Hi-Risk/Recurrent/Advanced PCa Video Chat, Nov 15, 2022
All AnCan’s groups are free and drop-in … join us in person sometime! You can find out more about our 12 monthly prostate cancer meetings at https://ancan.org/prostate-cancer/
Editor’s Pick: Severe side effects – a “Lupron Frankenstein” and an abdomen swollen by chemo – plus a surprise case of shingles. (bn)
Topics Discussed
Newcomer from northern Michigan finds he’s 5+4; shingles brought on by ADT?; end of radiation and a steak dinner; benefits of pelvic floor therapy; Lupron turns a newcomer’s life upside down; are Orgovyx and darolutamide chemotherapy? ; mini-poll on hot flashes: who uses what?; putting chemo on pause after success; self-advocating finally gets him Pluvicto; “what is chemo?” revisited; funny-smelling stool following chemo; chemo abdominal swelling diagnosed as ascites — he’s now on Pluvicto and improving; end-of-life discussions; gabapentin for neuropathy leaves him loopy; latest scan shows 30 bone mets gone.
Chat Log
Richaed Wassersug to Everyone 6:36 PM
Herb,
Richaed Wassersug to Everyone 6:36 PM
Can you put the ADT and Herpes ref here?
Herbert Geller to Everyone 6:37 PM
Andrologia . 2018 Mar;50(2). doi: 10.1111/and.12863. Epub 2017 Aug 8. Increased risk of a herpes zoster attack in patients receiving androgen deprivation therapy for prostate cancer F J Wu 1, L T Kao 2, S Y Sheu 1, H C Lin 3 4, S D Chung 4 5 6
Bob G to Everyone 6:37 PM
I had shingles at age 30 due to stress.
Paul Freda Lake Worth FL to Everyone 6:41 PM
Stan How is everything going with you ? Any new treatments ? PSA stable ? I am smae except for a spot on my Pancreas. Doc says its stable and not likley to become cancerous. Hope he is right. Paul Freda AEPi 1969
Steve Roux, Elk Rapids, MI to Everyone 6:44 PM
Hey guys, here is the clinical trial info – NCT#04513717 Cancer Research Consortium of West Michigan NRG-GU009, “Parallel Phase III Randomized Trials for high risk prostate cancer evaluating intensification of concurrent therapy for higher genomic risk with radiation”
Herbert Geller to Everyone 6:54 PM
Here is more information on the trial by the NRG:Parallel Phase III Randomized Trials For High Risk Prostate Cancer Evaluating De-Intensification For Lower Genomic Risk and Intensification of Concurrent Therapy for Higher Genomic Risk with Radiation (Predict-RT*) *Prostate RNA Expression/Decipher To Individualize Concurrent Therapy with Radiation Principal Investigator Paul L. Nguyen, MD, Co-Principal Investigator(s) A. Oliver Sartor, MD
Steve Roux, Elk Rapids, MI to Everyone 7:07 PM
My brother David, with ALS, was given a weekly ADT shot, NOT Lupron, which gave him these same symptoms I hear him saying. David quit the weekly shots just to have some level of normal quality of life.
Joe Gallo to Everyone 7:12 PM
len@ancan.org
Joe Gallo to Everyone 7:12 PM
embrwave
Bob G to Everyone 7:13 PM
I have a question, but have to step out for 5 – 10 min.
Steve Roux, Elk Rapids, MI to Everyone 7:14 PM
Guys, THANK YOU for allowing me to sit in for this. I will be back for future meetings! But I need to go attend another meeting!
Julian Morales – Houston to Everyone 7:38 PM
And many more!!!!
AnCan – rick to Everyone 7:40 PM
Thank you all
AnCan – rick to Everyone 7:50 PM
Beginners Guide to the End, BJ Miller MD and Shoshana Berger
Frank Fabish Columbus OH to Everyone 7:56 PM
Got to go guys. Thanks for the updates. I see my Doc next Tuesday for Labs and Exam.
Hi-Risk/Recurrent/Advanced PCa Video Chat, Oct 11, 2022
All AnCan’s groups are free and drop-in … join us in person sometime! You can find out more about our 12 per month prostate cancer meetings 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: Drug holiday…but what about that rising testosterone? (bn)
Topics Discussed
Longtime friend remembers John Birch; a thank-you from John’s wife; two more passings — George Degnon and Dave Myers; Dr. E patient wonders what’s next after discontinuing abi; newcomer gets care downstate when Dr. Antonarakis is in his backyard; mysterious red marks following chemo; why is genetic testing useful?; jitters as testosterone rises on a drug holiday; dosing at mealtime to economize on abi; PSMA ordered but PSA is undetectable; helping a new BRCA patient get help at UCSF.
