Hi-Risk/Recurrent/Advanced PCa Video Chat, March 3, 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: What’s the evidence to switch HT treatment after several years? (rd)
Topics Discussed
“Get thee to a GU med onc” – before further Tx errors!; nausea from Pluvicto may be the norm; – get ahead of it; when another recurrence is suspected, when’s the time to do a PSMA scan; same 4+5 Gents asks.” should ADT accompany RT on 2nd recurrence?”; is urinary retention a side effect of Mx PCa with a prostate?; recalcitrant VA MO rejects RT on recurrence – get 2nd opinion; chemo side effects , esp. nausea need meds; after 3 years, time to switch HT?; addressing hot sweats; pay no attention to the fantasy numbers on your Medical bills
Chat Log
AnCan – rick sent: 6:14 PM
rd@ancan.org rick
Luther Blake sent: 6:18 PM
OHSU patients are well represented in this group.
AnCan – rick sent: 6:32 PM
Matt Rettig https://www.uclahealth.org/providers/matthew-rettig
Wes – San Diego sent: 6:40 PM
Got a question for you all: 2. What kinds of hormone therapy are available?
Frank sent: 6:46 PM
Zofran is the medication that helps me Marc
Luther Blake sent: 6:48 PM
You can get big bags of ‘Gin-Gins’ on amazon
Brian Haack – Eagle, ID sent: 6:50 PM
My PSA went from 0.12 to nearly 20 before mets were seen on PSMA-PET/CT
Wes – San Diego sent: 6:52 PM
I buy fresh ginger, cut it, and squeeze it using a garlic press, and use it as the incredient for tea. Most chews have more sugar than ginger; be careful with them.
There are also wrist pressure bands, used for sea sickness that might also work. V credible; I keep them in my backpack for random trips out to the SD bay.
Wes – San Diego sent: 7:30 PM
A new sleeping pill Belsomra, creates a good sleep architecture (deep, REM, etc).
Alicia Morgens study of the Embr wave 2: “66% of participants rated the thermal device as effective for management of daytime and nighttime hot flashes, while 77% of participants reported being somewhat to very satisfied with the device.”
AnCan – rick sent: 8:00 PM
Good memory Len…..
Wes – San Diego sent: 8:04 PM
My PSMA via UCSD was $34K.
Good point for my uninsured brother.
Brian Haack – Eagle, ID sent: 8:07 PM
Private insurance sets their prices based on Medicare reimbursment
Wes – San Diego sent: 8:09 PM
Taking about the range of costs, so we know what is possible is good, including flying to France, Cuba, etc.
Hi-Risk/Recurrent/Advanced PCa Video Chat, Feb 3, 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: Fire your medical oncologist when he won’t share your results! (rd)
Topics Discussed
Canadian care partner presents on behalf of de novo Mx dad who sets up for triplet; down to single distant tumor but rash and weight gain are bothersome; VA med onc won’t share patient’s own info or provide him a community referral – time to give him the royal boot; do restless leg and urinary frequency result from Cymbalta or Trazadone; what type of equipment for palliative spot RT ?; concordance means it’s time to move from chemo to Pluvicto; recurrence takes this Gent back to UCSD and Rana McKay; do you pre-load Orgovyx when switching vs starting?; time to switch up HT but debulk first; Dr. Guancial leaves our man on a drug holiday – & he’s a fan; our docs suggest testicular hydrocele be drained before surgery considered.
AnCan is grateful to the following sponsors for making this recording possible: Bayer, Foundation Medicine, Janssen, Myriad Genetics, Novartis, Telix & Blue Earth Diagnostics.
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
AnCan’s Prostate Cancer Forum is back (https://ancan.org/forums). If you’d like to comment on anything you see in our Recordings or read in our Reminders, just sign up and go right ahead. You can also click on the Forum icon at the top right of the webpage.
All AnCan’s groups are free and drop-in … join us in person sometime!
