Hi-Risk/Recurrent/Advanced PCa Video Chat, Nov 15, 2021

Hi-Risk/Recurrent/Advanced PCa Video Chat, Nov 15, 2021

Hi-Risk/Recurrent/Advanced PCa Video Chat, Nov 15, 2021

Hi-Risk/Recurrent/Advanced PCa Video Chat, Nov 15, 2021

Hi-Risk/Recurrent/Advanced PCa Video Chat, Nov 9, 2021

Hi-Risk/Recurrent/Advanced PCa Video Chat, Nov 9, 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/

To sign up to receive a weekly Reminder/Newsletter for this Group or others, go to https://ancan.org/contact-us/

Editor’s Pick: The importance of having a GU Med Onc (genitourinary medical oncologist) comes up more than once. And keep good records!(rd)

Topics Discussed

If chemo didn’t do the trick….; uncertain if trial is effective; draft a GU med onc – quickly!; 3 yrs off HT and treatment holding; in the midst of Provenge; the importance of good record keeping; PSAMA baseline scan; the PROMISE germline trial

Chat Log

Edward Clautice (to Everyone): 4:15 PM: 3/29/201 PSA 8.9 5/6/201 Biopsy 8 cores Gleasons range from 3+3 to 4+5.  Average Gleason 7.5. Also has perineural invasion

6/29/2015 Urologist removers prostate and some associated nerve (the one which controls erections) are removed at surgery; Inova Hospital Fairfax VA Lymph nodes biopsied. 0/3 with cancer Seminal vesicles are involved Prostate. Gleason 4+5 Positive margins seen. Tumor volume 70%

7/30/2015 – 10/?/2015

Begin radiation treatments of the prostate bed Receive a whole bunch of radiation. Doc says, never again get radiation there.

10/16/2015 PSA 0.4

1/28/16 Switched to Dr J Aragon-Ching, Oncologist PSA –  <0.1 Also receive Lupron Testosterone 6 ng/L

5/15/2018 Continue with DR Aragon-Ching getting Lupron and generally getting <0.1 on PSA

5/15/2018

Move from Fairfax to central Kentucky Sign up with Dr. Monte Metcalf. Regular oncologisy at regular hospital

8/?/2018 PSA begins to rise. Not sure how high. Begin Casodex. PSA drops

12/?/2019 PSA now rising again Switched over to Abiraterone. Dr Metcalfe seems not as concerned as I am . Abiraterone works for maybe 6 months

6/?/2020 PSA begins to rise again I decide to switch over to that giant teaching hospital (U of Kentucky) I keep driving past. Also  I now have much better medical insurance so I actually can switch over.

11/2/2020 PET scans, CT scans, every other kind of scan Lots of bone tumors, not a lot of soft tissue tumors (there were some reasons for this next delay, and honestly I forget exactly what they were) A couple times Dr PW takes my scans to the weekly med school oncology faculty meeting. “Tumor of the week club.”

2/?/2021 Bone biopsy. Shows tumors to be metastatic. PSA running about 7; which Dr PW says is really low compared to the tumor mass I have. Dr PW has senior UK pathologist personally check biopsies to make sure it is prostate cancer and not “small cell.” Senior pathologist confirms this is true.

4/15/2021 +/- Stop abiraterone Begin Docetaxel every 3 weeks, for 10 treatments Zoledonic acid (?for bones) every 6 weeks and keep getting anti-hormone shot, elegard , every 12 weeks Also prednisone PSA 7.11 I am allergic to docetaxel and it tries to stop me from breathing. Docs give me stuff so this does not happen any more. Minimal side effects that stop me from wanting to get more treatments of docetaxel

8/12/21 PSA 4.88

11/3/2021 Docs just posted results of yesterday’s CT scans and nuclear medicine scans PSA 3.7 Scans show no soft tissue tumors Scans show lots of widespread bone tumors. “Impression: Widespread bone metastases.” “New subtle foci of….” 4 or 5 places “Bones/joints: Focal mildly intense increased uptake involving……” a four line list of different bones. “Compared to previous: Progressive bone metastases.

