Hi-Risk/Recurrent/Advanced PCa Video Chat, March 11, 2025

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Editor’s Pick: Don’t just call places — take your time and pick the best doctor. (bn)

Topics Discussed

What he needs is a PSMA PET, but he’ll need to push for one in Canada; de novo metastasis with a PSA of only 3.8 is unusual — he needs to take his time and pick a top doctor; a big bump in testosterone on drug holiday without much PSA change — “Enjoy it while you can!,” advises Dr. Paller; fearing the worst from his knee pain, but it’s much likelier to be something nonlethal; he’s found a doctor he likes and his PSA seems to have leveled out; his bone loss looks serious, but treating it hasn’t eased his hip pain; proof that worry works miracles — Dr. John shows how; tough night in the hospital for Jimmy G after catheter fails;  doing well on monotherapy darolutamide; his doctor’s finally ready to start doublet therapy — can he get daro?; seminal vesicle invasion calls for a double dose of caution.

Chat Log

Alfredo in Houston · 6:29 PM
In Saskatchewan, service is available in one location:      PET CT Department     Royal University Hospital, Ground floor,      103 Hospital Drive, Saskatoon     Phone: 306-655-3340

Alfredo in Houston · 6:31 PM
https://www.saskatchewan.ca/residents/health/accessing-health-care-services/medical-imaging/procedures/pet-ct–scanning

Wes – San Diego · 6:31 PM
PSA density is a better measurement of cancer density. (PSA divided by prostate volume). May not be meaningful in your case, Hank, not knowing your history.

Wes – San Diego · 6:33 PM
What does salvage radiation mean?

Len Sierra · 6:36 PM
When surgery fails to keep PSA undetectable, RT is often considered to attempt a cure.  That’s called Salvage RT

John  M · 6:49 PM
Question (When its my turn):  I have my initial meeting with my GU Oncologist (Szmulewitz, UChicago) on Friday. I just started Orgovyx 3 weeks ago. What second generation drugs should I suggest or discuss to supplement the Orgovyx? What other questions should I ask him?

Steve Roux, North Michigan · 6:59 PM
John – My GU put me on Orgovyx 1 years ago with  Abiraterone +prednisone. Ask about it.

Steve Roux, North Michigan · 7:15 PM
Lupron side effects include bone / joint pain

Wes – San Diego · 7:21 PM
Know your LDL size and density (particle sizes); those matter more than basic HDL, LDL numbers. Statins are effective at moving numbers, not at preventing heart attacks (despite what almost everyone in the industry says), although they are v useful in an ER if you have one. Do homework.

Alfredo in Houston · 7:25 PM

CTx Blood Test Results Meaning

John A · 7:27 PM
c-telopeptide, or c-terminal telopeptide.  it’s a fragment of collagen, the protein matrix in bone.  it’s a measure of bone resorbtion and can be used to follow

John A · 7:28 PM
…osteoporosis or bone mets

John A · 7:30 PM
90% of the things I worry about never happen.         Worrying works.

Frank Ciambra   · 7:32 PM
worrying about tommorowa problem will rob your peace today

dan · 7:33 PM
👍

Boyd Harrison, Regina SK · 7:47 PM
I have to leave the meeting now, thanks to everyone…..

Alfredo in Houston · 7:57 PM
November 25, 2024 The Food and Drug Administration (FDA) accepted a supplemental new drug application for Nubeqa (darolutamide) plus androgen deprivation therapy to treat metastatic hormone-sensitive prostate cancer.

Steve Roux, North Michigan · 8:01 PM
Good meeting guys – I got to grab a bite to eat and take my Orgovyx (so says my text reminder). See you next week!

Alfredo in Houston · 8:03 PM
Sorry I have to leave now (central time).  Thank you and best wishes to everyone.