Editor’s Pick: 1) Pluvicto pre-chemo… maybe? 2) Agree your stage before seeking treatment– rd
Topics Discussed
New denovo Nx Gent treated at VA gets less then SoC; get all docs to accept the same staging before seeking treatment; removing the surgical clip makes him feel better; 4x Pluvicto wasn’t enough – continues but is he concordant?; natural nausea remedies; intraductal/cribriform 4+5 Gent recurs 30 months post-RRP; extensive mets creep up on a Regular – Pluvicto pre-chemo?; gratitude!
JNJ-63898081 (JNJ-081) A bispecific antibody that targets PSMA on tumor cells and CD3 on T cells. JNJ-081 is designed to promote anti-tumor activity.
AnCan – rick
sent: 5:32 PM
Tx Len
Chuck Snyder
sent: 5:32 PM
Thanks all for the suggestions!
Len Sierra
sent: 5:41 PM
Aloxi (palonosetron) is another anti-nausea medication in the same class as ondansetron and granisetron (5HT3 antagonists).
Steve Roux, North Michigan
sent: 5:46 PM
hey guys, I need to run. Great Meeting, AGAIN. Don’t forget to get that survey done. Get ‘er done!
Chuck Snyder
sent: 5:46 PM
Thanks Len.
Len Sierra
sent: 5:50 PM
This is from AI, so understand the possible errors, but here is what they say: The choice of whether to use CTCs or ctDNA in a liquid biopsy depends on the specific clinical question being asked and the stage of cancer. For example, CTCs may be more useful for detecting early-stage cancer or monitoring the response to therapy, while ctDNA may be more sensitive for detecting advanced-stage cancer or identifying resistance mechanisms.
Julian – Houston
sent: 5:52 PM
• United States +1 (646) 749-3129
AnCan – rick
sent: 5:53 PM
222-583-973
Len Sierra
sent: 6:08 PM
I agree, great job, Dr. John!
Thomas M
sent: 6:09 PM
Was it Dr. Eshana Shah, MD at Fred Hutch who was mentioned?
Hi-Risk/Recurrent/Advanced PCa Video Chat, Aug 27, 2024
AnCan is grateful to the following sponsors for making this recording possible: Bayer, Foundation Medicine, Janssen, Myriad Genetics, Novartis, Telix & Blue Earth Diagnostics.
If you missed any recent recordings, you’ll find a full list either on our YouTube Playlist (click above) or visit our Blog Post https://ancan.org/our-recent-blog-posts-in-case-you-missed-them/ Sign up for our Blog by checking the New Blog box at https://ancan.org/contact-us/
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
AnCan’s Prostate Cancer Forum is back (https://ancan.org/forums). If you’d like to comment on anything you see in our Recordings or read in our Reminders, just sign up and go right ahead. You can also click on the Forum icon at the top right of the webpage.
All AnCan’s groups are free and drop-in … join us in person sometime!
Editor’s Pick: Age 50 with BRCA2 — surgery or radiation? and what about PARPi?
Topics Discussed
Newly diagnosed with BRCA2 mutation at age 50, extracapular extension and seminal vesicle invasion – surgery or radiation? PARP inhibitor upfront?; nomograms don’t account for mutations; didn’t love daro, but he’ll give it a second chance; after radiation, recurrence in the prostate but no metastasis — brachy or cryo next?; a new treatment puts an enzalutamide right into the prostate; after 1 1/2 years of monthly Xgeva, time to get off?; Pluvicto was working, so he skipped the last two treatments; insurance coverage for a second Pluvicto treatment; computer failure sends his hospital back to paper and pencil — but he gets his Orgovyx; psst – Dr. Elisabeth Heath plans a move to Mayo; PSA of 3.75 after radiation seems really high — but we’ve seen it take years to drop; doc suggesting a holiday from his abi monotherapy; taper off prednisone slowly and carefully, monitoring blood; for estradiol questions, check out our discussion video with Richard Wassersug.
