Hi-Risk/Recurrent/Advanced PCa Video Chat, Apr 26, 2022
BREAKING NEWS …. AnCan launches 2 new groups in April – Lupus and Pancreatic Cancer. Find more information on our website https://ancan.org under Groups menu tab.
And coming in May …. a Vets Prostate Cancer Group and Chronic Pain Group.
All AnCan’s groups are free and drop-in … join us in person sometime! You can find out more about this and our other 11 monthly prostate cancer groups at https://ancan.org/prostate-cancer/ Sign up to receive a weekly Reminder/Newsletter for this Group or others at https://ancan.org/contact-us/
Editor’s Pick:Perhaps enzalutamide/Xtandi is causing balance issues … sound familiar? And at the end – finding Pluvicto NOW (rd)
Topics Discussed
Peter K manages his own meds; pain issues from AUD; calcium & Vit D; Pluvicto vs Ac225+Lu177; denovo Mx man needs better guidance; balance issues & enz v daro; great report on UCSF’s GU med onc Dr. Borno; Pluvicto fails to hold chemo-naive man; long-term participant thinks about adding treatment
Chat Log
Herb : 3:24 PM: Len sent an e-mail that his eyes are dilated and filled with a dye so he can’t read the screen.
George Rovder Arlington VA (to Everyone): 4:03 PM: https://faculty.mdanderson.org/profiles/patrick_pilie.html
Peter Kafka – Maui (to Everyone): 4:04 PM: Dr. Pilie – Duke Medical school, He is a genitourinary med onc at MD Anderson
George Rovder Arlington VA (to Everyone): 4:05 PM: 2015-2018 Clinical Fellowship, Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX Assistant Professor, Department of Genitourinary Medical Oncology, Division of Cancer Medicine, The Univ. of Texas MD Anderson Cancer Center, Houston, TX
Hi-Risk/Recurrent/Advanced PCa Video Chat, Apr 18, 2022
All AnCan’s groups are free and drop-in … join us in person sometime! You can find out more about this and our other 10 monthly prostate cancer groups at https://ancan.org/prostate-cancer/ Sign up to receive a weekly Reminder/Newsletter for this Group or others at https://ancan.org/contact-us/
Two new AnCan groups starting this month – 1) Pancreatic Cancer 2) Lupus. Check webiste
Editor’s Pick:Hear about VERY rare form of PCa …. and we revisit metabolic syndrome more than once (rd)
Topics Discussed
Denova Mx Dx …. in Maui!!; germline vs somatic mutations; med onc leaves disease largely untreated; very rare PCa type Dx; did abi cause metabolic issues?; puzzling scalp pain after spot RT to skull base; gabapentin side effects; younger man with denovo Mx has successful Tx; switching to Nubeqa+Orgovyx vs metabolic issues; 2014 participant returns doing well; Dennis Correia back with us; KP caves over Lu177; Pluvicto experiences
Chat Log
AnCan – rick (to Organizer(s) Only): 5:04 PM: Dr. George !!! A leftover from Dominic days
Len Sierra (to Organizer(s) Only): 5:08 PM: Yes, it’s been years since Dr. George S. joined us.
Henry (Private): 5:17 PM: Hey Rick — for the new fellow — recommend triplet therapy per Arasens or Peace? (After PSMA scan of course).
Maria (to Everyone): 5:18 PM: Hi everyone, I just wanted to check in and say Hi, Jeff is enjoying his hormone & zytiga vacation, April PSA is undetectable. You are all in my thoughts…
Joe Gallo (to Everyone): 5:19 PM: Welcome. Thanks for the update Maria.
Joe Gallo (to Everyone): 5:25 PM: Rana Clinic 858-657-7876
Alan Babcock (to Everyone): 5:53 PM: I might be in the wrong group. I am 9 weeks out from a prostatectomy. Dr. Correa, from Fox Chase is minitoring my PSA.
George Rovder Arlington VA (to Everyone): 5:55 PM: Alan, This group is for Stage 4 metastatic and Stage 3 Very High Risk.
AnCan – rick (to Everyone): 5:55 PM: Alan – you are best in Peter’s Low/intermediate group that meets every 2nd & 4th Monday same time and place. We know Dr. C very well
Edward Clautice (to Everyone): 5:56 PM: I received lutetium treatment in Germany last week. Cost about $25k. The appointment was made and paid for before the FDA approved pluvitco. The care was very good. They ran daily scans to monitor lutetium attachment to tumor sites. I am looking now to continue pluvitco here in the USA, potentially at the U of Florida. Question:703-463-0490. clautice@verizon.net. Take care, Ed
George Rovder Arlington VA (to Everyone): 5:57 PM: Thanks Ed. Best of luck.