Chat Log
Dennis McGuire (to Everyone): 6:04 PM: she is on
AnCan – rick (to Everyone): 6:59 PM: Dr. Emanuel Antonarakis https://med.umn.edu/bio/hematology-oncology-and-transp/emmanuel-antonarakis
Jim B (to Everyone): 7:27 PM: Hi Bob, I think I am feeling much better today. BTW the chemo sores appeared almost immediately in my case and went away very soon after the steroid cream. The name of the cream is Clobetasol Propionate Cream.
Len Sierra (to Everyone): 7:37 PM: Low dose Abi reference:
Len Sierra (to Everyone): 7:37 PM: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5941614/
Herbert Geller (to Everyone): 8:00 PM: Gotta go. See you all on Monday.
AnCan – rick (to Organizer(s) Only): 8:00 PM: Great job tonight getting through everyone, Peter.
Len Sierra (to Everyone): 8:02 PM: Chromogranin A (CGA) and neuron-specific enolase (NSE) levels are biomarkers for NEPC. Also, they are synaptophysin positive. DLL3 (Delta-like Ligand 3) is positive in 76% of NEPC.
The AnCan team thanks Dr. John Antonucci for submitting his opinions on hospice and palliative care in end-of-life considerations. Dr. John is a retired clinical, academic and research psychiatrist. His most recent gig before hanging up the white coat was at the VA providing care in the addiction clinics. He is also a peer in our High Risk/Recurrent/Advanced Prostate Cancer Group.
Our discussion group (High Risk/Advance Prostate Cancer) hasn’t talked much about end-of-life care or making decisions about things like resuscitation status, stopping treatment or hospice care. But the topic has come up lately, and since we have Dr. BJ Miller, co-author of a relevant book and a palliative care physician, on the AnCan Advisory Board, it is appropriate to take a first or second look at his chapter.
The authors start by defining these often-confused terms: Hospice provides end-of-life care with the goal of comfort rather than trying to cure a disease. It is actually a sub-section of palliative care. Palliative care is treatments added-on to regular medical care, at any stage of serious illness, and is intended to improve the quality of our physical, spiritual and emotional lives.
The authors explain what qualifies a patient for Hospice care. Anyone who has a terminal illness and is ready to stop treatment aimed at curing it, and who is expected to live 6 months or less, may qualify. A multidisciplinary team is then assigned and the treatments are brought to us, in our own homes if desired. (There are also residential hospices but these are not as common as often assumed.) Health insurance policies, including Medicare, cover Hospice. There are useful tips in the book on finding and choosing Hospice providers, and a section for when the hospice is not performing well. The authors encourage us to not to wait until our last few weeks to get this process going.
Palliative care is now its own medical specialty. Again, the idea is to make our lives nicer by helping to reduce a wide variety of suffering, including pain, anxiety, drug side effects, depression, fear, nausea, and spiritual pain. Most of this type of care is delivered in the hospital or outpatient clinic. Palliative care is integrated into our existing treatment plan, rather than being comprehensive like Hospice. Health insurance will generally cover these services although it might leave us with co-pays and deductibles. And again, the authors urge us to start early; there is no requirement that we be close to the end, only that we have a serious illness.
The overall effect on me of reading this chapter was not only education but also reassurance. Not only reassurance that we deserve comfort and don’t have to hide our suffering, but also that Someone will be there to care about our suffering and try to help. Quite comforting, I believe.
Hi-Risk/Recurrent/Advanced PCa Video Chat, Nov 1, 2021
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/.
Editor’s Pick: Can you reallly avoid significant side effects when PCa recurs – right now AnCan thinks not BUT we hope Lu177 PSMA proves us wrong! We hear from two men who hope so. (rd)
Topics Discussed
Under 60 man faces Gleason 9 recurrence; recently Dx de novo Mx with G10; recurrent man seeks alternative to systemic Tx; side effects due to enz?; mobility trial at OHSU; pre-Mx abiraterone; more than nutritional option required; EMBR Wave still seeks trial particpants; GERD/acid reflux; super broccoli and power nutrients
Chat Log
Rich Jackson (to Everyone): 5:23 PM: Next gathering is Tuesday, Nov 9 at 6pm EST
Len Sierra (to Organizer(s) Only): 5:28 PM: What was Henry’s PSA and Gleason before surgery?
