Hi-Risk/Recurrent/Advanced PCa Video Chat, April 8, 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: Testosterone superman deflates — and his shrine is dismantled — after he checks his math (bn).
Topics Discussed
Will a switch to estrogen outsmart the cancer?; he was slated for 3 years of ADT, but may want to quit or or ease off on year 3 — many options exist but not all are proven; third Pluvicto round for Marc V — he’s looking well, and Dr. Aggarwal’s feeling good about the results; the right way to taper off a bone strengthener; the story of CD46, a promising PCa marker for theranostics; spotlight’s back on hot flashes — as usual, many suggestions; he wants to resume his job the day after brachy — possible?; cardio-oncologist in Chicagoland?; testosterone superman deflates — and his shrine is dismantled — after he checks his math; off ADT, should he worry about rising T?; too early in the game for neuroendocrine worries; even if you need to wait for a scan, don’t start ADT without one; don’t sweat the small stuff when it comes to rising PSA; insufficiency fractures; what to expect during radiation treatment — Dr. Mark’s the expert.
Chat Log
AnCan – rick · 6:41 PM
How Cancer Cells Travel to New Tissues and Take Hold… https://www.medscape.com/s/viewarticle/how-cancer-cells-travel-new-tissues-and-take-hold-2025a10007rt?ecd=WNL_trdalrt_pos1_250407_etid7346797&uac=529807HK&impID=7346797
AnCan – rick · 7:24 PM
Here’s the Mayo paper by Brad Stish re. oxybutynin https://www.medpagetoday.com/meetingcoverage/asco/110457?xid=nl_mpt_DHE_2024-06-03&eun=g1169472d0r&utm_source=Sailthru&utm_medium=email&utm_campaign=Daily%20Headlines%20Evening%202024-06-03&utm_term=NL_Daily_DHE_dual-gmail-definition&mc_cid=81fa35ee19&mc_eid=838454d636&mc_cid=1550e5c67f&mc_eid=838454d636
AnCan – rick · 7:27 PM
Forget that link – here’s the right one https://www.medpagetoday.com/meetingcoverage/asco/110457?xid=nl_mpt_DHE_2024-06-03&eun=g1169472d0r&utm_source=Sailthru&utm_medium=email&utm_campaign=Daily%20Headlines%20Evening%202024-06-03&utm_term=NL_Daily_DHE_dual-gmail-definition&mc_cid=81fa35ee19&mc_eid=838454d636&mc_cid=1550e5c67f&mc_eid=838454d636
AnCan – rick · 7:30 PM
The culprit that makes oxyb. work better with abi is the CYP3A4
Steve Roux, North Michigan · 7:54 PM
I’m late for dinner. GREAT Mtg guys! See you next week!
John A · 8:14 PM
insufficiency fractures: result of normal stress on abnormal bone ….fatigue fx: abnormal stress on normal bone…. .pathological fx: diseased weakened bone due to tumors or abnormal bone . ….stress fx: means chronic mechanical stress exceeds the bone’s capacity
Bob Schwartz, USN, Venice FL · 8:15 PM
Another good mtg., have to go.
Hi-Risk/Recurrent/Advanced PCa Video Chat, March 25, 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: A visit from Dr. Paul Schellhammer, first diagnosed with PCa in 2000. (bn)
Topics Discussed
Since 2000, he’s had every treatment on offer, including estradiol since 2008, but not docetaxel — and VA now is letting him skip it and get Pluvicto; experts say PSMA whole-body SUV is an important predictor — but where is it in the reports?; he’s opted for brachy and surgery and orgovyx and hoping PSA falls soon; doublet vacation quickly brings less fatigue and more enthusiasm; Pluvicto seemed a dud, but then PSA started plummeting around the fourth treatment – though blood marrow took a hit, and some lingering dry mouth 9 months later; don’t stay on zoledronic acid too long — get off and go back on; be careful with darolutamide and certain statins; American Cancer Society can help with lodging if you travel to treatment; despite high-risk cancer, he’s getting only Lupron — and wants to know why; drug holiday began Sept 2023 and he’s still celebrating; chemo “much tougher than I even thought it was” — but PSA went from 325 to 0.82; darolutamide monotherapy works, but timing is everything; how do you get darolutamide monotherapy when it’s not in the guidelines?; bloody urine can appear 18 months or more after radiation treatment.
Chat Log
AnCan – rick · 6:12 PM
dr.john@ancan.org
Larry (Alaska) · 6:44 PM
Patches, gel are OK; but don’t forget injections which I find to be more convenient
AnCan – rick · 7:49 PM
https://www.cityofhope.org/alan-bryce
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: We’re talking incontinence and tricks to manage it this week + Pluvicto works! ? (rd)
Topics Discussed
ATM germline Gent faces recurrence; slow moving recurrence brings urinary incontinence; MRI finds hip lesion raising early Mx – do PSMA for pace of mind; neuropathy dismissed by Mayo docs as ageing – not HT or chemo???; when to ask for PSMA on recurrence; Pluvicto brings great results – enjoy it rather than ask what’s next; how do differences in MRI equipment impact interpretation?