11/4/2021 Get last docetaxel Talk with Dr PW about what comes next

Note: Up to this time I have zero symptoms of pain from tumors or anything else in my bones. I exercise and lift weights regularly.

Vic (to Organizer(s) Only): 4:32 PM: Is sequencing of tumor the way to determine if the cancer as advanced from MSPC to MRPC?

Vic (to Organizer(s) Only): 4:34 PM: Are any LU-177 trails open to MSPC?

Len Sierra (to Everyone): 4:42 PM: Vic, no, sequencing is done to see if there are mutations for which there are therapies that target that mutation.

AnCan – rick (to Vic): 4:44 PM: Vic ….. PSA rising is the sign of hormone resistance.   The only trial available to HSPC requires no prior hormone therapy

Jake (to Organizer(s) Only): 5:07 PM: No, I checked. It actually recorded 49 seconds including my apologies and the discussion about logging off and back on. Weird! You made the right decision since it is too undependable …

Vic (to Organizer(s) Only): 5:14 PM: what is bi-polar androgen therapy? Eligard plus Abiraterone?

Joe (to Everyone): 5:18 PM: gotta run gents, great to see y’all again

Rusty (Private): 5:23 PM: BBL have another meeting going on.

Len Sierra (to Everyone): 5:23 PM: Carlos, this comes from the Provenge Treatment Guide:              How to Prepare:

  • Stay hydrated by drinking more water in the days leading up to your

appointment

  • Avoid caffeinated beverages on the day of your appointment
  • Eat calcium-rich foods such as dairy products, dark leafy greens, or

supplements

  • Eat a hearty meal within four hours of your appointment
  • Wear loose-fitting clothes, with sleeves that can be raised above the elbow
  • Bring a current photo ID
  • Consider arranging transportation to and from the procedure

eric  (to Everyone): 5:24 PM: ok thanks you.

eric  (to Everyone): 5:27 PM: hey rick in order to particoate in the trail you sent me. Are you saying if I was still on the Orgovyx. I would be eligible for the Netashim trial?

AnCan – rick (to eric ): 5:27 PM: If me I would consider getting back on an LHRH drug like orgovyx ASAP. If not orgovyx or firmnagon, then be sure they give you at least 15 days of bicalutamide first. Some docs forget! you don’t nbeed with Orgo or Firma. Put pressure on them to give youa  quick appt. You don’t need Song now you need a GU (genitourinary) medical oncologist

Herb Geller (to Everyone): 5:29 PM: Actually, one other person at Hopkins is Catherine Handy Marshall.  She is an Antanorakis understudy and I think Carl saw her.

AnCan – rick (to eric ): 5:29 PM: Eric – if you were still on Orgovyx AND your PSA was rising you would be eligible.

Carl Forman (to Everyone): 5:29 PM: Yes I did see her; impressive.

AnCan – rick (to eric ): 5:31 PM: So here’s another name above. Catherine Handy Marshall

Pat Martin (to Everyone): 5:33 PM: See ya all next Monday.

Herb Geller (to Everyone): 5:37 PM: https://www.hopkinsmedicine.org/profiles/details/catherine-handy

Frank Fabish (to Everyone): 5:39 PM: Got to go guys. Thanks

AnCan – rick (to Everyone): 5:47 PM: https://www.fiercehealthcare.com/tech/invitae-scoops-up-consumer-health-tech-firm-ciitizen-for-325m  Bought by Invitae

AnCan – rick (to Vic): 5:50 PM: Vic …. are you any realtion to Lauren Paglisotti? We spoke to her at Michael J Fox

Len Sierra (to Everyone): 5:52 PM: That’s the goal of most startups — get bought out by a larger compary and cash in!

Vic (to Everyone): 5:57 PM: Thanks all!

