Chemo, Hormone Therapy, and Radiation For Advanced Metastatic

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0:22 Which prostate cancer patients are most eligible for triple therapy?
2:08 Which Gleason scores are most likely to require triple therapy?
3:31 Is triple therapy always required in certain situations? What about lymph nodes?
7:21 Is triple therapy more advisable for very young prostate cancer patients?
9:01 What are the usual side effects associated with hormone therapy?
11:32 In what sequence are these treatments given?
12:55 How long does a course of hormone therapy usually last?
13:43 Can improving imagine techniques lessen the impact of hormone therapies?
15:04 How does chemotherapy for prostate cancer compare with other cancers?
17:51 Can chemotherapy, hormone therapy, and radiation all be tried again after recurrence?
19:11 Does the radiation treatment used in triple therapy need to be done at a center of excellence?
20:50 Alex's conclusions
23:23 If you need more help
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Who we are:
The Prostate Cancer Research Institute (PCRI) is a 501(c)(3) not-for-profit organization that is dedicated to helping you research your treatment options. We understand that you have many questions, and we can help you find the answers that are specific to your case. All of our resources are designed by a multidisciplinary team of advocates and expert physicians for patients. We believe that by educating yourself about the disease, you will have more productive interactions with your medical professionals and receive better-individualized care. Feel free to explore our website at pcri.org or contact our free helpline with any questions that you have at pcri.org/helpline. Our Federal Tax ID # is 95-4617875 and qualifies for maximum charitable gift deductions by individual donors.

[@frankperham5629]

This channel is the best by far for prostate cancer information. I have learned so much by watching your videos. Thank you.

[@georgemorris9616]

Grand Rounds in Urology, Cancer Patient Lab are also excellent. These three I watch regularly, although it can be depressing as a good number of these treatments are not available in Canada yet.

[@fredcarter6996]

I just want to give words of encouragement to other stage IV metastatic prostate cancer patients. I have been following the regimen discussed in this video, under the care of Dr. Eugene Kwon, for a year now (Lupron, Nubeqa, Taxotere, Radiation.) and it has worked to perfection.

[@n.c.b.8832]

Hi Fred, thank you for that , good to know, I am interested what country are you in to get this what I would call straight forward sensible treatment ?, I am in UK, north , my oncologists etc are also in UK the problem is I am in 2024 they are in some where around 1976 regarding treatment options

[@terriblepainter7675]

@@n.c.b.8832I understand that Dr. Kwon operates in the USA.

[@geogrman]

I will second this comment. I wasDiagnosed in Nov 22, did radiation on bone Mets followed by triple therapy (taxotere, firmagon, nubeqa) and have had an undetectable PSA last nine months. Looking forward to getting off ADT if I can.

[@ovidididaho]

Diagnosed in Feb 20, 2024 63 yrs old. PSA 255. Urologist treated me for urinary infection said come see me in six weeks. My family Doc set me up an MRI, showed large tumor in prostate and widespread throughout my pelvis. Had PSMA-PET scan. Went on Eligard , Nubeqa, had radiation therapy to bone and prostate, and now going in for my 5th Docetaxel treatment on the 13th. PSA was 1.2 last treatment. I have never had a prostate biopsy only bone biopsy. Thank you PCRI

[@edg531]

Thank God for your family doc, and best wishes in your battle. I was diagnosed in February as well, via a prostate biopsy. PSMA Pet scan revealed cancer in half of prostate, one seminal vesicle, and one local lymph node. Firmagon and Aberiterone lowered PSA from 87 to 3 in less than four weeks. Since then I’ve completed 28 radiation sessions. Will get my PSA checked again in October. The docs all agreed that checking any sooner might be confusing due to irritation caused to the prostate by radiation. I’m still on hormone therapy, of course, feeling good and hoping to continue making progress in my own battle. Take care!

[@ovidididaho]

@@edg531 The best to you as well, thank you.

