, Mayo Clinic , Cleveland clinic, and now MD ANDERSON in Texas. Nothing had brought remission. Some cases are not able to end up on the list of cured, remission, ect. He’s looking at his last hope.

@TERRY-cb2ku 5 месяцев назад

Prayers for all.

@ThePCRI 5 месяцев назад

Barbara, we are so sorry. Please reach out to our helpline if you need support: pcri.org/helpline

@koof1776 4 месяца назад

Google "Joe Tippins" MD And docs told him to transition to hospice because his cancer was from skull to liver to toes. Aft ~4 months of dosing fenbendazole the docs jaws dropped when scans revealed NED (No Evidence of Disease). God Speed 🫶🏻💪🏻🙏🏻

@dusanjez2011 4 месяца назад

Many many men die of prostate cancer, because drugs help a limited time, I am also in an uncurable condition. Dictors dont like to talk about these paliative hopeless cases.

@aidanmiller4595 5 месяцев назад

Alex you are a beautiful girl. Thank you so much for hosting these videos. You and Dr. Scholz are fantastic. I have been diagnosed with 3+4 prostate cancer 3 years ago but have not had treatment so far. My original urologist wanted to schedule surgery immediately but since watching your videos I have waited. My PSA is rising gradually up to 11 from 6 four years ago. The MRIs show slow progression for the last 3 years. I am under the care of UofM Ann Arbor Oncology. They seem very willing to work with me on what I would like to do. Based on your videos I am leaning toward radiation if it comes to that. Please continue your videos. Thank you.

@TERRY-cb2ku 5 месяцев назад

I had an MRI back in February that showed an 8mm lesion left anterior portion of my prostate. Nothing in the pelvic region or lymph glands outside of prostate. Due to an accident 15 years ago I had a full body CT with contrast that showed some "calcification" of the prostate. Who knows how long that had been there before that scan was done ? My highest PSA level has been 5.56, but came back down to 4.3 after a five day regimen of antibiotics for a UTI. My doctor is pressing me to have a biopsy asap. I'm still researching all the procedures and treatments and will not be pressured to do anything just yet. May not be able to get the PSMA scan done without first getting a biopsy to confirm if it is or isn't cancer. Or the genetic testing to determine if it will be something relatively benign or aggressive . I have questions and concerns and I would like to sit down with an oncologist before I proceed further. I'm still fully functional as a man, even at being nearly 73 years old. I'm going to start making phone calls tomorrow for appointments to try to talk to someone besides my urologist who's talking radiation even before I've had a biopsy. Our pastor's health was nearly ruined by brachytherapy radiation. Impotent, incontinent and wears depends. Has been "drilled" out three times, nearly bled out once, and has had to be catherterized multiple times. He's in constant pain.

@ThePCRI 5 месяцев назад

Thank you so much for your kind words and for sharing your story!

@jabster58 5 месяцев назад

He doesn't say how bad the side effects are that make you deathly ill.

@carmenvilleneuve5482 5 месяцев назад

The Chemo is not that bad it's well tolerated mostly fatigue for 3 to 5 days . The hormone therapy kills testosterone so your sex drive is gone . I find the hormone therapy makes you tired also . I manage quite well so far and can still get out and do what I want . It's not always easy but I push through it .

@northpointer7305 5 месяцев назад

I’ve been on hormone deprivation therapy for two years. I stopped for three months and 5he cancer came right back. I find it almost debilitating in terms of fatigue. My doctor told me I’m incurable, just do adt until it doesn’t work and then maybe do chemo all the way to 5he grave and be even more miserable. I’m looking right now for another opinion. Seems like doctors are afraid to be aggressive.

@carmenvilleneuve5482 5 месяцев назад

@northpointer7305 Absolutely get another opinion . They might have a recipe to help you . This is why the work that Dr Scholz and Alex do on their own time gives us hope and some very good pointers . My Oncologist from d.ay one was very aggressive and monitoring me closely she told me on step at a time should and when the current hormone therapy stops working she has tools in her tool box to try something else . Best of luck to you ! Go get more opinions

@ThePCRI 5 месяцев назад

Hello, we are so sorry you are dealing with this. Please feel free to reach out to our helpline if you need support. Here is the link to contact them: pcri.org/helpline

@vovodetna8828 4 месяца назад

Doctors seem to gloss over or not even mention the nasty side effects of any treatment. I think they have an OBLIGATION to do so.