Carlos Huerta (to Everyone): 6:00 PM: Good night all

AnCan – rick (to Everyone): 6:08 PM: Gotta run over to te RMCmeeting.G’night Gents

Hi-Risk/Recurrent/Advanced PCa Video Chat, Nov 15, 2021

Hi-Risk/Recurrent/Advanced PCa Video Chat, Nov 1, 2021

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/.

To sign up to receive a weekly Reminder/Newsletter for this Group or others, go to https://ancan.org/contact-us/.

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?

Jake (to Organizer(s) Only): 5:29 PM: 4 + 5 PSA 45

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)

AnCan – rick (to Everyone): 5:41 PM: https://www.clinicaltrials.gov/ct2/show/NCT04720157?term=PSMAddition&draw=2&rank=1

Henry (and Staci) Cornelius (to Everyone): 5:45 PM: Thanks everyone for all the time spent.

Herb Geller (to Everyone): 5:45 PM: The contact for the Lu trial in Jacksonsville is Jacob.Andring@CSNF.us

George (to Everyone): 5:49 PM: Genito Urinary Medical Oncologist

Herb Geller (to Everyone): 5:49 PM: He is not a GU oncologist. Vivek Arora at Siteman seems competent.

larry meddles (to Everyone): 5:54 PM: last week someone suggested that I get a PYL pet scan, what does PYL mean?

Jake (to Everyone): 5:55 PM: Pylarify

George (to Everyone): 5:55 PM: https://www.pylarify.com

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.

Len Sierra (to Everyone): 6:07 PM: Treating the primary in metastatic PCa https://journals.lww.com/co-supportiveandpalliativecare/Abstract/2019/09000/Treating_the_primary_in_metastatic_prostate.16.aspx

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

ken (to Everyone): 6:15 PM: got to sign off guys…

AnCan – rick (to Everyone): 6:30 PM: Cachexia Conference tomorrow https://www.cancersupportcommunity.org/cachexia-pfdd

George (to Everyone): 6:38 PM: https://www.urotoday.com/video-lectures/esmo-2021/video/2320-stampede-analysis-of-abiraterone-with-or-without-enzalutamide-added-to-androgen-deprivation-therapy-compared-to-adt-alone-in-high-risk-non-metastatic-prostate-cancer-patients-gerhardt-attard.html

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

Jeff Marchi (to Everyone): 7:07 PM: https://radiomd.com/show/her/item/45742-men-get-hot-flashes-too

David Muslin (to Everyone): 7:10 PM: Gotto go men, see you next week

Frank Fabish (to Everyone): 7:11 PM: Gotta go. good night all. Thanks for insight.

Joe Gallo (to Everyone): 7:12 PM: embrlabs.com

AnCan – rick (to Everyone): 7:12 PM: https://myrcc.redcapcloud.com/?#join=352a5988a6ee4219888676c627c3bd2f   That’s the trial – EMBR Wave

Herb Geller (to Everyone): 7:13 PM: Andrew Vetter (vetter@embrlabs.com) is the person to contact for the trial.

Henry (and Staci) Cornelius (to Everyone): 7:14 PM: Steve, I’ve been taking pantoprazole for GERD for 3 months and it’s been great.

Jim Stevens (to Everyone): 7:18 PM: I need to leave. Thanks for the conversation. I will be back.

Len Sierra (to Organizer(s) Only): 7:19 PM: I’ve got to drop off, guys. See y’all next week.

Jake (to Everyone): 7:19 PM: LHRH/GNRH still suppress testosterone even if ‘castrate resistant’.

Herb Geller (to Everyone): 7:25 PM: I think our friends now live in Elkins Park.

Pat Martin (to Everyone): 7:26 PM: I like drinking V8, the spicey variety.

Julian Morales-Houston (to Everyone): 7:28 PM: Have to call it a night – Very good conversation as always! thanks.

Henry (and Staci) Cornelius (to Everyone): 7:32 PM: thanks y’all!

Hi-Risk/Recurrent/Advanced PCa Video Chat, Nov 15, 2021

Hi-Risk/Recurrent/Advanced PCa Video Chat, Oct 26, 2021

Hi-Risk/Recurrent/Advanced PCa Video Chat, Oct 26, 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/.