Chat Log
Darren Chervitz · 6:49 PM
Thanks for listening and for all the incredible information!
Unknown · 7:02 PM
Change of plans, I have no need for time today. Recent Provenge cause pulmonary embolism took about 4 weeks before showing improvement, moderate improvement now. Latest PSA (8-22) trended down to 0.48.
Larry Schuller · 7:05 PM
The conventional wisdom about surgery after radiation is that surgery on tissues that have been damaged by radiation is problematic and most surgeons will try to avoid it.
Larry Schuller · 7:06 PM
Localized ablation is another matter.
Unknown · 7:06 PM
Larry S. – that was the ‘old’ wisdom. It really is no longer.
Larry Schuller · 7:08 PM
Rick, I would LOVE to see that research. I had prostatectomy and am recommended salvage radiation but expect to have future surgeries and am concerned about those.
Unknown · 7:10 PM
No recommendations on avoiding blood clots side effects. Dr stated that he has many patients who have had Provenge and that I am the only patient to report blood clots.
Len Sierra · 7:13 PM
Larry Schuller, there are now surgeions who specialize in post-RT prostatectomy. Dr. Eastham at MSK is one that I know of.
Larry Schuller · 7:14 PM
But is post-radiation surgery common outside of those specialists?
Len Sierra · 7:15 PM
Not sure, probably not common.
Jim Marshall, Alexandria, VA · 7:36 PM
Cookies, to me, are a better choice to donuts. always a nice touch. Jim M
Steve Roux, MI · 7:47 PM
The order I called in to the bakery included 1/2 dozen scones too. Almost like a giant cookie?
Kirt Schaper · 7:52 PM
i have to go, thanks all
Jim Marshall, Alexandria, VA · 7:56 PM
No more worrying about turning 80 an dno longer to worry abouit dying young. Jim
Talking Estradiol (E2) for Recurrent and Advanced Prostate Cancer: Wassersug et al
AnCan is grateful to the following sponsors for making this recording possible: Bayer, Foundation Medicine, Janssen, Myriad Genetics, Novartis, Telix & Blue Earth Diagnostics. Sincere apologies to all for failing to record our May 6 Group. It was totally a platform fault and not down to AnCan. As regulars are aware. this is a very rare event. AnCan hopes this session might make up for it.
Estrogen in its various forms has long been used as a primary and secondary means of managing prostate cancer. Primarily it can be used in place of an LHRH ADT drug. In its secondary capacity, it can be employed in addition to an LHRH drug to help men cope with side effects arising from lack of estrogen caused by the LHRH drug. These side effects include hot flashes and weakening bone density. Today Estradiol (E2) is considered to be a safe treatment when used as a skin patch or gel versus its original application in pill form that carried significant cardiovascular risks.
The foremost peer expert on the use of estrogen to manage prostate cancer is Richard Wassersug, Ph.D, author of Androgen Deprivation Therapy: An Essential Guide for Prostate Cancer Patients and Their Loved Ones that is now in its 3rd Edition https://connect.springerpub.com/content/book/978-0-8261-8403-0. Richard is also an AnCan Advisory Board Member.
In this 60 +minute discussion, Dr. Wassersug talks with two patients about using estradiol. One has used for primary control for 17 years, and the other just started using an Estradiol patch to control side effects alone. He is also joined by AnCan advanced PCa peer Moderators, Dr. John Antonucci and Rick Davis.
Rechallenging advanced disease with enzalutamide after Pluvicto is mentioned towards the end. Dr. Wassersug has since clarified that he favors rechallenging advanced disease with previous therapies after some form of radiation based on the abscopal effect. The use of enzalutamide in this context is not based on trial evidence.
AnCan asks that you first read Richard Wassersug’s book before reaching out to him. AND… Dr. Wassersug urges you to spend as much time exercising today as you have taken to watch this video!