@dcplunkett 5 месяцев назад

I had a five-digit PSA when initially diagnosed. That was almost five years ago. Lupron and six cycles of docetaxel brought my PSA down to single digits. When it doubled from nadir, I was started on abiraterone and had six cycles of cabazitaxel. Last chemo infusion was three years ago. I'm still on quarterly Lupron and daily abiraterone. PSA has been at or near 0.01 for two years now. I don't claim to be in remission, because quarterly CT scans and bone scans still show a lot of lymph node mets and bone mets, but they are not growing or spreading. The side effects are no fun, but the medications are doing what I need them to do. Some day the cancer will start to grow again. That might (or might not) be accompanied by an increase in PSA. It is encouraging to know that the variety of treatment option that will be available to me when that happens continues to grow.

@billhamilton7524 5 месяцев назад

Glad your here ,,side affects ,,

@steppenwolf3930 5 месяцев назад

Hi, did you include a radiation therapy as well? thanks

@dcplunkett 5 месяцев назад

@@steppenwolf3930 No, too many mets, and too widespread.

@dcplunkett 5 месяцев назад

@steppenwolf3930 No, too many mets, and too widespread.

@edg531 3 месяца назад

Happy for you, DC. I see us as being in it for the “long game.” Sounds like you do, too. The longer we live, the better chance we have of modern medicine developing new techniques that could lead to cures and/or better quality of life. Hang in there!

@paulsmith4369 4 месяца назад

I am 70 yrs old and was diagnosed Stage 4 in July 2019 with PSA of 5375. Went on ADT Lupron along with Zolomax for bone mets for 2 years. PSA dropped to 4. Couldn't continue treatment due to COVID pandemic etc. Went back into hospital in July 2023 with PSA of 1530, blocked ureters and tumor that was the size of a grapefruit. Put back on Lupron which dropped PSA down to 235 - then it started going up again so the Dr added Abiraterone which slowed PSA rise. I am going to start Taxotere in a couple weeks. My Dr is going to do genetic testing on the tissue from the 2019 biopsy to see what other treatments could be available in case the chemo doesn't succeed. It's been a long almost 5 year battle - but I am positive, I am still pain free and have been working 40-50 hours a week ( even with a urinary catheter). I appreciate all the tips on how to minimize the side effects of chemo. I will do the fasting suggestion and see how that helps - I will let you know. If you know of any additional actions that I can be taking on the natural/holistic side of the fence to augment my treatment I would appreciate it!

@zenman11 4 месяца назад

maybe investigate what DR Thomas Lodi of Oasis of healing has to say,..hes VERY knowledgable on that side of the fence,..there is a RU-vid video entitled 'Going integrative plus membership call with Dr Thomas Lodi' which will give you some idea of what hes about, he has the clinic in Arizona but also just opening a clinic in Bangkok

@stitcheruk1150 4 месяца назад

Would suggest that you keep your mouth cool with ice cubes during the chemotherapy and 30 minutes afterwards - this will prevent blisters and ulcers. Also, use ice (gel) gloves (NEWGO) and a frozen ‘hot’ water bottle for your feet- these will go a long way to prevent neuropathy. I developed neuropathy in my toes after the third of session. I used the frozen hot water bottle for the last three sessions and it didn’t get any worse. Mouth and fingers were ok.