To sign up to receive a weekly Reminder/Newsletter for this Group or others, go to https://ancan.org/contact-us/.

Editor’s Pick: This week’s repeating theme seems to be the need to switch your QB to a GU medical oncolcogist as your disease progresses. And great discussion about monotherapy 2nd line anti-androgens. (rd)

Topics Discussed

DenovaMx man treated by urologist; interviewing for a new QB doc; the role of palliative care; Bruce’s Breakfast Club!; recurrent PCa requires adding GU med onc; considering 2nd Lu177 trial; appoint with Dr. Beltran coming up; reading PSMA scan – who to beleive?; monotherapy darolutamide works; LHRH role in presence of 2nd line Anti-Androgen – QoL considerations; Lymph and Lung Mx; Fly fishing!

Chat Log

Bruce Bocian (to Everyone): 3:10 PM: It was excellent!

Jake Hannam (to Everyone): 3:11 PM:Len Sierra article  https://ancan.us14.list-manage.com/track/click?u=ece3f3da90f82cb974b407396&id=86fad2dc1a&e=6727193137

Mark Perloe, MD Atlanta (to Everyone): 3:12 PM: Having fun post prostate. First parathyroid surgery, now planning a pancreas biopsy early November. After prostate, parathyroid and pancreas, I’m running out of organs starting with “p”.

Bill Bradford (to Everyone): 3:18 PM: Has anyone had any experience with Dr. Eugene Kwon with Mayo Clinic in Rochester? Someone recommended him for a 2nd opinion consultation for treatments. If so, I can reach out off line later in the week if that is ok

Peter Monaco (to Everyone): 3:18 PM: Good luck Mark!

AnCan – rick (to Mark Perloe, MD Atlanta): 3:19 PM: Heh Doc ….. did they find all the parathyroids??

Mark Perloe, MD Atlanta (Private): 3:23 PM: yes. introspection sestimibi. only one gland +

Julian Morales (to Everyone): 3:25 PM: NCCN – National Comprehensive Cancer Network

AnCan – rick (to Bill Bradford): 3:28 PM: genitourinary GU

George (to Everyone): 3:28 PM: Genito Urinary Oncologist

Bill Bradford (Private): 3:31 PM: Thanks Rick – very helpful. I am seeing a GU medical oncologist at MD Anderson (Omar Alhalabi) for the last month. I am new to the disease and the treatments available so wasn’t sure if I should get a 2nd opinion at this early point in my battle

AnCan – rick (to Everyone): 3:36 PM: Jacqueline Vuky, Julie Graff, Tom Baer all at OHSU. All genitourinary medcial oncologists

Len Sierra (to Organizer(s) Only): 3:43 PM: Guys, the fact that Tom has bone pain with a PSA less than 0.1 makes me wonder if he has PCa cells that are not producing PSA and that I might want to see him get another scan like an FDG-PET.

Julian Morales (to Everyone): 3:44 PM: • United States +1 (646) 749-3129 – LogMeIn/GtM

Joe Gallo (to Organizer(s) Only): 3:44 PM: I have a 50Vets call in 15min so I will leave quietly

AnCan – rick (to Everyone): 3:49 PM: To dial in: +1 (646) 749-3129 #222 583 973

Mark Perloe, MD Atlanta (to Everyone): 4:00 PM: Chol11 should be retired and I think a PYL PET is indicated.

John Antonucci (to Everyone): 4:20 PM: I imagine for any lutetium trial a subject has to have a certain minimum psa?

AnCan – rick (to Everyone): 4:23 PM: rarely is there a PSA eligibility criteria, Dr. John

John Antonucci (to Everyone): 4:23 PM: then what is the outcome measure, Rick?

