Hi-Risk/Recurrent/Advanced PrCa Video Chat, Dec 15, 2025

Hi-Risk/Recurrent/Advanced PrCa Video Chat, Dec 15, 2025

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Editor’s Pick: Finishing 10x Pluvicto; and, following up post-surgery for BRCA germline Gent

Topics Discussed

Endorsing AnCan; 10 rounds of Pluvicto – with a break after 6; low dose estrigen enquiry; Newbie want to know when to intervene on recrrence post-surgery; Tempus report shows PTEN and more; cribriform favors radiation over surgery; time for another PSMA scan; IHT or mono daro – beware of gynecomastia; can reduciing daro dose loer fatigue?; more on cribriform and RT; debulking primary tumor post chemo; BRCA germline Gent wondes when to intervene with RT post RP – and if to include HT

Chat

• Jeff Marchi – San Francisco

  sent: 6:12 PM

  friday this week

• Thomas Matica

  sent: 6:14 PM

  Glad to hear Peter Kafka is doing well.

• Stan Friedman

  sent: 6:29 PM

  after 5 sessions, my psa is now undetectable

• Mark N

  sent: 6:30 PM

  What is the drug that was just discussed?

• Larry Schuller – Alaska

  sent: 6:31 PM

  Mark, Pluvicto work the same way imaging for PSMA-PET scans do. Instead of just giving an image of where the cancer is, it delivers a higher dose that is therapeutic

• Mark N

  sent: 6:31 PM

  Thanks!

• AnCan–John A

  sent: 6:33 PM

  Lee–still undetectable psa?

• Larry Schuller – Alaska

  sent: 6:34 PM

  Many side effecs of standard ADT is actually caused by estradiol deficiency (which is caused by the absence of testosterone). This deficiency is the same as what causes osteopoosis in post-menopausal women.

• Larry Schuller – Alaska

  sent: 6:35 PM

  Men normally have between 15 and 50 levels of estradiol

• Larry Schuller – Alaska

  sent: 6:36 PM

  Breast growth and nipple sensitivity is a side effect of standard ADT too, but at a lower incidence than with estradiol.

  Jerry G, Brighton, MI

  sent: 6:39 PM

  I’ll add support for higher dose estradiol, for me in the absence of testosterone. My osteopenia cleared up, and I am now in the normal range for bone density. I have been on permanent ADT for almost 7 years now, and estradiol for just over 6. My PSA is still undetectable

  Larry Schuller – Alaska

  sent: 6:49 PM

  Tom Miller’s Lymph nodes?

• Lee Baylin, Baltimore

  sent: 6:52 PM

  Dr. John, I’m still undectable.

• AnCan – rick

  sent: 6:59 PM

  Curtis DeVille an Channing Paller at Sibley

• Bob Schwartz U.S.N. Venice, FL.

  sent: 7:00 PM

  Once again, many thanks to the Unknown Anonymous Benefactor, who is matching donations to AnCan. Please know that your kindness is very much appreciated. Good meeting as usual, unfortunately have to go early.

• Larry Schuller – Alaska

  sent: 7:08 PM

  A promising area of research, though

• Larry Schuller – Alaska

  sent: 7:09 PM

  Immunotherapy is a promising area of research.

• Larry Schuller – Alaska

  sent: 7:09 PM

  Immunotherapy is a promising area of research

• Larry Schuller – Alaska

  sent: 7:09 PM

  Oops. Sorry about the triple post

• Eric James; Tyler TX

  sent: 7:12 PM

  Genetic Variant Results ALK – p.G5R – c.13G>A Missense variant Assessment:Detected CDKN2A – CDKN2A Copy number loss Assessment:Detected CDKN2B – CDKN2B Copy number loss Assessment:Detected MTAP – MTAP Copy number loss Assessment:Detected PIK3CA – p.E545K – c.1633G>A Missense variant (exon 9) – GOF Assessment:Detected PTEN – p.A34fs – c.101del Frameshift – LOF Assessment:Detected TMPRSS2::ERG Fusion – TMPRSS2 – ERG Chromosomal rearrangement Assessment:Detected

• RJ Smith (Seattle)

  sent: 7:12 PM

  SYNC-T? https://syncromune.com/science/

• Darren Chervitz

  sent: 7:17 PM

  Gedatolisib is a PI3K/AKT/mTOR (PAM) pathway inhibitor showing promising early results in clinical trials for metastatic castration-resistant prostate cancer (mCRPC), often combined with AR inhibitors like darolutamide, targeting the PI3K pathway which is frequently altered in advanced prostate cancers, especially with PTEN loss, to control cell growth and survival, with studies aiming to find optimal doses and demonstrate improved survival and response rates.

• Larry Schuller – Alaska

  sent: 7:26 PM

  Get a baseline bone density, too

• Larry Schuller – Alaska

  sent: 7:29 PM

  Exercise program. A healthy body withstands the rigors of treatment better

• RJ Smith (Seattle)

  sent: 7:30 PM

  Along with all the other tests, PROSTOX might help to know if you are prone to long-term side effects from the radiation. Most people aren’t. Like Rick said, though, if you’ve decided on radiation–might just take go for it. 😉

• Steve L

  sent: 7:44 PM

  By the way, My immunotherapy induced Pulmonary embolism cleared this summer after about 12 months. I started feeling better immediately. They have pulled me off Eliquis. I am back to scuba diving. Currently feeling very good.

• AnCan–John A

  sent: 7:46 PM

  Noted, Steve. that’s good

• Bruce Schrimpf

  sent: 7:55 PM

  Again A very good discussion! Should I not see you before, Merry Christmas!

• AnCan – rick

  sent: 8:00 PM

  https://jamanetwork.com/journals/jamaoncology/article-abstract/2840006?guestAccessKey=a83645e8-deae-423a-9139-d772a3301482&utm_medium=email&utm_source=postup_jn&utm_campaign=article_alert-jamaoncology&utm_content=olf-recommended-tfl_&utm_term=110625

• Larry Schuller – Alaska

  sent: 8:15 PM

  Re: Second reads on PSMA-PET scan. I had a scan at Fred Hutch Cancer Center and the report was MUCH MORE detailed than the scan I had at my local imaging center. So, Second reads on the original scan imaging is valuable, in my opinion.

• Larry Schuller – Alaska

  sent: 8:17 PM

  On top of that, the written report is only words. Actually showing the imaging to my surgeon saved me an extra surgery. Not mentioned on the report’s text wat that a reservoir from a prior surgery would complicate a robotic prostatectomy. It turns out that if a robotic had been started, it would have had to have been aborted, necessitating a subsequent open procedure.

• Larry Schuller – Alaska

  sent: 8:18 PM

  Show your original imaging to your doctors, especially if approaching surgery

• dan-s

  sent: 8:21 PM

  Thanks all for another great mtg – I have to leave (up early tomorrow)

• AnCan – rick

  sent: 8:22 PM

  Gents – long posts in the Chat poses a problem when we write up these meetings. There is a limit in You Tube on what we can paste.