At AnCan, we love our veterans of any branch, and we sincerely thank you for your service. Our AnCan “Vet-In-Chief” Marine Captain Joe Gallo recently learnt about a clinical trial at the West Los Angeles VA that offers 18F-DCFPyl PSMA scanning for any Vet whatever their diagnosis. Mike Crosby, CEO of Veterans Prostate Cancer Awareness together with ZERO are working to find transportation subsidies. It is open and available to any veteran at no cost!
What is PSMA-PET imaging? It has emerged as a new frontier in prostate cancer diagnosis and treatment.
The key advantage to PSMA-PET imaging is the fact that it’s a lot more sensitive than standard imaging. It picks up lymph nodes, visceral metastases, bone metastases, and does it at a very low PSA level
PSMA is a membrane-bound protein that’s highly expressed in 90% of prostate cancer.
This is the first anniversary of a second study. Close to 200 Veterans have been enrolled and benefitted from PSMA imaging at West Los Angeles VA medical center. The first study also enrolled over 160 subjects with newly diagnosed prostate cancer from all around the country.
Peter Kafka, our Board Chair and Lead Moderator for several of our video-chat virtual support groups, poignantly reflects this week on the meaning of 7 years living with his prostate cancer. (rd)
One subject that comes up fairly often in our prostate cancer support calls is “fatigue”. Usually in the context of dealing with physical fatigue as a side effect of various treatment drugs. But I am thinking today about a different level of fatigue that affects us mentally and emotionally. We hear a lot about this in regards to the ongoing Covid-19 pandemic. A year or so into it and people are crying out, “Enough already!”. But I would guess that many of you feel the same sentiment regarding your ongoing experience with a prostate cancer diagnosis.
I have reached my 7-year anniversary since my official diagnosis of prostate cancer. What is it about the number seven? Yes, it has some kind of man-made spiritual significance. The seven colors of the rainbow, the seven days of the week, Snow White and the Seven Dwarfs and of course the Seven-year Itch. But as I (celebrate?) this seven-year anniversary of dealing with my prostate cancer I hear myself crying out, “Enough Already!”. Fatigue is setting in.
I have done my best to look at this disease from a wide variety of angles. The friendships I have made with many of you. The increased understanding of the dynamics of prostate cancer among an ever-increasing body of men and women. The empowerment of taking on the job of being one’s own best advocate. But in honesty, prostate cancer and all the accompanying side effects of the variety of treatment modalities that I have, and continue to experience, bring on a good deal of mental and emotional fatigue.
I don’t believe that medical science graphs this fatigue factor. We read a lot about “overall survival – OS” or “progression free survival – PFS”. I guess the category of “Quality of Life” might come closest to what I am talking about, but it doesn’t quite capture the essence. I suspect that any of you who have been on this journey for any length of time know what I am talking about. I don’t have an answer, and I am certainly not selling any kind of snake oil for treatment. I know in my heart and mind that this bump in the road will pass and I will move forward. I always do.
We had our first The TALK, a series of webinars addressing how families speak to each other about their health conditions, of 2021! On Wednesday March 31st, we were honored to have many “pairs” of different types talk about inherited mutations.
With opening commentary and resources from Melissa Rosen(Sharsheret) and Lisa Schlager (FORCE), Rick then introduced moderator extraordinaire, Lindsey Byrne!
We met Ilana Feuchter, with mom, Rozzie Brilliant (BRCA), Peter Kafka, with son Joel Kafka (Lynch mutation, MSH6, and somatic BRCA), sisters Karin Roseman and Stefanie Tsantilis (BRCA), and Dr. Pamela Munster, and with son, Max Daud (BRCA). They shared open and honestly about their own “talks”, and shared many relatable experiences.
The Role of Estrogen-Based Hormone Therapy for Treating Prostate Cancer – Mar 29, 2021
Summary
AnCan’s Advisory Board Member, Richard Wassersug PhD, has almost 20 years of personal experience using high dose estrogen therapy to manage his recurrent prostate cancer. Dr. Wassersug is also an expert in hormone therapy; he is the lead author of ‘Androgen Deprivation Therapy- an essential guide for prostate cancer patients ane their loved ones’. And Richard has led many studies on the psycho-social aspects of hormone therapy.
In this interactive seminar, Dr. Wassersug discusses his personal experience on estrogen based therapy. He is joined by our AnCan Brains Trust, Herb Geller and Len Sierra monitoring audience quesions, as well as PCa patient and fertiltiy endocrinologist, Dr. Mark Perloe.
Chat Log
Peter Kafka (to Everyone): 5:04 PM: I have seen reference to using Estrodile in combo with Relugolix in uterine conditions to boost hemoglobin in women, For men like myself might Estrogen with Relugolix insteade of Lupron knock down my anemia?