Len Sierra (to Organizer(s) Only): 5:30 PM: Thanks,
Jake. He never should’ve had surgery. That’s a shame.
Herb Geller (to Organizer(s) Only): 5:31 PM: I agree. I have no clue why he got surgery with Gleason 9 and positive nodes.
Herb Geller (to Organizer(s) Only): 5:31 PM: What is his current PSA?
Len Sierra (to Organizer(s) Only): 5:31 PM: I think he said 4.8 post surgery.
Herb Geller (to Organizer(s) Only): 5:32 PM: Mark Pomerantz is publishing with Eli. But surgery was in August, right?
Peter Monaco (to Everyone): 5:35 PM: September
Jake (to Organizer(s) Only): 5:35 PM: diagnosed in august
Pat Martin (to Everyone): 5:38 PM: Hutchinson is great, in my opinion. Been with them for 7 years. I have not found any “klinkers” in the whole staff. i was Gl 9(5+4)
Herb Geller (to Everyone): 5:55 PM: It is a scan that will identify areas of high PSMA levels in your body.
Stephen Saft (to Everyone): 5:59 PM: I am on the elliptical now
Edward Clautice (to Everyone): 6:00 PM: my exercise experience is similar to jimmy greenfield. round 10 of docetaxel, run, lift weights. minimal side effects felt
Joe Gallo (to Everyone): 6:05 PM: Germline genetic test looks at inherited dna variants Sonomic genomic test look at the actual tissue sample.
Ted Healy- Portland, OR. (to Everyone): 6:08 PM: I had a genetic test due to my family history and stage of my cancer. turns out i carry the HOXB13 variant which predisposes all of my offspring, brother and sisters offspring to early prostate cancer. At least i can give them a heads up.
Henry (and Staci) Cornelius (to Everyone): 6:10 PM: Can genetic testing be done on tissue taken during my surgery on Sept. 21? It seems too late for that, right?
Stephen Saft (to Everyone): 6:10 PM: no oos that tisse is available for long time not too late.
Henry (and Staci) Cornelius (to Everyone): 6:11 PM: Copy that. Thanks.
Stephen Saft (to Everyone): 6:13 PM: my prostectomy tisse from 2017 has been many places
AnCan – rick (to Everyone): 6:46 PM: joeg@ancan.org
larry meddles (to Everyone): 6:58 PM: Gotta go, have another meeting in 2 minutes. Thanks.
AnCan – rick (to Everyone): 7:01 PM: EMBR Wave trial
Ted Healy- Portland, OR. (to Everyone): 7:02 PM: Gotta go as well. Thank you all for being here and special thanks to all that make this meeting possible!
Henry (and Staci) Cornelius (to Everyone): 7:02 PM: I’m going to say goodnight to my 11 year old daughter. Be back in a bit.
Edward Clautice (to Everyone): 7:06 PM: gotta go, thanks to all
3 survey opportunities have come our way for you …… and AnCan receives a donation for each approved respondent:
…… if you are taking or have taken and stopped relugolix (Orgovyx), you can earn upto $200 for 80 min of your time, mostly a one-on-one interview. Or, upto $350 if you interview together with your caregiver. Please reach out to us via info@ancan.org and we’ll connect you.
……. if you experience a cough or shortness of breath and are in any type of active treatment, including for urinary issues, there is an opportunity to earn $100 for 60 minutes of time from your home computer. The cough or shortness of breath does not have to be related to your diagnosis or treatment. If interested, please go to https://gigs.savvy.coop/stcancer/?r=a…
…… if you have experienced mouth swelling and sores (stomatitis) as a result of past or current treatment, there is another opportunity to earn $100 for 60 minutes of time from your home computer. If interested, please go to https://gigs.savvy.coop/cancer-stomat…
Editor’s Pick: Loads of cutting edge this week – cytokine storms from pembro or just an infection??? Two men fare diferently with Lu177 PSMA. And heed the warning – don’t pussyfoot when PCa first recurs – it may return.(rd)
Topics Discussed
Caregiver discusses 50+ husband’s metastatic disease; slow moving recurrence requires RT a SECOND time; exercise via a PT???; cytokine storm or just an infection – be sure before more pembro; two experiences from different Lu177 trials; is Pylarify Medciare approved?; agonist ADT resumed after 12-mo holiday with no buffer; low testosterone/metastasis are formula to get Covid booster
Chat Log
Bruce Bocian : 3:21 PM: Berger is our friends Urologist
Jake Hannam : 3:30 PM: Provenge since PSA is low right now?