@carmenvilleneuve5482 5 месяцев назад

Great information I was diagnosed in March 2023 with advanced prostate cancer mets to bones and Liver . PSA at time of diagnosis was 204 I was referred to an Oncologist and Urologist they quickly had me in the Chemo Lazy Boy and started hormone therapy. I was surprised how quickly they got me to 0.1 . 12 months later my psa is at 0.3 My Oncologist will monitor my situation again on May 24 and go from there . My last psa test was near the end of my Zoladex next injection I'm not sure if that is the reason for the slight increase . Thank you for the information Dr Scholz and Alex . More tools and options 🙂

@billhamilton7524 5 месяцев назад

Glad your here ,,side affects ,,

@carmenvilleneuve5482 5 месяцев назад

@@billhamilton7524 Hi Bill Like Dr Scholz said the chemo is actually not that bad , following the chemo you will have plenty of energy seeing they give you prednisone. But after 48 hrs you really feel the side effects of the chemo treatment mostly fatigue for 3 to 5 days . The hormone treatment is real it kills your testosterone . Basically you're not the strong Bull Moose you once were . Sex drive is gone , you feel weaker for sure . The treatments work, definitely some side effects but manageable . I consider myself lucky and hopeful that perhaps I can stretch this out for some years to come . Stay positive Stay busy Stay happy We didn't get run over by a cement truck or attacked by a bear . We have Met prostate cancer , it's not an immediate death sentence. Dr Scholz and Alex give hope and options . All the best to Everyone Stay strong mentally and physically.

@carmenvilleneuve5482 5 месяцев назад

@@billhamilton7524 Mostly fatigue Restless crazy legs at times Some muscle aches All in all not bad at all .

@xt8ob 5 месяцев назад

Thank you so much for this video. I had an initial PSA above 1,600 with over 25 bone mets at age 51. My team put me on 1st and 2nd gen ADT but NOT chemo. Question, does it make sense for me to start chemo 3 years after my diagnosis? I know every situation is different, but all things being equal, is it too late to start me on triplet therapy?

@bobliening5783 5 месяцев назад

Outstanding question. I’m in a similar situation. PSA 1,300, Mets all over in ribs and vertebrae, ADT 1st and 2nd gen, no chemo. PSA to 0.09 after about three and a half months. Steady PSA since May 2022. Oncologist and Urologist say I’ll be on Lupron and probably Xtandi forever. My question is the same as yours. Does it make sense to add chemo at this point?

@xt8ob 5 месяцев назад

@@bobliening5783 I think this video messed me up a little bit. The claim that if you aren't at zero, you need to add more treatment, is not backed up by research. I spoke with two oncologists this week and they say that my response (and yours) are just fine and that chemo should be held until castration resistance.

@peterkooistra8442 5 месяцев назад

@xt8ob similar experience with my oncologist at City of Hope in Duarte, CA. I was diagnosed with a PSA of 50 at age 53 in 2021. Went with a prostatectomy and they found it spread to my seminal vesicles and 1 lymph node. My PSA started climbing to 2.6 soon after so they did low dose radiation in my pelvic region for about 4 weeks and out me on Lupron. The PSMA PET scan wasn’t FDA approved yet. That bought my PSA down to .017. That lasted until Oct 22 when my PSA jumped back up to 2. Got a PSMA PET scan and it was found in 2 ribs. Did SBRT radiation in Dec as well as adding daily Zytiga and by Feb 2023 PSA was down to

@xt8ob 4 месяца назад

@@koof1776 Your opinion is ill-informed. Considering he said it had spread, it was NOT a false positive.

@koof1776 4 месяца назад

@@xt8ob Who really knows, most men die not knowing they have mets. Think~

@roboodonnell3224 5 месяцев назад

Thank you, folks!

@TERRY-cb2ku 5 месяцев назад

I have a cousin who's PSA levels range at around ten. He says that's normal for him as he gets tested at regular intervals. He's had a biopsy that was negative for cancer. I'm of the opinion that he might have something else going on such as inflammation or Chronic UTIs causing his PSA levels to stay high.

@ThePCRI 5 месяцев назад

Hello, 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

@SeekingWisdom17 4 месяца назад

He may have bigger prostate. There's a formula called 'PSA density' to test if PSA is in normal range. Divide the prostate volume (in cc/ml) into the PSA. If it is lower than 0.15 then the PSA is normal. For example: If prostate volume is 74 mL and PSA is 5.7 then PSA density is 5.7 / 74 = 0.077 which is less than 0.15 and therefore in normal range.

@JSmith-p6i 4 месяца назад

Any comment about FAPI pet scans for PSMA negative cancer such as sensitivity compared to PSMA and when they might be available?