AnCan – rick (to Everyone): 4:24 PM: usually rPFS

John Antonucci (to Everyone): 4:24 PM: You mentioned a study for guys like me, hormone sensitive and de novo metastatic. but my psa is to low to measure outcome

John Antonucci (to Everyone): 4:27 PM: oh, right. thanks

Gary Peters (to Everyone): 4:27 PM: What is the meaning of “de novo metastatic”? What about “rPFS”?

Len Sierra (to Everyone): 4:28 PM: de novo metastatic means metastatic on diagnosis. first diagnosis, prior to any treatment.

John Antonucci (to Everyone): 4:29 PM: radiographic progression free survival

Gary Peters (to Everyone): 4:31 PM: Thank you Len, thank you John

Bruce Bocian (to Everyone): 4:39 PM: https://radonc.uchicago.edu/faculty/stanley-liauw-md If your in the Chicago area this guy is awesome!

Paul Freda (to Everyone): 4:43 PM: What is rPFS ??

Len Sierra (to Everyone): 4:45 PM: radiographic progression free survival

Bruce Bocian (to Everyone): 4:57 PM: Excellent call tonight! Len, the article is awesome. Rick, great job as always! Herb,”Give a man a fish, and you fed him for a day. Teach a man to fish and you feed him for a lifetime.

Hi-Risk/Recurrent/Advanced PCa Video Chat, Nov 15, 2021

Hi-Risk/Recurrent/Advanced PCa Video Chat Recording, Oct 18, 2021

Hi-Risk/Recurrent/Advanced PCa Video Chat Recording, Oct 12, 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/.

To sign up to receive a weekly Reminder/Newsletter for this Group or others, go to https://ancan.org/contact-us/.

Editor’s Pick:A tough choice between Herb goes fishin’ and reading PSMA scans …. very tricky still (rd)

Topics Discussed

VERU-111 trial – oral chemo; recurrent diesease at age 56; RNA sequencing but maybe not quite ready for prime time; what next after cyclophosphamide; is CHEK2 significant; Provenge discussion; Lu177 trials; brain met slows progression to trial; dubious CBCs; reading PSMA scans … x 2!; when to start chemo; SBRT dosage; CT vs PSMA SCANS; how long to remain on ADT; Herb goes fishing!

Chat Log

Jake Hannam (to Everyone): 5:22 PM: GU (genito-urinary) medical oncologist

rick stanton (to Everyone): 5:29 PM: might consider immunotherapy – might consider sequencing and considering appropriate targeted therapy (or both)

Pat Martin (to Everyone): 5:34 PM: A good rule of thumb I stay close to: ​Pain is NOT therapeutic

Jefff Preston (to Everyone): 5:37 PM: Wouldn’t Mr. Ernst’s father have taken some much more challenging chemo… different than the meds now.

Rick Ernst (to Everyone): 5:49 PM: Thanks for listening to my story. I need to leave the meeting.

rick stanton (Private): 5:54 PM: I could weigh in on targeted and immunotherapy if you wish

Joe Gallo (to Everyone): 5:59 PM: germline/iinherited. somatic.

rick stanton (to Everyone): 5:59 PM: I recommend whole exome RNASeq as well

rick stanton (to Everyone): 6:00 PM: Tempus XT will run that test in addition to ~648 “hot spot” genes. This can provide your med oncologist insights into immunotherapy options

Jake Hannam (to Everyone): 6:02 PM: You can buy it but ask about the trial (free)

Rick Davis (to Everyone): 6:03 PM: Embr Wave trial https://myrcc.redcapcloud.com/?#join=352a5988a6ee4219888676c627c3bd2f .

Rick Davis (to Len Sierra): 6:08 PM: Will RNA Seq show anything that is currently available???

Len Sierra (Private): 6:10 PM: My guess is no.

Carl Forman (to Everyone): 6:11 PM: Interesting 30 min. video with Dr Aparicio at MD Anderson – PC & Immunotherapy, Changing the outlook for metastatic PC https://summit.cancerresearch.org/event/prostate-cancer-and-immunotherapy/

Rick Davis (to Everyone): 6:14 PM: Most interesting point made by Aparicio – that bone Mx is more resistant to immunotherapy!