[@jimbaker2698]

Below de wormer?I've been treated for 5 yrs and say there's nothing else than they can do for me,thanks for all your info for the last 5 yrs❤

[@rickycinco9541]

Very enlightening to us patients. Thank You so much! Highly appreciated!

[@andrewharms2460]

I’m advanced p ca . I’m so grateful for your work.

[@oscarsalazar8693]

I appreciate all the information this channel is providing to everyone as a 77yrs young person having to undergo radical prostatectomy at age 68 and was told I was fully cure with psa 0.080 for 7 yrs, with a recurrence in 2022 with psa10 having done PSMA Pet scan shows a small nodule that was extracted and psa fell to 0.080 started on lupron22.5mg (Eligard) every 3months after which i did a full pect ct scan that shows metastasis on my L5 and hip bone since then still on lupron injection 22.5 mg bicalutamide 50mg daily and abiraterone 250mg, recently did a blood test that shows psa at 42.3 and Dr increased dosage of aberaterone to 1000mg and 10mg presdnisone and requested another pect ct scan.Its been rough but the good Lord takrs care of us and must be patient.thanks for your so important info.❤

[@rustywolf7329]

Exercise video I'm looking forward to, that is not easy to find good information about. Thanks for all your efforts and videos to get us informed!

[@tomconnelly109]

Very helpful and comprehensive video on triple therapy, thanks!

[@markylindyscrib2120]

I would like you to address paralysis caused by metastaes prostate cancer.

[@johnmartinez9295]

Wow, that is me. All three, I came in with PSA 51 and G9, biopsy confirmed 1-12-2024. Bone scan found met.in 5 area. After watching you videos, begged Oncologist to request a PMSA scan, they said they don't usually order those because never approved. Ins.spproved it, since I have stage 4 met.cancer with 2 years to live. This is what they said to me. We did the PSMA scan and found more tumors on lung, liver,spin,throt and stomach. My question is, if all three don't work, what is the best secondary treatment I should be looking at. Thank you again. John

[@Skwarek-wp8dc]

Lutetium 177, my guess

[@terriblepainter7675]

Call the number of Prostate cancer research institute. You can get information there.

[@SeekingWisdom17]

I don't know which is best for you, you should consult this with your medical oncologist. Here are some choices: Pluvicto (Lutetium-177). Stronger chemo: add carboplatin to docetaxel/cabazitaxel. Olaparib (Lynparza) if you have BRCA1/2 genome. The least toxic of these may be Pluvicto.

[@ThePCRI]

Hello John, please reach out to our Helpline at pcri.org/helpline. They can talk to you about further options.

[@terriblepainter7675]

A family member was scheduled for 6 cycles of Taxotere, but decided not to do the 6th cycle due to onset of Neuropathy which caused balance issues after the 5th cycle. The PSA went down to .18 after the 5th cycle. A repeat PET PSMA is scheduled.

[@lrs7777]

More information on cognitive & emotional side effects of triple treatment would be helpful.

[@JenE3377]

I'd like to know if the prostate has been removed in these scenarios.

[@jeanetteshaw5177]

My question is about the survival rate of metastatic prostate cancer over 5 years. Many sites on the internet say men have a 30% chance of surviving 5 years. I get the impression that this is quite a bit higher these days as 30% is quite low. How can l get accurate information regarding survival rates? My husband has metastatic pc with 2 bone mets and 2 lymph nodes affected. He's 69 . He is on 1st and 2nd generation hormone therapy but not chemo yet. His doctor said he has years not months but this is pretty vague . Thankyou.

[@KathleenMonday]

I'm happy for recommend DOC UROMI on KZbin to everyone, as he cure my STD..............❤❤

[@abi310]

My father 69 at the time went from a PSA of 3.9 to 5000 in one year (2021/2022) it’s not always a lack of checking.

[@dondgc2298]

Wow. I had no idea that was possible.

[@Skwarek-wp8dc]

How about HDT and cardio and stroke side effects? Do not hear anything mentioned about it ...

