Hormone therapy may boost prostate cancer growth

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SPT
SPT Member Posts: 40

Hormone Depletion Activates Tumor Survival Process in Prostate Cancer, Study Shows

 

The article linked above begins:

 

"Prostate cancer hormone depletion treatments might, in fact, be boosting cancer growth and making a tumor more aggressive, researchers at England’s University of Surrey found."

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Comments

  • Jpsweld
    Jpsweld Member Posts: 6
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    What is this for real? 

    What is this for real? 

  • hewhositsoncushions
    hewhositsoncushions Member Posts: 411 Member
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    Misleading

    The OP title is misleading and disingenous. The  article suggest that there MIGHT be a correlation in some instances and that HT in conjunction with something called PARP might reduce / resolve the problem. Further research required. All papers are speculation until they become accepted practice and even then, things change.

    I'm really annoyed now.

    On one hand, Vascodagama is getting grief from the mods for posting well researched and well thought medically sound posts giving solid advice that may save lives. On the other hand we have people who are openly hostile to proper medicine promoting pseudo-science and presenting misleading information.

    I beleive the mods need to take a stand on this and that that stand ought to be - science first. last and always.

    Post reported.

  • SPT
    SPT Member Posts: 40
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    Jpsweld said:

    What is this for real? 

    What is this for real? 

    Yes it is for real
    The study included both tests in a lab petri dish and tests on men with prostate cancer.

    "But a finding in a lab dish does not necessarily translate into human reality. So to verify their observations, the team set up a prospective study with prostate cancer patients. Participants were split into two groups — one had anti-hormone therapy before radiation treatment, while the other started radiotherapy before hormone depletion. Those who received hormone depletion before radiation therapy had fewer cells dying from the radiation.

    "Looking at tumor biopsies, the study showed that hormone deprivation impacted DNA repair, which was linked to higher PARP activity in the cells. To further verify this, the team compared PARP levels in patients before and after hormone therapy, and saw that PARP levels increased as a result of the androgen-depleting treatment."

    PARP is an enzyme that participates in DNA repair. It also renders cancer treatments less effective. That's why the paper's authors, and many other groups, are studying PARP inhibitors as potential new drugs.
  • SPT
    SPT Member Posts: 40
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    Misleading

    The OP title is misleading and disingenous. The  article suggest that there MIGHT be a correlation in some instances and that HT in conjunction with something called PARP might reduce / resolve the problem. Further research required. All papers are speculation until they become accepted practice and even then, things change.

    I'm really annoyed now.

    On one hand, Vascodagama is getting grief from the mods for posting well researched and well thought medically sound posts giving solid advice that may save lives. On the other hand we have people who are openly hostile to proper medicine promoting pseudo-science and presenting misleading information.

    I beleive the mods need to take a stand on this and that that stand ought to be - science first. last and always.

    Post reported.

    Can't have any dissenting opinions
    I'll match my scientific education, credentials, and publication list against yours or anyone else. I have 3 degrees from MIT and make my living in science.

    Science first last and always must tolerate dissent and criticism, and doesn't shy away from unwelcome facts and observations. Singing the praises of doctors and uncritical acceptance of everything they do is not science. Most doctors are not scientists - they are technicians. Well trained technicians for the most part. You really don't want a scientist experimenting on your body. Trust me on this one.

    In this case, it wasn't even criticism, just some news that could be unwelcome to many men here. I used the word "may" in the title of the original post.

    Report away, if the mods won't tolerate dissent this place is worthless.
  • Will Doran
    Will Doran Member Posts: 207 Member
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    Please don't argue

    Since I have been through all the surgery, Radiation and yes, two years of HT, I can't say that I want to hear this argument.  I'm 4 + years post diagnosis and started with a PSA of 69, and as of two weeks ago my PSA is still < 0.5, and my testosterone is back to full levels. And, yes, the beast could rear it's ugly head again at any time.  My Doctor keeps it real and reminds me of that every time I go in.  I, like "Cushions", "Vasco", and many more have had good results, and, yes, maybe "luck", and success with the use of surgery, radiation and HT.  Many of us want to only share what we have been through and the results we have had.  So, others may learn and make their own decisions.  

    Please don't turn this web site, which means so much to all of us, into a battle ground like we now have in the USA with all the fighting and separation. It's as bad as it was in the 60's when I was in college.   We have too much else on our minds to have to take opposing sides.  We are worried enough about our situations to have to come on here and see disagreement going on.

    Sincerely,

    Love, Peace and God Bless to all

    Will

  • hopeful and optimistic
    hopeful and optimistic Member Posts: 2,339 Member
    edited October 2017 #7
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    Well said hewhositsoncusions.