Joe Gallo (to Everyone): 6:22 PM: Most common somatic are Oncotype Dx, Prolaris, Decipher.’

Rick Davis (to Everyone): 6:26 PM: Joe – those are not really suitable for advanced PCa

rick stanton (to Everyone): 6:30 PM: gotta help my wife – so I need to hop off – THANK YOU all!! Look forward to next time

Rusty (to Everyone): 6:31 PM: Have a great week everyone! I will not be on next week due to my shoulder replacement next Monday.

Jake Hannam (to Organizer(s) Only): 6:31 PM: good luck rusty!

Rick Davis (to Everyone): 6:33 PM: Wish you the very best with your shoulder, Rusty! Watch the recording to find out how Herb did at Reel Recovery

Jake Hannam (to Organizer(s) Only): 6:40 PM: Hi Herb!

Len Sierra (to Organizer(s) Only): 6:41 PM: What happened Herb? Did you get a fish hook through your finger??

Herb Geller (to Organizer(s) Only): 6:42 PM: :Greetings from Reel Recovery

Joe Gallo (to Organizer(s) Only): 6:42 PM: Take pictures Herb!

Jake Hannam (to Everyone): 6:46 PM: Procrit

Len Sierra (to Everyone): 6:46 PM: Procrit = erythropoietin

Jake Hannam (to Everyone): 6:46 PM: https://www.procrit.com/

Bill Bradford (to Everyone): 6:47 PM: Thanks to all for listening to my story and providing great information. I will try to be a regular / frequent attendee to this group, as well as the U60 group. I did have one generic question for the group. I just started Zytiga + prednisone (in addition to the eligard I started 6 weeks ago). I know Zytiga is tough on the liver. I do enjoy a glass or two of wine each evening and a few beers on the weekend. Is it recommended to strictly abstain while on Zytiga?

Pat Martin (to Everyone): 6:47 PM: When I was anemic they prescibed Fe pills and licquid meds. All they did was constipate me. I brought it to my PCP she had me get a couple infusions.

Jeff Marchi (to Everyone): 6:49 PM: you can drink moderate amounts without issues, normally I drink a glass of wine or a beer every day, tests are good for liver and kidney dr never said to stop CONTINUED AT

Bruce Bocian (to Everyone): 6:50 PM: Pecking order at U of Chicago Adekunie “Kunie” Odunsi, Director ​Dr. Walter Stadler, Deputy Director, this is who I see.

Martin Wice (to Everyone): 6:54 PM: Have to go. Thank you.

Jake Hannam (to Everyone): 6:54 PM: I suggest you get a copy of the CD and ask for a 2nd opinion

John Ivory (to Everyone): 7:00 PM: I saw Szmulewitz at UChicago for a year (till my insurance didn’t work)–thought he was fantastic

Bruce Bocian (to Everyone): 7:00 PM: Good night!

Alan Moskowitz (to Everyone): 7:00 PM: Thanks Jake.

Joel Blanchette, Reston VA (to Everyone): 7:00 PM: Impression IMPRESSION: No definite marrow replacing lesion in the right occipital condyle. Focus of increased uptake on recent PET CT could be related to degenerative change. Multilevel degenerative changes in the cervical spine. Images and interpretation personally reviewed by: Arvin Kheterpal, MD

Bill Bradford (to Everyone): 7:00 PM: I have to drop off guys – glad to be part of the group.

Alan Moskowitz (to Everyone): 7:01 PM: Thanks everyone for your thoughts. Have to leave now.

Joe Gallo (to Everyone): 7:05 PM: joeg@ancan.org

Stephen Saft (to Everyone): 7:15 PM: I am going to say good night. I am exhausted. It is great to be part of these high level discussions. i appreciate the opportunity to listen and share. Good Night. Night.

Jake Hannam (to Everyone): 7:15 PM: Good to see you!

Ken (to Everyone): 7:22 PM: thanks guys…got to go! good job LenJ