Mark Perloe (to Everyone): 5:05 PM: Is there a role for SERMS selective estrogen receptor modulators. in dealing with prostate cancer?
Ronald Goldberg (to Everyone): 5:09 PM: For men, which serum estradiol test do you recommend: Estradiol or Estradiol Sensative? For the estradiol sensative test, what is the “Healthy Range” for a man using estradiol to mitigate the side effects of ADT?
Ronald Goldberg (to Everyone): 5:14 PM: Is monitoring serum bone turnover markers useful to monitor bone density when on ADT?
Mark Perloe (to Everyone): 5:23 PM: Does estrogen suppress adrenal androgen production. If not, what cut-off for T suppression should be the target.
Mark Perloe (to Everyone): 5:26 PM: Isn’t much of the T behavioral effect due to aroma taste activity converting T to E.
Richard Stanton (to Everyone): 5:30 PM: What are your thoughts on whether cycling monotherapy with estradiol patches, LHRH agonists, LHRH antagonists, and ARSI’s could or might avoid, inhibit, or delay castration resistance caused by adaptive or other resistance mechanisms?
Rick Davis (to Everyone): 5:36 PM: The male breast cancer patients HATE tamoxifen.
John Ivory (to Everyone): 5:42 PM: Can you talk a little more about the mechanics of wearing the patches (is it like a bandaid? where, how often you change them, Issues of it coming off in bath/swimming/shower, how the gel is used vs. the patch)?
Herb Geller (to Everyone): 5:45 PM: Randomized Controlled Trial Eur J Endocrinol . 2018 May;178(5):565-576. doi: 10.1530/EJE-17-1072. Epub 2018 Mar 16. Short-term effects of transdermal estradiol in men undergoing androgen deprivation therapy for prostate cancer: a randomized placebo-controlled trial Nicholas Russell 1 2 , Rudolf Hoermann 3 , Ada S Cheung 3 2 , Michael Ching 4 , Jeffrey D Zajac 3 2 , David J Handelsman 5 , Mathis Grossmann 3 2
John Ivory (to Everyone): 5:47 PM: Thanks, Herb. Here’s the link: https://pubmed.ncbi.nlm.nih.gov/29549104/
Patrick (to Everyone): 6:00 PM: What level does the estrogen have to be at to suppress the testosterone?
ALFRED LATIMER (to Everyone): 6:01 PM: I may be the only one here that is on estrogen. I wear three .1 patches at a time and change one patch per day. My testosterone levels and estrongen levels stay fairly consistant. I also take avodart. This combo kept my psa lees than 0.1 for almost 10years. My patches are on my upper legs Has Richard used avodart in combination?
ALFRED LATIMER (to Everyone): 6:04 PM: Could Richard repeat the discussion of not using estrogen if you have a BRAC 1 or 2 mutation.
Gary (to Everyone): 6:10 PM: When is the PATCH study likely to be done and the data published?
Herb Geller (to Everyone): 6:12 PM: Transdermal oestradiol for androgen suppression in prostate cancer: long-term cardiovascular outcomes from the randomised Prostate Adenocarcinoma Transcutaneous Hormone (PATCH) trial programme. Langley RE, Gilbert DC, Duong T, Clarke NW, Nankivell M, Rosen SD, Mangar S, Macnair A, Sundaram SK, Laniado ME, Dixit S, Madaan S, Manetta C, Pope A, Scrase CD, Mckay S, Muazzam IA, Collins GN, Worlding J, Williams ST, Paez E, Robinson A, McFarlane J, Deighan JV, Marshall J, Forcat S, Weiss M, Kockelbergh R, Alhasso A, Kynaston H, Parmar M. Lancet. 2021 Feb 13;397(10274):581-591. doi: 10.1016/S0140-6736(21)00100-8. PMID: 33581820
Mark Thompson Rehoboth Beach DE. (Private): 6:27 PM: Thank you very much for having this discussion.
Rick Davis (to Mark Thompson Rehoboth Beach DE.): 6:28 PM: pleasure Mark – hope it is helpful
Rich Jackson (to Everyone): 6:36 PM: Webinar: The TALK – Inherited Mutations Register here: https://bit.ly/2Oq2YkG Wednesday, March 31 2021 @ 8 pm ET, 7 pm CT, 6 pm MT, 4 pm PT, 2 pm HI
Rick Davis (to Everyone): 6:36 PM: registration for webinar https://register.gotowebinar.com/register/3736798432724445452
Join Richard Wassersug, Ph.D lead author of “Androgen Deprivation Therapy: An Essential Guide for Prostate Cancer Patients and Their Loved Ones“, and patient on estrogen-based hormone therapy, for an informational evening on the risks and rewards of estrogen-based hormone therapy for prostate cancer.
Free, Drop-In, and NO Registration required! Simply enter our Barniskis Room.