    Well said hewhositsoncusions...

  • GeorgeG
    GeorgeG Member Posts: 152
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    Are there any other studies

    Are there any other studies that agree with this conclusion/hypothethis?

    George

     

  • RobLee
    RobLee Member Posts: 269 Member
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    Sticking with science for HT duration

    Yesterday I had my final meeting with my RO and now have only four more ART treatments using the RapidArc.  We discussed how long I should remain on Lupron and between the two of us concluded 18 months total.  I asked if 2 years would be preferable and he said no for the reasons stated earlier, in that it could reduce the efficacy of HT in the event of a future recurrence.  He also said we could stop at one year if I was not tolerating it well, and I said I can do another six months okay.  Note this is just Lupron, no Casodex. My only other meds are Venlafaxine and Gabapentin for the hot flashes and mood swings.

    Additionally he informed me that the radiation will continue to kill cancer cells for about nine more months after RT ends, so another nine months of HT (when my next shot will wear off) will nicely cross over with the curve of the RT's effectiveness.  It seems like a good plan.  Also he said that my testosterone should return around nine months after the Lupron wears off. Also we will not know for sure whether or not all this has worked until after three consecutive PSA tests after everything has ended, worn off, and stabilized... so we're looking at 2019 (yes, 2019) before we know for sure.

    As for the sentiments expressed in this thread, I feel that HeWhoSits stated it perfectly.  I for one read just about everything that Vasco writes. It is always good information, even if it does not specifically pertain mto my own situation. And I never bother reading anything posted by the other guy anymore.  I just skip over them.  My day just goes much better and my heartrate stays lower if I do no expose myself to such contentiousness, especially early in the day.  It's just my own means of self preservation. Call it Darwinism.

  • VascodaGama
    VascodaGama Member Posts: 3,662 Member
    edited October 2017 #10
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    Self preservation

    RobLee,

    In my opinion your RO has chosen the best plan. Unfortunately it will take time before you really get the final conclusion and deserved peace of mind. The long period on HT with its side effects is never a wanted situation but you can trust on its influence in the overall treatment. I am glad for knowing that the RO has given you the freedom to stop HT if such becomes an inconvenience in your quality of living.

    The nine months of RT effect regards the period cells take to duplicate and die. Prostatic cells life cycle (cell-division cycle) goes from two to six months and it is during this period that the damage of the DNA will take action and provide results. The survival-ship (Darwinism) enters into action trying to save the situation forcing duplication of cells which, due to the impared strands, cannot duplicate anymore. You can imagine the havoc going on in a cell, caused by the lack of testosterone in one side and the tentative in forcing repair on the other side, creating a total confusion in the system that ends in our favor. This is when we win and later celebrate.

    The process involves risks too. Cells that were not much affected because of the timing of the RT administration (those at the interphase period that missed the burst) may continue duplication and living. Some can also survive with a damaged DNA that may later become cancerous. However these are minimal probabilities as RT is administered along side the period of cell'slife cycle (8 weeks in daily administration), or burst with a stronger dose in a period of one week to assure the best killing. Those that survived would take years for showing prejudice in our life span.

    How about trying to extend that "self preservation" to see man on Mars by 2034?

    2019 is just around the corner. You can do it

    Out of the context; I wonder how you can keep reading my posts. English is not my mother tongue and grammar is not respected as it should be. When reading back past posts I am puzzled for the numerous spell errors I have committed. Sometimes I cannot even understand the main meaning of my sentences. It must be boring for the English speaking community.

    Best,

    VG

  • RobLee
    RobLee Member Posts: 269 Member
    edited October 2017 #11
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    Thank you for your reply

    Vasco, thank you for your reply.  You and a few other regulars here make this forum what it is, a valuable source of information. I do frequent several other forums and each has it's own flavor. This one, on CSN requires the most effort and patience to navigate, but is well worth it.

    Brilliance is apparent no matter what language. Diligence in constructing meaningful sentences and paragraphs shows through dispite awkward grammer and perhaps unfamiliar terminology. I too have some difficulty both composing and interpreting these posts as I am mildly dyslexic, even though English is my primary tongue it is sometimes awkward and difficult to comprehend. Plus we all make even the simplest (and sometime humorous) spelling errors... 'typos'.

    Of course, once this particular battle of prostate cancer ends for me, as it hopefully will eventually, I may tire of reading these forums and hopefully move on to another phase of my life. I will remember the people who were a tremendous influence during this period, which if it extends into 2019 will be five years long. And with great hopes that it will never be necessary for me to return to these forums to resolve a future recurrence.

