Options after Abiraterone and Lupron
I was first diagnosed with prostate cancer in January of 2020, with a Gleason score of 9 (5+4).
I opted for radiation, Lupron and radiation seed implants instead of surgery and that all went well with few side effects (actually only ED). The cancer went into remission with undetectable PSA for almost 5 years and then came roaring back and spread to my lungs, which is unusual but not unheard of.
I had lung surgery last September to remove the section of my left lung that had the most and largest nodules, and afterwards was put on Lupron (again), Pregnisone and Abiraterone. So far, the drugs are doing their job and my CT scans (done every 3 months) show that the remaining nodules are either stable or in some cases shrinking, and my PSA continues to drop (it's now at .03).
However, my oncologist told me this is a temporary solution, as the cancer will eventually become resistant to the drugs, and he's hoping to get two years before this happens. When the drugs no longer work, it looks like my two choices for further treatment will be either chemotherapy or Pluvicto. I'll find out more when this eventually happens.
My question is this: has anyone else out been faced with a similar situation (the cancer become hormone resistant) and if both chemo and Pluvicto were both options for you (Pluvicto isn't for everyone), which one did you choose and why?
Thanks for any info or advice anyone can offer.
Tom
Hi
. I know we've traded messages before about lung metastasis and various treatments for advanced PCa. I also want to share with you this article about the paradox of testosterone when it comes to advanced PCa and the unique treatments they are doing: https://corporate.dukehealth.org/news/study-solves-testosterones-paradoxical-effects-prostate-cancer. It may not be for everyone, but want to share the information with you in case you want to ask your doctors about it. Hoping others chime in with their experiences with chemo and Pluvicto. Best, Richard (Team Member) Thanks, Richard. This was very interesting, as it contradicts some current treatment theories, in that it postulates that suppressing all hormones can actually make the cancer worse, whereas in some cases upping the hormones to a normal level can in some cases help. Naturally, I'm pretty confused now! I'll definitely bring this up at my next appointment. Like you, I'm really hoping to hear from some people in regards to the Chemo vs Pluvicto question.
Hi
. It really is counterintuitive to what has been followed for years, but only in relation to advanced cases. There is also the bipolar androgen therapy (BAT) out of Johns Hopkins that alternates the testosterone levels to keep resistance from happening. Here is an early article on this BAT treatment: https://www.pcf.org/could-more-testosterone-be-the-hidden-key-to-fighting-prostate-cancer-part1/ and here is a more complex article from the researchers at Johns Hopkins: https://pure.johnshopkins.edu/en/publications/the-testosterone-paradox-of-advanced-prostate-cancer-mechanistic-/. It is understandable that this is all confusing (can't say that I completely get it), but it does raise some interesting possibilities for longer term care of advanced cases. Best, Richard (Team Member)
Great articles! BAT looks extremely promising for advanced stages. I'm not there yet, but you can bet I'll be bringing these articles up at my next appointment in October.
Richard,
I can't tell you how much I appreciate the information you've given me. You are obviously extremely knowledgeable and on top of developments in the prostate cancer field. Keep up the excellent work!
Best Regards,
TomHi Tom (
). Thank you for the kind words and feedback. It is always great to hear that the information is helpful. It may take it a while to make it to general usage, but there really is some exciting work happening in figuring out the long-term nature of prostate cancer. Best, Richard (Team Member)