[@n.c.b.8832]

Hi abi, I too got caught out in 2021, no checks done , why ? Covid !!! It will not say Covid on my death certificate but a massive contribution Phil

[@threeftr3349]

My husband 65, had a PSA of 4.7--but because it went up 2 points in 6 months, Gleason 4+3=7, MRI, PSMA, 4k, he has prostate cancer. He is in treatment right now.

[@terriblepainter7675]

A family member was checked, found to have high PSA and difficulty peeing. Urologist was repeatedly convinced it was just Prostatitis and prescribed antibiotics and did ultrasound which showed nothing. This went on for months. Family member said I am not getting better and then finally an MRI was done which showed suspicions for cancer. Then biopsy and diagnosis of stage 4 Metastatic Prostate CA with mets in bones and a lymph node. The family member happened to tell this MD on his first consultation that his father had prostate cancer and that should have been a red flag for the MD. Almost a year lost in treatment.

[@TheMrvatcher]

Thanks for the info. I tick a lot of box's from your phone list. Do they send medication or from your nominated chemist?

[@pamdann2636]

What is your opinion of “predict” to determine your prognosis and possible treatment paths.

[@3007akhil]

What do you suggest who was (61 yrs) diagnosed with Gleason 9, with negative PSMA PET Scan treated with radical radiation therapy and ADT for 3 years. His PSA is beginning to rise again and the repeat PSMA is still normal. Can he go back on ADT with our workout chemo?

[@jabster58]

Was your tumor on both sides of prostate and what was your psa when you were first diagnosed?

[@ThePCRI]

Hello, we are not able to answer case questions on our comment section but we can help you through our Helpline who can speak with you either by phone or email. Here is the link to contact them: pcri.org/helpline

[@Mark_Lacey]

Hi. Some links to the research on triple therapy would be useful. My PSA started at 3,500, heavily metastasized, over six months on ADT dropped to 0.6 Spoke to my medical oncologist about triple therapy but he wants to keep tools in reserve. I could do with maybe showing him some papers.

[@stitcheruk1150]

In 10/2023 my PSA was 310, Gleason 5+4 and metastasised throughout skeleton ( Bone and CT scans - PSMA PET not available ) Was started on 1st generation ADT, immediately followed by Chemotherapy x 6 and 2nd generation Nubeqa. PSA dropped to .10 ( or below ) in 03/2024. Now on ADT and Nubeqa until PSA increases.

[@kawaahangar4570]

Thanks Looking forward for your exercise video. Cheers

[@richardwilkinson321]

A 78 year old man went for regular PSA tests and physical exams, latest check August 2023. No indication of a problem. January 2024 he had blood in urine. In March 2024, PSA scan showed multiple lesions on axial skeleton, spine, pelvis, scapula etc. Stage 9 Gleason. PSA at 10. Was placed on Eligard / Lupron in February. By late May PSA had dropped to 0.36. Oncologist recommended not proceeding with chemotherapy due to rapidly dropping PSA score. Rather keep chemotherapy in reserve. Should the patient proceed with chemotherapy?

[@SeekingWisdom17]

Is he also on second-generation ADT like Xtandi/Zytiga/... ?

[@richardwilkinson321]

@@SeekingWisdom17yes

[@shelleyhale563]

Husband, age 60 had only12 lymph nodes in pelvis/abdominal region at dx. He had a severe reaction after 1 infusion of docetaxel and was discontinued. He's only on Xtandi, since refused ADT, and PSA is slowly rising now and urologist is wanting to add Pluvicto. I am worried about neutropenia because of chemo reaction. What other options do you suggest? He doesn't qualify for BAT because of high Testosterone. Also he has not had any radiation yet. Looking into prostatic chemoembolization as an option.

[@ThePCRI]

Hello Shelley, We would love to help. Here is the link to our Helpline. They can give you information for your husbands case: pcri.org/helpline

[@johnmartinez9295]

Do the all three, find Chemo that he can stan, and live your life.