Stephen Saft (to Everyone): 3:54 PM: Didn’t someone say they have been tolerating 20 Docetaxel treatments because of physical exercise
Len Sierra (to Everyone): 3:55 PM: That would be Iron Man Ken Anderson
Herb Geller (to Everyone): 3:56 PM: Exercise Preserves Physical Function in Prostate Cancer Patients with Bone Metastases. Galvão DA, Taaffe DR, Spry N, Cormie P, Joseph D, Chambers SK, Chee R, Peddle-McIntyre CJ, Hart NH, Baumann FT, Denham J, Baker M, Newton RU. Med Sci Sports Exerc. 2018 Mar;50(3):393-399. doi: 10.1249/MSS.0000000000001454.
Richard G. (to Everyone): 3:58 PM: Is the value of exercise more for the cardio (running)or for the strength (weights)? Probably both but does one win out over the other? rg
Len Sierra (to Everyone): 3:59 PM: Both are very important/
Richard G. (to Everyone): 3:59 PM: Was John’s recurrence after 10 years after RP caught by having PSA test every 3 months for the 10 years? rg
Maria Anderzunas (to Everyone): 4:00 PM: I wonder that same thing as Richard G with the exercise, cardio or streghth , which is best, both would be optimal I’m sure.
John Vandenberg (to Everyone): 4:02 PM: yes, PSA test every 6 months for 10 years before recurrence; must leave – shared computer – thanks very much I’ll be calling in – John
Richard G. (to Everyone): 4:04 PM: tks Richard G. (to Everyone): 4:19 PM: what is the trial name? what is the term sidocan storm?
John Antonucci (to Everyone): 4:20 PM: cytokine
Len Sierra (to Everyone): 4:20 PM: cytokine storm
Richard G. (to Everyone): 4:20 PM: tks
Herb Geller (to Everyone): 4:21 PM: Cytokine storm is a result of a massive reaction of the immune system to an insult. Cytokines are hormones released from immune cells that signal to other immune cells, but also affect other cells.
John Antonucci (to Everyone): 4:22 PM: I don’t think it can account for the destrution of the platelets???
Peter Kafka (to Everyone): 4:28 PM: The Keytruda test: IMUDX swab test The resuts came from Soomi Fabian-Aguilar. Indicated I was “Low Risk” for Keytruda. Ordered by Dr. Mark Scholz of Prostate Oncology Specialists. ImuDX Testing – MiraDxhttps://miradx.com › imudx-testing This test predicts the risk of developing immune related adverse events in response to anti-PD1 or anti-PDL1 treatment. Already performing ImuDx Testing? ImuDx …
Stephen Saft (to Everyone): 4:32 PM: is there a possibility that Lu 617 will be approved soon?
Len Sierra (to Everyone): 4:33 PM: John Antonucci: Hematological Side Effects of Immune Checkpoint Inhibitors: The Example of Immune-Related Thrombocytopenia https://www.frontiersin.org/articles/10.3389/fphar.2019.00454/full
Herb Geller (to Everyone): 4:33 PM: All the information we have says that early next year.
Alan Moskowitz (to Everyone): 4:33 PM: Do we know when Medicare will cover Pylarify? (DCF-Pyl – Psma scan)
Len Sierra (to Everyone): 4:35 PM: Alan, I don’t think that is known.
John Antonucci (to Everyone): 4:35 PM: thanks Len got the article
Alan Moskowitz (to Everyone): 4:36 PM: Len – I had heard that possibly it could be covered now, in a private radiology setting vs in a hospital. But have not been able to confirm.
Len Sierra (to Everyone): 4:37 PM: Hmm, that’s seems odd, Alan. You’d think it would be the opposite.
Alan Moskowitz (to Everyone): 4:38 PM: Len – something about ‘pass through’ status is required for hospitals to bill it. I had talked to a rep from the company that makes it, Lantheus, and there was some vague comments that the company was possibly reimbursing radiology centers for the difference in cost for pylarify vs generic tracer. Again – not so clear.
Richard G. (to Everyone): 4:44 PM: Why not a psma pet scan for Alan M?What is the other name for PSMA petscan? “pilarafy”?
Len Sierra (to Everyone): 4:50 PM: 18F-DCFPyL
Alan Moskowitz (to Everyone): 4:53 PM: Richard G – I have also searched for clinical trials for psma scan – but having been in 2 of these already , i have not found any that is relevant.
ALFRED LATIMER (Private): 4:55 PM: I need to leave. See you next time. Thanks again for all your and groups help
AnCan – rick (to ALFRED LATIMER): 4:55 PM: pleasure – stay in touch
