Hi-Risk/Recurrent/Advanced PCa Video Chat, Aug 27, 2024

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Newly diagnosed with BRCA2 mutation at age 50, extracapular extension and seminal vesicle invasion – surgery or radiation? PARP inhibitor upfront?; nomograms don’t account for mutations; didn’t love daro, but he’ll give it a second chance; after radiation, recurrence in the prostate but no metastasis — brachy or cryo next?; a new treatment puts an enzalutamide right into the prostate; after 1 1/2 years of monthly Xgeva, time to get off?; Pluvicto was working, so he skipped the last two treatments; insurance coverage for a second Pluvicto treatment; computer failure sends his hospital back to paper and pencil — but he gets his Orgovyx; psst – Dr. Elisabeth Heath plans a move to Mayo; PSA of 3.75 after radiation seems really high — but we’ve seen it take years to drop; doc suggesting a holiday from his abi monotherapy; taper off prednisone slowly and carefully, monitoring blood; for estradiol questions, check out our discussion video with Richard Wassersug.

Darren Chervitz · 6:49 PM

Thanks for listening and for all the incredible information!

Unknown · 7:02 PM

Change of plans, I have no need for time today. Recent Provenge cause pulmonary embolism took about 4 weeks before showing improvement, moderate improvement now. Latest PSA (8-22) trended down to 0.48.

Larry Schuller · 7:05 PM

The conventional wisdom about surgery after radiation is that surgery on tissues that have been damaged by radiation is problematic and most surgeons will try to avoid it.

Larry Schuller · 7:06 PM

Localized ablation is another matter.

Unknown · 7:06 PM

Larry S. – that was the ‘old’ wisdom. It really is no longer.

Larry Schuller · 7:08 PM

Rick, I would LOVE to see that research. I had prostatectomy and am recommended salvage radiation but expect to have future surgeries and am concerned about those.

Unknown · 7:10 PM

No recommendations on avoiding blood clots side effects. Dr stated that he has many patients who have had Provenge and that I am the only patient to report blood clots.

Len Sierra · 7:13 PM

Larry Schuller, there are now surgeions who specialize in post-RT prostatectomy. Dr. Eastham at MSK is one that I know of.

Larry Schuller · 7:14 PM

But is post-radiation surgery common outside of those specialists?

Len Sierra · 7:15 PM

Not sure, probably not common.

Jim Marshall, Alexandria, VA · 7:36 PM

Cookies, to me, are a better choice to donuts. always a nice touch. Jim M

Steve Roux, MI · 7:47 PM

The order I called in to the bakery included 1/2 dozen scones too. Almost like a giant cookie?

Kirt Schaper · 7:52 PM

i have to go, thanks all

Jim Marshall, Alexandria, VA · 7:56 PM

No more worrying about turning 80 an dno longer to worry abouit dying young. Jim

John A · 7:56 PM

🎉

dan, alexandria · 7:58 PM

🏆

GARY Z · 7:58 PM

Thank you, everyone!

AnCan – rick · 7:58 PM

🎆

Steve Roux, MI · 7:59 PM

that’s a sparkler