ADT Side Effects & Different ADT Drugs

Oldernow

https://csn.cancer.org/discussion/comment/1718091#Comment_1718091

I was told that as long as my PSA stays non-detectable that testosterone replacement would have no effect. It sounds counterintuitive but that's what the docs have told me.

Old Salt

Testosterone Replacement Therapy (TRT) has to be used very carefully, if at all. A full discussion is outside the focus of this thread.

Josephg

My Oncologist told me that I would have to be in remission for 5 full years, before a discussion of Testosterone replacement therapy could take place, as the risk of awakening any injured, but not yet dead cancer cells, associated with this therapy is too high. I've been under the stewardship of this Medical Oncologist specializing in PCa for almost 13 years, and I trust my life to their opinion.

alampy

All' the best.I think I wll also follow your path

eonore

https://csn.cancer.org/discussion/comment/1718127#Comment_1718127

My oncologist takes the same position. I reached the five year point last June, and still have found it hard to pull the trigger.

mamakath

Is there a correlation between length of cancer cell suppression with ADT and length of libido suppression?

Old Salt

https://csn.cancer.org/discussion/comment/1718557#Comment_1718557

Yes, basically the longer one is on ADT, the greater the CHANCE of not getting back to normal (libido etc). Age plays a major role in this as well.

Josephg

Absolutely true in some cases, but every case is different. For me, I had 2 years of ADT (Lupron, Zytiga, Prednisone) on my second round of ADT (first round was 11 years ago with Lupron, Casodex for 6 months), and today, almost 2 years after the second round of ADT treatments stopped, my Testosterone level has only risen to 27, and it is unlikely to rise much further. Hence, a permanent loss of libido. For reference, I am almost 72 in age.

SuperDave

Has anyone on this or any other cancer.org thread discussed using simple OTC senolytics (eg. fisetin) to limit the ongoing damage caused by radiation and/or chemo?

“Cancer treatment–induced early aging accounts for significant morbidity, mortality, and health expenditures among cancer survivors. One major mechanism driving this accelerated aging is cellular senescence; cancer treatments induce cellular senescence in tumor cells and in normal, nontumor tissue, thereby helping mediate the onset of several chronic diseases.”

https://pubmed.ncbi.nlm.nih.gov/35775492/

Background: When the cell's DNA is sufficiently damaged by radiation or chemotherapy agents, many of the surviving cells enter a "senescent" phase, where they stop dividing and shut down most normal cellular functions. These cells unfortunately hang around and continue to secrete harmful signaling molecules that generate damaging inflammatory responses. Senolytics are compounds that selectively kill these senescent cells by pushing them over the apoptotic edge.

The benefits in preclinical studies are very impressive, and the safety profiles appear to be fine. I think it really is worth pushing the clinicians you work with into at least reading up on senolytics. My guys were not even aware of this treatment option. After explaining it to them, they were still extremely hesitant to recommend anything not FDA approved, and in the current tort environment I get that.

That doesn't mean its not a good idea. I've done it. I think it worked.

VascodaGama

Hi,

I haven't seen any discussion on 'senescent cells' in my 14 years of participation in this prostate cancer forum.

I know that many of the late side effects caused by RT (years after) involve those senescent cells to which oncologists refer as progressive RT effects.

My oncologist suggested that my late incontinence issues (24 years dry after RP, 18 years after RT) could be due to progressive radiation effects at the sphincter ((bladder's or urethra).

Of course, the probability of initiation of senescent cells in radiation therapies depends on the life-cycle of cells (timing of administration) and influence of concomitant treatment, such as ADT.

It is known that, in the case of prostatic cells, the combi RT+ADT improves the RT outcome to about 35% better that if administered as monotherapy (my case in 2006). I wonder what could be done for other tissues or none prostatic cells.

Best of luck

VG

SuperDave

Happy Thanksgiving VG,

I was diagnosed in February this year with a pretty mean GS=8 high-risk cancer. HDR Brachytherapy + 5 wk EBRT + 2yr Lupron.

I should say up front that Im a 63 yr old PhD biochemist with experience in academic, pharma, and biotech settings and I was looking into senolytics previous to my diagnosis. My brother, who has been battling cancer for more than 30 years and has had tons of radiation and chemo and I was simply amazed at the body of pre-clinical evidence out there supporting senolytics to limit this damaging SASP. Plenty of safety data too.

So I wrote up the attachment below for my medical teams. Basically just a mini-review of the field. The links are excellent, but must be copy-and-pasted (sorry). If you like cool videos of macromolecules, the YouTube link is excellent. Instructive too.

As I mentioned, I actually did this with the OTC senolytic fisetin 30d after the end of my EBRT in August. Just 2x bolus doses and done, as described in ongoing clinical trials at Mayo and St Judes. I've written about that experience too. I really think it worked for me. Trying to spread the word.

