Hi-Risk/Recurrent/Advanced PCa Video Chat, April 22, 2025
AnCan is grateful to the following sponsors for making this recording possible: Bayer, Foundation Medicine, Janssen, Myriad Genetics, Novartis, Telix, Blue Earth Diagnostic and Foundation Medicine.
AnCan respectfully notes that it does not accept sponsored promotion. Any drugs, protocols or devices recommended in our discussions are based solely on anecdotal peer experience or clinical evidence.
AnCan cannot and does not provide medical advice. We encourage you to discuss anything you hear in our sessions with your own medical team.
AnCan reminds all Participants that Adverse Events experienced from prescribed drugs or protocols should be reported to the pharmaceutical manufacturer or the FDA Adverse Event Reporting System (FAERS). To do so call 1-800-332-1066 or download interactive FDA Form 3500 https://www.fda.gov/media/76299/download
All AnCan’s groups are free and drop-in … join us in person sometime!
Editor’s Pick: If you’re thinking Pluvicto, consider TLX591 (rd)
Topics Discussed
Younger Newbie concerned how to speak with his teenager; doublet or triplet for Canadian; Capt. Jim appreciates Dr. John’s heart intro; rising PSA remains a mystery; if you’re thinking Pluvicto, consider TLX591; remission continues thanks to AnCan; concerned about tentacular involvement; just home from HDR brachy
Hi-Risk/Recurrent/Advanced PCa Video Chat, April 14, 2025
AnCan is grateful to the following sponsors for making this recording possible: Bayer, Foundation Medicine, Janssen, Myriad Genetics, Novartis, Telix, Blue Earth Diagnostic and Foundation Medicine.
AnCan respectfully notes that it does not accept sponsored promotion. Any drugs, protocols or devices recommended in our discussions are based solely on anecdotal peer experience or clinical evidence.
AnCan cannot and does not provide medical advice. We encourage you to discuss anything you hear in our sessions with your own medical team.
AnCan reminds all Participants that Adverse Events experienced from prescribed drugs or protocols should be reported to the pharmaceutical manufacturer or the FDA Adverse Event Reporting System (FAERS). To do so call 1-800-332-1066 or download interactive FDA Form 3500 https://www.fda.gov/media/76299/download
All AnCan’s groups are free and drop-in … join us in person sometime!
Editor’s Pick: Testosterone and estrogen return after stopping HT – and play tricks on two gents (rd)
Topics Discussed
Testosterone storms back – but so does estrogen!; Yale Smilow doc requests Dceipher test and MSKCC doc refuses; time for salvage protocol but Canadian protocols for RT and HT not exactly clear; bone biopsy may be best but least invasive method to determine if lesion is metastatic; hot flashes start with Intermittent Hormone Therapy – screwed up ‘sex’ hormones return; how many ways can we lower the HT dose?… or should we prior to at least 18 months duration.
I am really tired tonight i catch up next time thanks and Good night
John A sent: 5:43 PM
my ATM notes don’t mention RT
Michael. Denver sent: 6:00 PM
Thanks y’all. Have to leave early.
Jim Marshall, Alexandria, VA sent: 6:02 PM
Abiraterone Acetate.
AnCan – rick sent: 6:03 PM
relugolix, Orgovyx
Larry (Alaska) sent: 6:03 PM
Mechanism of action of abiraterone is different from Docetaxel. Abi is an androgen blocker. Doce interferes with cell division. (rd: not exactly – it’s more of an androgen destroyer than blocker)
Relugolix suppresses Testosterone (which signals prostate cancer dells to divide).
John A sent: 6:06 PM
562
Larry (Alaska) sent: 6:06 PM
I have my spreasheet for conversion Pmols//L to ng/mL. But I don’t have the figures we are talking about.
Len Sierra sent: 6:06 PM
Levels above 500ng/dl or 17.3358 nmol/L is considered optimal.
Gary V Portland, Oregon sent: 6:07 PM
Sorry Gents I have to leave..Thanks so much for all the information
Jim Marshall, Alexandria, VA sent: 6:08 PM
19.7 = 568. marshall’s math. who agrees
Close enough for government work
Len Sierra sent: 6:11 PM
Bravo, Jim!
Larry (Alaska) sent: 6:17 PM
Does any practice use BOTH pelvic-wide radiation in combination with focused radiation on selected spots? Or is that just never done?
Patient take charge!
Jim Marshall, Alexandria, VA sent: 6:32 PM
Bone Biopsies can be done asleep.