    Thank you once again for all that you do for everyone here, VascodaGama, and may good fortune be with you in your own struggle.

     

  • GeorgeG
    GeorgeG Member Posts: 152
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    VG

    VG

    Don't worry about it. I worked with hundereds of Engineers during my career and the better the Engineer the worse the grammar, spelling and speaking skills. Knowledgable is knowledgable.

     

    George 

  • Grinder
    Grinder Member Posts: 487 Member
    edited October 2017 #13
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    Hawaiian vacation

    Someone just called me "f*cktarded" on Facebook.

    Why? Because I quoted verbatim an FBI terrorism expert that disagreed with something he said.

    This forum is like an Hawiian vacation for the brain after dealing with the insults, pejorarives, aspersions and character assassination on Facebook, Twitter, and other social media.

    Probably because everyone here shares a common misfortune that tends to make one sober minded and less concerned about pretenses.

  • Max Former Hodgkins Stage 3
    Max Former Hodgkins Stage 3 Member Posts: 3,813 Member
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    RobLee said:

    Thank you for your reply

    Vasco, thank you for your reply.  You and a few other regulars here make this forum what it is, a valuable source of information. I do frequent several other forums and each has it's own flavor. This one, on CSN requires the most effort and patience to navigate, but is well worth it.

    Brilliance is apparent no matter what language. Diligence in constructing meaningful sentences and paragraphs shows through dispite awkward grammer and perhaps unfamiliar terminology. I too have some difficulty both composing and interpreting these posts as I am mildly dyslexic, even though English is my primary tongue it is sometimes awkward and difficult to comprehend. Plus we all make even the simplest (and sometime humorous) spelling errors... 'typos'.

    Of course, once this particular battle of prostate cancer ends for me, as it hopefully will eventually, I may tire of reading these forums and hopefully move on to another phase of my life. I will remember the people who were a tremendous influence during this period, which if it extends into 2019 will be five years long. And with great hopes that it will never be necessary for me to return to these forums to resolve a future recurrence.

    Thank you once again for all that you do for everyone here, VascodaGama, and may good fortune be with you in your own struggle.

     

    Agree

    VG,

    Like Rob, I must say that your writing is excellent.  You write English better than most American high school students, for what that is worth.

    English is among the hardest of all languages to spell, even for native speakers.  My only other language is German, which is fully phonetic in spelling, easy even for a non-native of German.  One of my German professors noted the fact about how hard spelling English is.

    I have never had the least bit of trouble reading a post from you,

    max

  • Max Former Hodgkins Stage 3
    Max Former Hodgkins Stage 3 Member Posts: 3,813 Member
    edited October 2017 #15
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    Yes, Grinder

    I find Facebook filthy in much of its members and overtly biased in its administration. Most of the Friends suggestions I get appear to be prostitutes from Third World countries; most are nude or semi-nude, and provocative.  What "algorithm" tells Facebook that these people might somehow be my "friend"?  None that I can comprehend.  NONE of my settings, other friends, or preferences would indicate this.

    A friend and I, due to its addictive nature, refer to it as Facecrack. Bored people with nothng else to do.  Social media really provide nothing of worth to the world; a diversin for the easily diverted.

    I noted an axiom years ago, from my years teaching logic: People with no ability at reasoning resort to volume and the outrageous to make points, lacking any other mental devices.  If you can't outreason someone, shout them down.  And make up some farcical gingles; something easy for a mob to remember.

    max

  • hopeful and optimistic
    hopeful and optimistic Member Posts: 2,339 Member
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    vg

    There were many immigrants that I had contact with when I was growing up.....they were mainly survivors from Europe and really experienced the challenges of life. Many of these people, who I respected a lot were a lot smarter than me. At a young age, I learned to value what a person said, not how it was presented. 

    .............................

     Also, I doubt if Luís Vaz de Camões, Eça de Queirós or Fernando Pessoa can write  technical English better than you.

    .................

    PS. Max, the friend suggestions that I get from facebook are young body building males from third world countries. 

     

     

  • Grinder
    Grinder Member Posts: 487 Member
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    Nail on head

    "I noted an axiom years ago, from my years teaching logic: People with no ability at reasoning resort to volume and the outrageous to make points, lacking any other mental devices.  If you can't outreason someone, shout them down.  And make up some farcical gingles; something easy for a mob to remember. "

    Nail on the head, Max.

    I was a Philosophy minor as an undergrad, so I can appreciate your analysis of debate on social media.