Cheers, Dave

fisetin.pdf

VascodaGama

Hi SuperDave,

Thanks for the attachment.

Since my RP failure of 2000 that I become curious and have been searching for reasonable answers on the matters that protect and lead to the survival of the cancer. In other words, what is causing the failure in treatments for prostate cancer.

Surely enough, our "body" is prepared to live and not to die. We need to find ways and understand those "switches" that could "turn-off" those cells we do not need anymore.

I am going to entertain myself exploring your links and contents. Let's talk more about the matter later.

Best wishes for a successful treatment.

Happy Thanksgiving to you and yours.

VGama

VascodaGama

SuperDave,

You as a biochemist may be interested in the article of below link from scientists researching the theme on cells and the aging process. They work at a Champalimaud research laboratory, an institution of relevance in Lisbon.

Enjoy 😉

https://www.fchampalimaud.org/news/rolling-back-years-cell-competition-ageing

Old Salt

Thanks SuperDave. The area that you touched upon hardly ever gets mentioned on patient prostate cancer forums. I will challenge my brain (what's left of it) and try 'to come up to speed'.

SuperDave

Hi VGama, Old Salt, and others …

(1) I am very new to this cancer and this board, and it is quite different than the medical boards I've visited previously with my wifey (ALS). Those boards seemed much more focused on recent advancements, including preclinical (animal) and phase I,II clinical studies. Lots of hyper links to current research. Does anyone know of a thread like that - either here or on another forum? Ive looked at Milken's PCRI and didn't see much.

(2) As for the use of senolytics following radiation or chemo, I feel very strongly about the potential therapeutic benefits of timely and aggressive treatment using these agents. Im attaching both Parts 1&2 detailing my personal experience with fisetin. Part 1, "An argument for fisetin…" has been posted previously. Part 2 is titled "My fisetin experience…". As an update, my gouty arthritic pain relief continues to this day.

Unfortunately the responses from the clinicians I dealt with during this self-guided therapy have ranged from totally unaware of senolytics (most) to simple indifference to preclinical ideas. Im not sure how seriously they take people who aren't MDs. Its been frustrating, but I havent given up. Im at a really good place and Im confident somebody will figure it out. I really think Im right about this.

Whats driving me nuts is that its so damn easy to test (also attached). So far Ive been unsuccessful finding somebody willing to take the risk, but the way I see it, that whole "do no harm" thing goes out the window when the X-rays start flying.

Merry, Merry … Dave

fisetin1&2.pdf

mini-trial.pdf

SuperDave

Hi VGama, Old Salt, and others …

(1) I am very new to this cancer and this board, and it is quite different than the medical boards I've visited previously with my wifey (ALS). Those boards seemed much more focused on recent advancements, including preclinical (animal) and phase I,II clinical studies. Lots of hyper links to current research. Does anyone know of a thread like that - either here or on another forum? Ive looked at Milken's PCRI and didn't see much.

(2) As for the use of senolytics following radiation or chemo, I feel very strongly about the potential therapeutic benefits of timely and aggressive treatment using these agents. Im attaching both Parts 1&2 detailing my personal experience with fisetin. Part 1, "An argument for fisetin…" has been posted previously. Part 2 is titled "My fisetin experience…". As an update, my gouty arthritic pain relief continues to this day.

Unfortunately the responses from the clinicians I dealt with during this self-guided therapy have ranged from totally unaware of senolytics (most) to simple indifference to preclinical ideas. Im not sure how seriously they take people who aren't MDs. Its been frustrating, but I havent given up. Im at a really good place and Im confident somebody will figure it out. I really think Im right about this.

Whats driving me nuts is that its so damn easy to test (also attached). So far Ive been unsuccessful finding somebody willing to take the risk, but the way I see it, that whole "do no harm" thing went out the window when the X-rays start flying.

Merry, Merry … Dave

fisetin1&2.pdf

mini-trial.pdf

Marlon

IMO, this is more of a forum for patients providing group support to each other, so mostly non-medical professionals visit. The research information is interesting, but I think most visitors here are in the situation of making imminent decisions on treatment or dealing with post-treatment recovery.

paulguenette

https://csn.cancer.org/discussion/comment/1719178#Comment_1719178

re: radiation treatment after effects. Yes, a few years later I had incontinence, then bleeding. After too many urethra rooto-rooter experiences by Uro, I experienced complete blockage and a hospital ER and surgery. Eventually landed at JohnsHopkins and had Urostomy (summer 2023). 3 surgeons, 6 hours, then 7 dys in hospital recovery. Surgeons removed bladder (“handfuls of mush”) and shaved pelvis bone a tad. 18 months later I’m still a happy patient. I now pee through a stoma on my tummy!