AnCan – rick (to Organizer(s) Only): 6:23 PM: Dennis Correia is in the house … please give him a shout out! Welcome back.
Don Kramer (to Everyone): 6:40 PM: I just got appeal approval for PSMA formerly denied by UHC med. advantage. Don’t give up if you are originally denied on a potential option for diagnosis you know is approved by medicare but advantage is denying. will share more next week. great meeting thank you all.
Frank Fabish – Ohio (to Everyone): 6:53 PM: Got to go guys. See you next week.
George A Southiere Jr (to Everyone): 6:59 PM: great to see all the new guys and the old guys.enjoyed the meeting tremendously
Jerry Pelfrey – Mexico (to Everyone): 7:09 PM: Jerry, sorry I have to leave.
Henry (to Everyone): 7:12 PM: Thanks all; I have to drop off now. Have a great rest of your evening, gents!
MIke Yancey (to Everyone): 7:17 PM: Enjoyed being on this call for the first time. Plan to join again next week. Gotta run for tonite.
John Birch (to Everyone): 7:19 PM: Need to go, thank you everyone for sharing and info
Some may have read the excellent ediorial written by Moderator Ben Nathanson in a recent High Risk/Recurrent/Advanced Prostate Cancer Reminder. Ben explains ‘time toxicity’ … a concept that effects many living with serious disease. If you missed his musings, here they are again:
Treatment that gives us time to live demands time in return. It drags with it scans, blood work, drives to the hospital, doctors running late, computers down, battles with insurance. Part of our gained lifetime is lost in dead time. Toxicity is always in the cancer mix. Financial toxicity has become part of the conversation alongside physiological toxicity, and time toxicity — time lost in an effort to gain time — is joining it. In a thoughtful 2018 essay, physician Karen Daily notes “Much of our patients’ time investments remain invisible to clinicians.” This year, in ASCO’s lead journal, three physicians have taken up the challenge, proposing that clinical trials, when reporting overall survival, distinguish between “Days with Physical Health Care System Contact” and days the patients actually own — “Home Days.” This a new idea only in cancer, say the authors — cardiology and other fields already make these kinds of measurements. When medicine’s best offer is a handful of months, we face difficult choices. Time toxicity casts a shadow over both survival time and quality of life. As we try to balance days added against side effects, it would be good to know how much of the time we’re gaining will be ours to spend.
Reading Ben’s thoughts prompted one of our regular participants to write a reply to us both that touched me to the core. I asked if we could reprint that too, and was graciously given permission on condition of anonymity. Here it is!
Ben, thanks for the article on “time toxicity” in the (recent) meeting announcement. It identifies an important consideration for all to think about in the fight vs. cancer and from my personal experience an impact that changes over time. Your write-up got me to thinking and pushed me to a holistic realization that this is basically an investment decision with expected returns.
For the prostate component of my cancer fight (now 17 years and counting), I did not think about the time investment in the first 14 years that I (and family members) were making to “do battle” (eg lab work, appointments with doctors, scans, treatments, family meetings, insurance challenges and personal downtime / reduced effectiveness in work due to treatment, etc.), It was a “no-brainer” decision and I never considered the tradeoff as the benefits for the opportunity to “continue to live life” due to treatments as my “life” returns were overwhelmingly positive vs.the “investment” required to do battle.
Having retired three years ago and simultaneously entering a new phase of my cancer fight I am aware of the increased time I (and family members) now spend on cancer treatment yet obtaining reduced time for life (and quality of life). I’m now spending significantly more time at Doctors appointments, treatments and longer periods of time post treatment feeling the physical effects of treatment and have begun to recognize I’m going to hit a point where this equation gets out of balance….and I’m not equipped with a decision model to manage that occurrence. Given my personal nature is to grind on stuff (I can make it work, give me time and let me try!) — I’m likely to blow right past the point of equilibrium where time toxicity and balance of life toxicity begin to get out of hand. For much of the first 14 years of my cancer fight I practiced a very large (and for me, healthy) dose of self-denial that I was dealing with prostate cancer. I was able to keep the cancer part of my life cordoned off, did not have significant residual time spent thinking / worrying / etc. about the disease and lived life to the max both personally and professionally. Now, in the last three years I am finding growing quantities of “thinking time” consumed by the disease and also sucking family members…. wife and children….deeper into the cancer battle as discussions / time encroach on them as well increasing the cost of investment (time) in the battle vs. cancer.