As I contend Hormones will do it to you every time. Jim
Hi-Risk/Recurrent/Advanced PCa Video Chat, April 8, 2025
AnCan is grateful to the following sponsors for making this recording possible: Bayer, Foundation Medicine, Janssen, Myriad Genetics, Novartis, Telix & Blue Earth Diagnostic.
AnCan respectfully notes that it does not accept sponsored promotion. Any drugs, protocols or devices recommended in our discussions are based solely on anecdotal peer experience or clinical evidence.
AnCan cannot and does not provide medical advice. We encourage you to discuss anything you hear in our sessions with your own medical team.
AnCan reminds all Participants that Adverse Events experienced from prescribed drugs or protocols should be reported to the pharmaceutical manufacturer or the FDA Adverse Event Reporting System (FAERS). To do so call 1-800-332-1066 or download interactive FDA Form 3500 https://www.fda.gov/media/76299/download
All AnCan’s groups are free and drop-in … join us in person sometime!
Editor’s Pick: Testosterone superman deflates — and his shrine is dismantled — after he checks his math (bn).
Topics Discussed
Will a switch to estrogen outsmart the cancer?; he was slated for 3 years of ADT, but may want to quit or or ease off on year 3 — many options exist but not all are proven; third Pluvicto round for Marc V — he’s looking well, and Dr. Aggarwal’s feeling good about the results; the right way to taper off a bone strengthener; the story of CD46, a promising PCa marker for theranostics; spotlight’s back on hot flashes — as usual, many suggestions; he wants to resume his job the day after brachy — possible?; cardio-oncologist in Chicagoland?; testosterone superman deflates — and his shrine is dismantled — after he checks his math; off ADT, should he worry about rising T?; too early in the game for neuroendocrine worries; even if you need to wait for a scan, don’t start ADT without one; don’t sweat the small stuff when it comes to rising PSA; insufficiency fractures; what to expect during radiation treatment — Dr. Mark’s the expert.
Chat Log
AnCan – rick · 6:41 PM
How Cancer Cells Travel to New Tissues and Take Hold… https://www.medscape.com/s/viewarticle/how-cancer-cells-travel-new-tissues-and-take-hold-2025a10007rt?ecd=WNL_trdalrt_pos1_250407_etid7346797&uac=529807HK&impID=7346797
AnCan – rick · 7:24 PM
Here’s the Mayo paper by Brad Stish re. oxybutynin https://www.medpagetoday.com/meetingcoverage/asco/110457?xid=nl_mpt_DHE_2024-06-03&eun=g1169472d0r&utm_source=Sailthru&utm_medium=email&utm_campaign=Daily%20Headlines%20Evening%202024-06-03&utm_term=NL_Daily_DHE_dual-gmail-definition&mc_cid=81fa35ee19&mc_eid=838454d636&mc_cid=1550e5c67f&mc_eid=838454d636
AnCan – rick · 7:27 PM
Forget that link – here’s the right one https://www.medpagetoday.com/meetingcoverage/asco/110457?xid=nl_mpt_DHE_2024-06-03&eun=g1169472d0r&utm_source=Sailthru&utm_medium=email&utm_campaign=Daily%20Headlines%20Evening%202024-06-03&utm_term=NL_Daily_DHE_dual-gmail-definition&mc_cid=81fa35ee19&mc_eid=838454d636&mc_cid=1550e5c67f&mc_eid=838454d636
AnCan – rick · 7:30 PM
The culprit that makes oxyb. work better with abi is the CYP3A4
Steve Roux, North Michigan · 7:54 PM
I’m late for dinner. GREAT Mtg guys! See you next week!
John A · 8:14 PM
insufficiency fractures: result of normal stress on abnormal bone ….fatigue fx: abnormal stress on normal bone…. .pathological fx: diseased weakened bone due to tumors or abnormal bone . ….stress fx: means chronic mechanical stress exceeds the bone’s capacity
Bob Schwartz, USN, Venice FL · 8:15 PM
Another good mtg., have to go.
AnCan is grateful to the following sponsors for making this recording possible: Bayer, Foundation Medicine, Janssen, Myriad Genetics, Novartis, Telix & Blue Earth Diagnostic.
AnCan respectfully notes that it does not accept sponsored promotion. Any drugs, protocols or devices recommended in our discussions are based solely on anecdotal peer experience or clinical evidence.
AnCan cannot and does not provide medical advice. We encourage you to discuss anything you hear in our sessions with your own medical team.