@zenman11 4 месяца назад

Ive heard that chemo wipes out the major tumours but does not kill off the cancer stem cells which go on spreading and the cancer 'comes back',.. after a few years with a vengeance and that the immune system has been weakened or destroyed by the chemo and not able to mount a defence. I this true with the treatments for PC that you're talking about in this video? so are these patients you are talking about in real remission or are they likely to encounter the scenario just mentioned?

@mikeoniones667 5 месяцев назад

Thanks for hope Dr. I'm On docetaxel 2nd time. ADT washed out-So did Radiation..

@sachin271093 5 месяцев назад

Thanks. Very informative and assuring

@orangeguy3314 5 месяцев назад

I hear there's a test call PSE. That's more accurate than the standard PSA. Why isn't everyone going to get the PSE test?.

@barrie888 5 месяцев назад

tks the effort to discuss this important topic

@michaelhelfand8773 5 месяцев назад

18:52

@jabster58 5 месяцев назад

Ok I'm confused can someone explain to me how, the five-year survival rate for men with localized prostate cancer is nearly 100%. However, up to 40% of men will experience a recurrence, so it is important to understand your risk for recurrence..so reoccurrence means it spreads up to almost 50 percent of the people...what the heck...explain this

@lensierra-scacalossi7718 4 месяца назад

That 40% recurrence rate might be on the high side, but even so, having a recurrence doesn't mean that the survival rate will be changed substantially at the 5-year mark. After recurrence, there are still many treatment options that can work to prolong survival well beyond 5 years.

@ahmadijaz34 4 месяца назад

How can I contact you is there any email?

@ThePCRI 4 месяца назад

Here is our contact page: pcri.org/helpline

@rytenny1 5 месяцев назад

Is Intermittent Hormone therapy an option for cases with Advanced Prostate Cancer but has become undetectable within 6 months? If so what is the general length of time they stay on hormone therapy? Dr. Scholz mentioned his patient was on hormone therapy for 18 months then taken off and in other cases I have heard people going on "vacation" at 9-12 months? Thanks for the great information!

@ThePCRI 5 месяцев назад

@JasonRoberts556 5 месяцев назад

For all of those with extremely high PSA’s ~ How did your PSA’s get that high & How old were you when you found out your high PSA level.

@dcplunkett 5 месяцев назад

When I reached age 50, my doctor included a DRE in my annual physical, and it was unremarkable. He did not order a PSA test. Later that year he retired, and I never got around to finding a replacement primary care physician. That was a mistake. Four years later, lower back pain finally motivated me to do find a doctor. So I had just turned 55 when I was diagnosed metastatic de novo.

@JasonRoberts556 5 месяцев назад

@@dcplunkett Sorry to hear about your situation but am glad to hear that you’re doing well. You mentioned that your PSA levels were in the 5 digits? From what it sounds like with numbers that high, I highly doubt the PC started and increased that much within those five years. Probably had PC much longer. What are your thoughts?

@dcplunkett 5 месяцев назад

@jasonroberts556 It was 11,201.7 -- so I have to wonder what it was when I had the "unremarkable" DRE at age 50.

@shannonrogers5648 5 месяцев назад

My husband had been treated for a prostate infection for two years. His PSA was actually flagged high years earlier, but CT and MRI were clear. By the time he had symptoms, urologist insisted it was just an infection. Threw antibiotics at it for 2 years. Eventually husband landed in ER for what we thought was a stroke-it was metastatic PC. PSA was over 300. Found out the urologist had done another MRI which showed suspicious for cancer and he never did anything about it, never told us, nothing. Tried filing a malpractice suit but were told we didn't have a case either. Go figure.

@dcplunkett 5 месяцев назад

@@shannonrogers5648 😪

@jabster58 5 месяцев назад

Why should the patient have a backup plan..isn't that the doctors job to know the best backup plans

@carmenvilleneuve5482 5 месяцев назад

The information provided gives us the tools to ask our Oncologists what is plan B or C ..... Should the initial treatment stops working. The more information we have the better . Best of luck