Prostate cancer is my second cancer fight, Ten years prior to the prostate cancer diagnosis I was diagnosed with a rare leukemia (rare as it was diagnosed in a limited number of folks (~2,000 / per year in the United States) and was usually fatal shortly after diagnosis as there were no lasting treatments until about 4 years prior to my diagnosis. As a freak outcome of scientific research a drug treatment was developed; the drug was intended for another cancer that had a much larger annual incidence of new cases; the drug was not effective on the targeted cancer but it was very effective on the rare leukemia. And at the time the treatment protocol was 7 days of continuous drip via a small pump one wore around the waist as an outpatient; minimal side effects; and if the first treatment didn’t work a second round was almost guaranteed to work. Talk about lucky! There was no way research funds would have been spent on this cure except by accident — which was exactly the case. The time toxicity for me in my first cancer battle was non-existent and I believe has indirectly helped me in the prostate cancer fight by giving me a dose of optimism and coping skills.
I think the topics raised by both of you….including Rick’s statement on treatment longevity results are important for the group to consider. These are relevant points of management in the cancer battle that I haven’t seen addressed by my oncologists (except one) nor psychologists and psychiatrists that I’ve also used in my treatment.
Editor’s Comment: In the original Reminder, I responded to Ben’s comments by adding one of my own. I pointed out that frequently Overall Survival benefits were shorter than might be expected because trials are often run on patients at a very late stage of their disease. This caveat should be considerd when we see the FDA reporting short life extension, sometimes as few as 2 or 3 months, for newly approved drugs.(rd)
In April, we had Dr. Christopher Wallis(Assistant Professor of Urology, Department of Surgery, University of Toronto and Urologic Oncologist) give a talk to our AS group titled “Prostate Cancer and Treatment Regret”, a common phenomenon patients experience after making their choices for treating their prostate cancers.
Dr. Wallis found in his research that about 13% of patients with localized disease overall have second thoughts about their choices. This includes patients on active surveillance. The surgical group had the most reset followed by radiation and AS.
“Every choice has risks and benefits. The goal isn’t just to cure the disease but to live a better quality of life” Wallis said.
He said that in counseling patients, one of his challenges is that there is not “a perfect correlation between symptoms and disease.” In other words, some patients are OK with losing their sexual potency—a major concern—while others are devastated. Some have similar reactions to incontinence. “Patient-centered care improves outcomes,” he observed. Walis said long-term, “financial toxicity” from treatment also is a largely unexplored topic.
Watch this presentation here:
Slides will be posted when available.
For information on our peer-led video chat ACTIVE SURVEILLANCE PROSTATE CANCER VIRTUAL SUPPORT GROUP, click here.
To SIGN UP for the Group or any other of our AnCan Virtual Support groups, visit our Contact Us page.
Hi-Risk/Recurrent/Advanced PCa Video Chat, Apr 12, 2022
All AnCan’s groups are free and drop-in … join us in person sometime! You can find out more about this and our other 10 monthly prostate cancer groups at https://ancan.org/prostate-cancer/ Sign up to receive a weekly Reminder/Newsletter for this Group or others at https://ancan.org/contact-us/
Editor’s Pick: We are talking lots of appetite, diet and exercise to manage ADT & chemo this week (rd)
Topics Discussed
Appetite issues; enz and dizzy spells; ARASENS darolutamide trial; hot flashes … again; creeping up on darolutamide ; PSA testing – to how many decimal places?; 2 men consider mitigating ADT with exercise and more; not all PCa in same man makes PSMA; Pluvicto continues to bring PSA down
Chat Log
Marc Valens (to Everyone): 3:23 PM: Try Larabars. No added sugar, just fruit and nuts
AnCan Herb (to Everyone): 3:38 PM: Enzalutamide can cause hypertension, but no information on postural hypotension
Len Sierra (to Organizer(s) Only): 3:40 PM: From RxList website: Stop using enzalutamide and call your doctor at once if you have: dizziness, spinning sensation; a seizure (black-out or convulsions);
AnCan – rick (to Organizer(s) Only): 3:43 PM: Len – that’s the concern around it causing seizure
AnCan – rick (to Everyone): 3:44 PM: ARANOTE and ARASEC
James Barnes (to Everyone): 4:43 PM: I also was on Enzalutimide and could not tolerate the anxiety and brain fog. I have been doing much better on Aberaterone for the past 6 months.
Frank Fabish – Ohio (to Everyone): 4:45 PM: Hey guys got to go. Thanks for your input. See you next Monday.
Jim Ward (to Everyone): 5:08 PM: Gotta run, gents. Good night!
Len Sierra (to Organizer(s) Only): 5:12 PM: G’night, Gents.
Peter Monaco (to Organizer(s) Only): 5:17 PM: Good evening gents!
John Birch (to Everyone): 5:17 PM: Great news on the numbers Dennis! Need to go, thanks everyone!
AnCan Herb (to Everyone): 5:18 PM: I gotta go. For those celebrating Passover, I hope you enjoy your Seder. And then for those celebrating Easter, all the best.
Some may have read the excellent ediorial written by 