    And yes, emotional outrage and righteous indignation are the stock and trade of social media today.

    My own Logic professor would patiently let us wander off the reservation, then gently reel us back into the basic building blocks of reasoning. He's long passed away now but he was a good guy and everyone liked him.

    Like I said, the relaxed atmosphere here, even when we have a disagreement, is an intellectual haven compared to other social media.

  • Grinder
    Grinder Member Posts: 487 Member
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    Ps

    PS I get the body builder ads that have these immensely inflated massive muscles as well, as if I would ever want to look like that and take whatever poison they are selling that will more likely end in cardiac arrest than massive musculature.

    And I also get unknown friend "requests" from mysterious women. Someone is falling for this.

    I heard Glen Beck say that every one of those little clickbait ads represents over $200,000 in annual income. 

  • SPT
    SPT Member Posts: 40
    edited October 2017 #19
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    A leap step taking us closer to the “Silver Bullet”

    I believe in the main argument in this thread regarding the consequences in hormonal treatments/manipulations as an initiator in the so called refractory status. I have commented in my past threads about the danger involving continuous HT administration which may be behind the bandit’s wish in looking for survival at its own means. Oncologist researchers like Myers have studied the problem and by experience in treating his/their patients, they have confirmed that intermittent administration done with an appropriate protocol can extend the period of IADT for several years before refractory sets in. Refractory is a status given to the treatment when the bandit mutates its AR (androgen receptors) or when it starts manufacturing androgens for own survival.

    In one of my threads of 2011, I had a similar discussion on the above with some of the comrades of this forum, in regards to the “behavioral adaptation” of cancer cells in surviving on low levels of testosterone. Cancer behavioral is triggered and reacts to survive by mutation. In this “adaptation process” the beneficial mutations are preserved because they aid survival. This is a process known as "natural selection" from Darwin’s theory. We all got it at all levels including the cancer. It is in our genes.

    In my opinion, researchers of the above study (presented by SPT) reached further and found the genes involved in such survival principles. In any case, I think that linking HT treatment to the cause of “boosting cancer growth and making a tumor more aggressive” is over stating because we know that hormonal manipulations involve many weapons working solo (IADT) or in combination (IADT3) and aiming at several means of hormonal blockades. Another aspect to consider is the same principle in survivorship that can be expected to occur if cell’s DNA stability are threaten by bursts of radiation or chemo induced damage. Cells could be damaged and initiated to a status of cancer. That could be imagined as boosting cancer.

    This finding in genes is now the subject for newer means of treatment of prostate cancer. We have been expecting this to happen and without doubts this will be the way for future interventions. It will be a more tailored way to treat each individual case that deals in fact with the cancer itself. Not as the present approaches that aim in dissecting/burning the whole flesh where the cancer is expected to hide. It makes me think that we are closer to the “Silver Bullet”.

    Some of my inputs on the matter;

    https://csn.cancer.org/comment/1013947#comment-1013947

    https://csn.cancer.org/comment/1300510#comment-1300510

    https://csn.cancer.org/node/241249

    https://csn.cancer.org/node/267154

    Thanks for starting this thread.

     

    Best wishes,

    VGama 

    Thank you

    It really isn't a very surprising result.  We know that ADT invariably fails, with a mean time to failure of about 2 years.  ("Invariably fails" is a direct quote from several medical journal papers on ADT, not my opinion.)

    That strongly suggests that the cancer somehow adapts to the low-T environment.  This paper, as you correctly note, has identified and investigated some of the specific pathways.

    We know that castration-resistant prostate cancer cells grossly overexpress androgen receptors (AR), so much so that 2 clinical trials are investigating killing resistant cancer with supraphysiological doses of testosterone.  Google the BATMAN study.

    I strongly agree with your statement that "Another aspect to consider is the same principle in survivorship that can be expected to occur if cell’s DNA stability are threaten by bursts of radiation or chemo induced damage. Cells could be damaged and initiated to a status of cancer. That could be imagined as boosting cancer."

    My own investigations and background in nuclear physics leads me to believe that the risks of radiation, especially nuclear medicine like the PET/CT scans, are grossly underestimated for cancer patients.  That's being polite, as far as I can tell no one has ever looked carefully.

    Essentially all radition safety studies are done on healthy patients.  PET/CT gives a very large dose, but not enough to kill cancer cells like IMRT, EBRT, or protons.  In an hour or so the patient gets as much radiation as they get in 8 years or more from natural background.  The RATE of radiation (which is well known to matter) is over 20,000 times background.  Since the whole point of PET is to concentrate the radioactive isotope on tumors, their rate is much higher still.

