Hi-Risk/Recurrent/Advanced PCa Video Chat, Oct 22, 2024

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High-profile British cyclist Chris Hoy fears the worst — Rick wants him to know there’s hope; ADT doesn’t just give you reasons to be sad, it physically causes depression — and if you don’t treat it, everything else gets worse; jury’s been out a long time on ADT and dementia; ADT side effects don’t wear off, as with other drugs — they get worse;  on a drug holiday, his PSA has stayed undetectable — but not so fast: it only counts if testosterone is going up; drug holidays can’t come right away — they have to be earned;  PSA rises, rises, rises, after he’s taken off Lupron, but Kaiser doc hasn’t acted;  VA may be his way out of the Kaiser trap; after hating it twice before, darolutamide now suits him well; that lead box is a clue he’s not about to get the FDG PET he needs for his non-avid lesions; whirlwind of confusion over the new Part D rules and the magic $2,000 number; now that radiation treatments are over, when should he get a PSMA PET scan?; off Lupron and on darolutamide monotherapy, he feels about the same — does that make sense?; he’s already doing what his intraductal diagnosis suggests he do; doc who says no to everything should be saying yes to PSMA PET

Jim Marshall, Alexandria, VA · 6:29 PM

On ADT & Abiraterone for 5 years,stayed active, volunteering, bike rides even when fatigued, keepig my mind active doing research on PC and Veterans Affairs.   No time to feel sorry for myself.    Jim Marshall, USAF(Ret)

Steve L · 6:37 PM

I was classified low volume metastatic even with 12 of 12 cores positive because I have only 2 bone mets.   Does the seem right?

AnCan  – rick · 6:47 PM

$@Steve L-ID-400003$… low volume Mx is different from low volume Biopsy. Very different kettles of fish

Jim Marshall, Alexandria, VA · 6:48 PM

Been on Monthly PSA & testosterone blood tests since the  beginning.    Jim Marshall

Steve L · 6:49 PM

No Decipher.   Gleason of 4 plus 5.

Steve L · 6:51 PM

Great that Bruce has had extended non-detectable PSA

AnCan  – rick · 6:55 PM

I would disagree with @Jeff M.  A Deicpher test at this point is not going to tell you much. It is designed to predict recurrence. 4+5 tells you all you and your med onc need to know.

Steve L · 6:59 PM

My treatment is ADT(lupron), Abi (now with Dexamethasone}.    Also had Provenge in June/July.

Steve L · 7:12 PM

Jeff,  After 2 years of undetectable,  PSA started increasing in January and I was classified castrate resistant.   No radiation nor surgery except turp.  Denovo Mets.   Most recent PSA 0.59

Doug D · 7:34 PM

Unfortunately, I need to leave early for an appointment.  I will be attending these sessions regularly.  I really appreciate your help, guidance, and time.  Thank you very much.

Steve L · 7:51 PM

I recently proposed circulating tumor DNA test,

 PSMA scan, and radiation to primary and mets with negative response.   Any recommendations for a second opinion?  Perhaps MD Anderson or ?????   I am in Seattle area.

AnCan  – rick · 7:55 PM

Steve – this a big question that should be posed to the group. Too much to handle via Chat window.

Steve L · 8:01 PM

Okay,   I will try next meeting if no time today.

Thomas M · 8:04 PM

Good night , Gents,,,,,,,Thomas

dan: alexandria, virginia · 8:12 PM

I have to leave… thanks for advice, Gents.  Night, dan

Julian – Houston · 8:21 PM

Need to go. See you 11/4