Chat Log
Wes – San Diego sent: 5:17 PM
Intraductal commonly, I’m told, has a low PSA.
Wes – San Diego sent: 5:22 PM
What does a medical oncologist add to surgeon and radiologist? Hormones?
Gary sent: 5:24 PM
Medical Oncologist deals with everything from ADT to lutetium, docetaxel, etc.
So it would seem to me that any prostate guy would be wise to have a medical oncologist, albeit others can prescribe Lupron, etc.
Jim Marshall, Alexandria, VA sent: 5:26 PM
Specifically one should look for a Genitourinary Medical Oncologist. NOt a General Meneral Oncologist. Jim
Gary sent: 5:26 PM
I agree.
Jim Marshall, Alexandria, VA sent: 5:37 PM
Somatic testing. Jim
John A sent: 5:44 PM
dr.john@ancan.org
Wes – San Diego sent: 5:55 PM
Is it related to drinking carbonated water, beer, etc. ? which prompts me much, much more than other drinks.
AnCan – rick sent: 5:57 PM
Gemtessa
Alfredo in Houston sent: 5:58 PM
I think it is NOT generic yet, and around $500/ 30 days
Bob Schwartz, USN, Venice FL sent: 6:20 PM
Another good mtg. Have to go.
Wes – San Diego sent: 6:32 PM
heart BP meds can prompt gout and edema, which can be related to nueropathy, as they have been for me.
Don Rogers sent: 6:32 PM
Dan, I would suggest you contact the radiologist and set up a meeting and have the doctor explain the report. I have done this twice with great success. Don Rogers
AnCan – rick sent: 6:33 PM
Don – may be harder to do at Kaiser.
Hank Zajic Springfield VA sent: 6:38 PM
I just did a PSMA PET using Pylarify. The test result report recorded 8.86 mCi (millicurie) dose. not much.
Alfredo in Houston sent: 6:38 PM
The amount of radiation exposure from an imaging test depends on the imaging test used and what part of the body is being tested. For instance: A single chest x-ray exposes the patient to about 0.1 mSv. This is about the same amount of radiation people are exposed to naturally over the course of about 10 days. A mammogram exposes a woman to 0.4 mSv, or about the amount a person would expect to get from natural background exposure over 7 weeks. Some other imaging tests have higher exposures, for example: A lower GI series using x-rays of the large intestine exposes a person to about 8 mSv, or about the amount expected over about 3 years. A CT scan of the abdomen (belly) and pelvis exposes a person to about 10 mSv. A PET/CT exposes you to about 25 mSv of radiation. This is equal to about 8 years of average background radiation exposure.
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 25, 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: Will estradiol replace the hated ADT?
Topics Discussed
After a few rounds of, “Hmm, this is worse than we expected,” he aims to get ahead of the curve; off ADT, and waiting apprehensively for his bloodwork; exciting news from Dr. Wassersug about estradiol — no hot flashes, preserves bone density, the patches are cheap, and they’re already available (but for women); surgery or cortisone for his trigger-finger syndrome — and is it ADT-related?; was PSA spike due to a faded 6-month Eligard shot?; doc sees results and says, “Let’s start the drug holiday now!”; what’s a crosslink collagen test?; Pluvicto trial’s four-month survival gain feels troublingly small; doc wanted to keep chemo in a back pocket — is it time?; “what’s impacting my life most now is a shortness of breath” — a cardio-oncologist might help; after a week of Orgovyx he feels no change…but ADT’s side effects develop over time.
Chat Log
Steve Roux, North Michigan · 6:49 PM
Matthew – sign up for the reminder emails for meeting reminders and a lot of other good stuff.
Jim Marshall, Alexandria, VA · 6:49 PM
1st & 3rd Mondays at 08:00pmET and 2nd & 4th Tuesdays at 06:00pmET High Risk Group
Jerry Grimes, Brighton, MI · 6:56 PM
I am on estradiol, through informed consent. I feel great. Can confirm Dr. Wassersug’s comments about symptom relief.
Jerry Grimes, Brighton, MI · 7:00 PM
I was paying approx $140 per 3 months for two 0.1mg/day patches, changed twice weekly.
Jerry Grimes, Brighton, MI · 7:01 PM
My insurance did not cover this.
John M · 7:05 PM
Robert: Which ADT drug were you on?
Matthew L · 7:09 PM
the names are gone. at each person on the main screen how what happen
AnCan – rick · 7:10 PM
Make the window larger
Steve Roux, North Michigan · 7:10 PM
👍
Steve L · 7:11 PM
names gone if one person has enlarged image but names present if all small images.
AnCan – rick · 7:42 PM
David Smith, GU MO at Uof M (Go Blue)!! https://www.rogelcancercenter.org/physicians/david-c-smith-md
AnCan – rick · 7:47 PM
👍
Jim Marshall, Alexandria, VA · 7:49 PM
Pluvicto and ATM mutation says it works very well. jim marshall
AnCan – rick · 8:14 PM
Effie Andrikopoulou, MD
AnCan – rick · 8:14 PM
https://www.uwmedicine.org/bios/effie-andrikopoulou