    Yet doctors hand out these scans like candy, to patients at high risk of metastasis.  Just a few cells in the tumor bed who have their already-scrambled DNA hit in the right places could turn an indolent Gleason 6 into something far more dangerous.

    The first rule of radiation safety is that you never accept a dose unless it is medically necessary.  Whole-body MRI has been shown to have better sensitivity, better specificity, and vastly superior spatial resolution than PET.  That's why they add a CT insult to PET radiation injury, to improve the image quality.

    Whole body MRI is better and far safer than PET/CT for investigating suspicion of bone metastases.  The only reason the US still exposes patients to such high radiation risks is money.  The machines that make the isotopes and the PET scanners are already paid for, even though MRI has made them all but obsolete. 

  • Max Former Hodgkins Stage 3
    Max Former Hodgkins Stage 3 Member Posts: 3,813 Member
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    RobLee said:

    Sticking with science for HT duration

    Yesterday I had my final meeting with my RO and now have only four more ART treatments using the RapidArc.  We discussed how long I should remain on Lupron and between the two of us concluded 18 months total.  I asked if 2 years would be preferable and he said no for the reasons stated earlier, in that it could reduce the efficacy of HT in the event of a future recurrence.  He also said we could stop at one year if I was not tolerating it well, and I said I can do another six months okay.  Note this is just Lupron, no Casodex. My only other meds are Venlafaxine and Gabapentin for the hot flashes and mood swings.

    Additionally he informed me that the radiation will continue to kill cancer cells for about nine more months after RT ends, so another nine months of HT (when my next shot will wear off) will nicely cross over with the curve of the RT's effectiveness.  It seems like a good plan.  Also he said that my testosterone should return around nine months after the Lupron wears off. Also we will not know for sure whether or not all this has worked until after three consecutive PSA tests after everything has ended, worn off, and stabilized... so we're looking at 2019 (yes, 2019) before we know for sure.

    As for the sentiments expressed in this thread, I feel that HeWhoSits stated it perfectly.  I for one read just about everything that Vasco writes. It is always good information, even if it does not specifically pertain mto my own situation. And I never bother reading anything posted by the other guy anymore.  I just skip over them.  My day just goes much better and my heartrate stays lower if I do no expose myself to such contentiousness, especially early in the day.  It's just my own means of self preservation. Call it Darwinism.

    Administrators

    Rob, HeWho, and all others,

    I have had two dear friends booted from CSN over the years. Both were stellar men writing at Lymphoma, both were highly liked, both were insufficiently PC to survive.  I am completely unfamiliar with what the controversy with VG pertains to, but he has been absolutely the best writer at PCa ever, at least over the years that I have been reading here.  He has never submitted anything even remotely objectionable that I have seen, but I do not read everything here.

    I have myself been "warned" more than once over trivia that would cause no issue with any rational adult.

    I have no issue with the report that SPT submitted, except that it is wholly outside any form of context.  HT has been providing thousands of suvivorship years to PCa patients for decades, and will continue to do so; in clinical terms, the report will change nothing: not now, maybe never. 

    This site is mostly about clinical and practical advice for men who are not biochemical researchers.  Me, I'll read anything, and am interested in both practical as well as theoretical advances.  Most men probably are not.   Fairly often, a news areticle is shared here about some "revolutionary" new practice.  Usually these relate to diagnosis.  And always, they are not at all "revolutionary."  Frequently they are feeds from public relations organizations.   And that too is ok: it just has no context around it for people who don't know what the context is.

    Men will read here what they want, when they want.  There are a couple of guys whose stuff I just skip, but others may enjoy their commentary.  I wouldnopt want them to depart. Good.  The freer the flow, the better.  Undoubtedly a few never read my posts, not liking the way I wag my chops.  That is good also. As Thoreau (paraprasing) said to potential readers in the beginning of his classic work Walden:  "Don't stretch you jacket reading this, read something else if it is not to your taste."

    If I needed HT, and I'd go get started today, and have no qualms whatsoever.

    Blessings to all (but especially to Vasco),

    max

    .

     

  • redbelly7
    redbelly7 Member Posts: 34
    edited October 2017 #21
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    back to the topic

    Lupron starves the PCa from getting testosterone and Zytiga stops the PCa from eating the testosterone or other forms of growing.  So..., wouldn't it be best to have Lupron and Zytiga before and during radiation?  this is what I am doing.  I had prostatectomy on 05/30/17 and soon will be starting radiation.  Waiting on continence, but ready to put a clamp on it and radiate away.