AnCan reminds all Participants that Adverse Events experienced from prescribed drugs or protocols should be reported to the pharmaceutical manufacturer or the FDA Adverse Event Reporting System (FAERS). To do so call 1-800-332-1066 or download interactive FDA Form 3500 https://www.fda.gov/media/76299/download
All AnCan’s groups are free and drop-in … join us in person sometime!
Editor’s Pick: We’re talking incontinence and tricks to manage it this week + Pluvicto works! ? (rd)
Topics Discussed
ATM germline Gent faces recurrence; slow moving recurrence brings urinary incontinence; MRI finds hip lesion raising early Mx – do PSMA for pace of mind; neuropathy dismissed by Mayo docs as ageing – not HT or chemo???; when to ask for PSMA on recurrence; Pluvicto brings great results – enjoy it rather than ask what’s next; how do differences in MRI equipment impact interpretation?
Chat Log
Wes – San Diego sent: 5:17 PM
Intraductal commonly, I’m told, has a low PSA.
Wes – San Diego sent: 5:22 PM
What does a medical oncologist add to surgeon and radiologist? Hormones?
Gary sent: 5:24 PM
Medical Oncologist deals with everything from ADT to lutetium, docetaxel, etc.
So it would seem to me that any prostate guy would be wise to have a medical oncologist, albeit others can prescribe Lupron, etc.
Jim Marshall, Alexandria, VA sent: 5:26 PM
Specifically one should look for a Genitourinary Medical Oncologist. NOt a General Meneral Oncologist. Jim
Gary sent: 5:26 PM
I agree.
Jim Marshall, Alexandria, VA sent: 5:37 PM
Somatic testing. Jim
John A sent: 5:44 PM
dr.john@ancan.org
Wes – San Diego sent: 5:55 PM
Is it related to drinking carbonated water, beer, etc. ? which prompts me much, much more than other drinks.
AnCan – rick sent: 5:57 PM
Gemtessa
Alfredo in Houston sent: 5:58 PM
I think it is NOT generic yet, and around $500/ 30 days
Bob Schwartz, USN, Venice FL sent: 6:20 PM
Another good mtg. Have to go.
Wes – San Diego sent: 6:32 PM
heart BP meds can prompt gout and edema, which can be related to nueropathy, as they have been for me.
Don Rogers sent: 6:32 PM
Dan, I would suggest you contact the radiologist and set up a meeting and have the doctor explain the report. I have done this twice with great success. Don Rogers
AnCan – rick sent: 6:33 PM
Don – may be harder to do at Kaiser.
Hank Zajic Springfield VA sent: 6:38 PM
I just did a PSMA PET using Pylarify. The test result report recorded 8.86 mCi (millicurie) dose. not much.
Alfredo in Houston sent: 6:38 PM
The amount of radiation exposure from an imaging test depends on the imaging test used and what part of the body is being tested. For instance: A single chest x-ray exposes the patient to about 0.1 mSv. This is about the same amount of radiation people are exposed to naturally over the course of about 10 days. A mammogram exposes a woman to 0.4 mSv, or about the amount a person would expect to get from natural background exposure over 7 weeks. Some other imaging tests have higher exposures, for example: A lower GI series using x-rays of the large intestine exposes a person to about 8 mSv, or about the amount expected over about 3 years. A CT scan of the abdomen (belly) and pelvis exposes a person to about 10 mSv. A PET/CT exposes you to about 25 mSv of radiation. This is equal to about 8 years of average background radiation exposure.
Hi-Risk/Recurrent/Advanced PCa Video Chat, March 11, 2025
AnCan is grateful to the following sponsors for making this recording possible: Bayer, Foundation Medicine, Janssen, Myriad Genetics, Novartis, Telix & Blue Earth Diagnostic.
AnCan respectfully notes that it does not accept sponsored promotion. Any drugs, protocols or devices recommended in our discussions are based solely on anecdotal peer experience or clinical evidence.
AnCan cannot and does not provide medical advice. We encourage you to discuss anything you hear in our sessions with your own medical team.
AnCan reminds all Participants that Adverse Events experienced from prescribed drugs or protocols should be reported to the pharmaceutical manufacturer or the FDA Adverse Event Reporting System (FAERS). To do so call 1-800-332-1066 or download interactive FDA Form 3500 https://www.fda.gov/media/76299/download
All AnCan’s groups are free and drop-in … join us in person sometime!
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.
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.
