Cancer went to lungs

Momschooling

We just found out (this week) my husbands's cancer has gone to his lungs. He went off ADT for only 6 months, and this happened. The dr started him back on ADT today (originally he was going to do it earlier, but he said my husband could wait until after vacation and do a CT scan once we returned to see how everything looked) (lupron/zytiga) and said this will be the only treatment until it stops working. I am just wondering if anyone has had a similar situation and went on to live many, many years beyond the avaerage, with adt being enough? I asked the dr for data on life expectancy, once it reaches the lungs, and he said 4 to 5 years on average. 

 

 

 

VascodaGama

Systemic treatment

I am sorry about the news on PCa in the lungs. Can you please tell us how was it diagnosed? Did they find it via a biopsy or from a PET scan?

I do not think that the lack of ADT during six months has to do with the PCa spread to the lungs. The bandit may have been trapped at the lymph nodes in the chest from where it reached the lungs. In systemic cases typically from the lungs it goes to the liver. This is a nasty diagnosis. 

In any case, PCa in the lungs can be dissected  with surgery. I wonder if he has had the PET scan we discussed in your April thread. How many spots have been identified?

ADT and chemotherapy are the recommended therapies for systemic treatment but recently there has been successful results in extending biochemical free survival with Lu-177 PSMA. This is a systemic radiation treatment that has been on clinical trials in USA. If interested you can inquire on his doctor if he manages to include him in one of these trials. 

Here are details for you to read;

https://www.clinicaltrials.gov/ct2/show/NCT03828838

https://csn.cancer.org/node/323698

Please note that there is no time frame for death due to PCa but your husband's situation is quite advanced once the bandit invaded other vital organs. At 59 he is very young and he may resist this fight for many more years. I would recommend you to get a second opinion from another  medical oncologist. 

Best wishes and luck in this journey. 

VG

Momschooling

VascodaGama said:

Systemic treatment

I am sorry about the news on PCa in the lungs. Can you please tell us how was it diagnosed? Did they find it via a biopsy or from a PET scan?

I do not think that the lack of ADT during six months has to do with the PCa spread to the lungs. The bandit may have been trapped at the lymph nodes in the chest from where it reached the lungs. In systemic cases typically from the lungs it goes to the liver. This is a nasty diagnosis. 

In any case, PCa in the lungs can be dissected  with surgery. I wonder if he has had the PET scan we discussed in your April thread. How many spots have been identified?

ADT and chemotherapy are the recommended therapies for systemic treatment but recently there has been successful results in extending biochemical free survival with Lu-177 PSMA. This is a systemic radiation treatment that has been on clinical trials in USA. If interested you can inquire on his doctor if he manages to include him in one of these trials. 

Here are details for you to read;

https://www.clinicaltrials.gov/ct2/show/NCT03828838

https://csn.cancer.org/node/323698

Please note that there is no time frame for death due to PCa but your husband's situation is quite advanced once the bandit invaded other vital organs. At 59 he is very young and he may resist this fight for many more years. I would recommend you to get a second opinion from another  medical oncologist. 

Best wishes and luck in this journey. 

VG

Thank you, this was found via

Thank you, this was found via CT scan and the dr doesn't see any reason to do a PET or PSMA (which I orginally wanted) because he said the treatment is the same. It seems both lungs are covered in these tiny solid nodules all over (the term used was innumberable), and he doesn't believe trying to put my husband though a biopsy or getting a PET scan will help the outcome. He did have lymphnode involvement at diagnoses and one lymphnode was not regional, but higher up his chest. It seems it was already heading that direction but immediate ADT and radiation had supressed that. We asked about chemo, the dr said zytiga replaces that need for that now and he hopes we can get 2 years out of this treatment before having to change meds. I wanted to mention in case anyone is reading, be aware that not all prostate cancer makes much psa. My husband never had much psa (it was usually 2 or less) which is why everything was missed for so many years. The oncologist understands this now and looks for trends in it going up vs how high it is. His psa doubled in just a month when we had the results of CT scan. 

Clevelandguy

Second opinion needed

Hi,

Got to agree with Vasco on this one, a second opinion is needed.  Maybe another hospital network with a different set of doctors. I have included a link on lung nodules from the Mayo Clinic.

 

https://www.mayoclinic.org/diseases-conditions/lung-cancer/expert-answers/lung-nodules/faq-20058445

Dave 3+4

Momschooling

Clevelandguy said:

Second opinion needed

Hi,

Got to agree with Vasco on this one, a second opinion is needed.  Maybe another hospital network with a different set of doctors. I have included a link on lung nodules from the Mayo Clinic.

 

https://www.mayoclinic.org/diseases-conditions/lung-cancer/expert-answers/lung-nodules/faq-20058445

Dave 3+4

Thank you for the information

Thank you for the information

Momschooling

My husband's drs are at the

My husband's drs are at the University of Michigan, so we feel pretty confident in their diagnosis. They work as a group and have a lot of expertise specifically in treating prostate cancer. Apparently the type of nodules (being solid) and the amount, combined with my husband's history of lymphnode involvement, they are confident enough it's cancer and don't see the need to test further and just wanted him back on the meds immediatley. He had scans back in December and those were clear, so this is completely new, and ties in with his psa doubling and being off the meds. If adt doesn't seem to work then we will be looking for new treatment options.

curren

Momschooling said:

Thank you, this was found via

Thank you, this was found via CT scan and the dr doesn't see any reason to do a PET or PSMA (which I orginally wanted) because he said the treatment is the same. It seems both lungs are covered in these tiny solid nodules all over (the term used was innumberable), and he doesn't believe trying to put my husband though a biopsy or getting a PET scan will help the outcome. He did have lymphnode involvement at diagnoses and one lymphnode was not regional, but higher up his chest. It seems it was already heading that direction but immediate ADT and radiation had supressed that. We asked about chemo, the dr said zytiga replaces that need for that now and he hopes we can get 2 years out of this treatment before having to change meds. I wanted to mention in case anyone is reading, be aware that not all prostate cancer makes much psa. My husband never had much psa (it was usually 2 or less) which is why everything was missed for so many years. The oncologist understands this now and looks for trends in it going up vs how high it is. His psa doubled in just a month when we had the results of CT scan. 

Low PSA high cancer

 

We all hope for the best fot You and your Husband, I'm so happy that you mentioned that PSA doesn't always rise while tha cancer growes and spreads. I am like your husband in that my low PSA didn;t rise quickly untill the cancer was well established on bone in my pelvic area. This and a missed read CT scan delayed my cancer diagnosis by two doctors for 7 months. So YES men need to pay attention to trends in going up PSA numbers.  Thank you so much for pointing this out  Aloha and best wishes!