[@SeekingWisdom17]

Was that an allergic reaction to docetaxel? Has he had Benadryl prior the infusion? If he tried docetaxel again then maybe try slower speed of delivery, Benadryl and steroids (dexamethasone), maybe . Or try to switch to cabazitaxel instead of docetaxel. Against neutropenia: Routine in top hospitals is to use Neulasta (with claritin) with docetaxel or cabazitaxel. He should consider ADT. Fatigue can be dealt with working out, possible temporary erectile dysfunction can be treated with pills.

[@shelleyhale563]

@SeekingWisdom17 I didn't know about Neulasta then as I do now. We tried to ask about doing lower dose docetaxel but MO refused saying there is no efficacy which I have found supporting evidence that there is. However, he won't do it anyway. I don't believe he has an allergy to docetaxel. It was cytotoxic reaction resulting in fluid restoration. He went syncope several times after that chemo for a few days. I have been trying to convince him to start orgovyx. One of the guys from PCRI called and explained it to him. So I think he is on board now. He wants to do another psa and if it's elevated again he will start.

[@SeekingWisdom17]

@@shelleyhale563 If he got intense hot flashes from ADT then transdermal estrogen patches would help him with that.

[@ayodotunjolaoso3807]

Please if a patient has prostate CA which is responsive to hormonal therapy, and confided to only the prostate, should they have radiotherapy,

[@ThePCRI]

Hello, we are not able to answer case questions on our comment section but we can help you through our Helpline who can speak with you either by phone or email. Here is the link to contact them: pcri.org/helpline

[@jimbaker2698]

Have you ever heard of someone trying fendbezodol dog de worker? And it working? As a last resort?

[@DCGreenZone]

👍

[@johnmartinez9295]

Don't wait, true it has none for me side affect.

[@DCGreenZone]

Mebendazole has been added to Docetaxel by the University of Glasgow. Thoughts?

[@johnmartinez9295]

Wow, how can I try that?? Can I ask the Oncologist? Or is this a trail? If not, I can order Fembendazol, a cousin to that.

[@shelleyhale563]

Mebendazole is the only version approved now for human use. Integrative oncologists csn order from a compound pharmacy.

[@DCGreenZone]

@@shelleyhale563 While that may be true, I clipped this from a Joe Rogan video before it was removed. >>Was diagnosed with Prostate cancer Gleason 7 (3+4) at the age of 37. I knocked back all urologists recommendations and used Fenbendazole 1500mg-2000mg a day. My recent 2 year biopsy stated I have eradicated 3 out of my 4 tumors. I personally believe this stuff works

[@DCGreenZone]

@@shelleyhale563 I have dozens of these, of course, they will be removed, however, Dr. Tom Roger's video on artemisinin and fenbendazole is still up and the comments are pretty wild as well. >>Fenbendazole! My brother-in-law has been symptom free for three years now, from Stage 4 metastatic prostate cancer , using this drug daily

[@johnmartinez9295]

Yes but they don't always give it here in Texas. Stage 4, I want to try it all to save my self. The Dr. Won't speak to me about alternative or diet. As if they just want money and not cure. Only my thoughs, I want this 6 month nightmare to end...

[@threeftr3349]

I wonder why LDR (low dose radiation) brachytherapy is not discussed more? Dr. Ankit Agarwal and Dr. Steven Kurtzman, are Radiation Oncologists in Mountain View, CA, they are the two best MD's for this procedure in the nation.

[@ThePCRI]

Hi! Here is a presentation they did with us in September: kzbin.info/www/bejne/fYu3fGl_mKx8Y9k

[@threeftr3349]

@@ThePCRI Thank you

[@thomasbrady63]

Are you aware of HIFU therapy? Who does that work for. Why does not one seem to use it or bring it up . High Frequency.

[@williammack571]

All the information shows me that I do not want to live through this.I am on adt 4 months and I see only worsening side effects and deteriorating mental health. My wife died of breast cancer 22 years ago. The medical industry failed her and deceived me with optimism that was unfounded.

[@DCGreenZone]

Fenbendazole is plainly listed for humans on Amazon, 222mg and 444mg. No disrespect, but that's a fact Shelley.