Oligomicrometastatic cancer

Thanks fellas for the comments.

Old Salt; you are right. I forgot to lay down the test results in my above post (my mind is away). Both, the PSA and Testosterone have risen from 1.75,T=284 (July) to 1.96, T=404 (October). This PSA level is still within the plateau (bouncing between 1.5 and 2.0) it has accommodated since May of 2016. I believe it will still continue a slow increase for several more months. According to the IADT protocol, the trigger threshold for restarting ADT should be 2.0 (maximum 2.5) but I cannot see the point in continuing this vacation period (off drugs) if no other purposes exists apart from this systemic treatment.
The cystoscopy has shown radiation cystitis. The doctor indicated that the bleeding is from inflammation of bladder's walls as a natural process of my body that occurs from time to time in an apparent attempt to repair the tissues. He said nothing about other issues but I believe that the bleeding also occurs at the urethra which leads to blood clogs and urine retention (two occurrences in May). This sort of inflamation is not caught by choline so that the PET scan results were not influenced by such as I previously thought.

Somehow I am upset for the conclusion. I do not think that I can choose a treatment that goes against the NHS guidelines, unless I find a radiologist interested in trying to radiate under the circumstances. Probably Datolli in USA would do but I cannot afford it. In any case, I have still a scheduled consultation with a radiologist done for a second opinion on rads over rads. I also would like to get an opinion that could explain the reason for the recurrence of cancer at the same irradiated area of 2006. I know that some cells resist radiation, modifying its DNA and surviving. If such is the case then what assurances one would have that added radiation to these newer cells would do the job well this time.(https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4429645/).
At least I will learn something in case I need radiation for pain control in the future.

This month I also had several cardio tests to check for issues related to high blood pressure (146/97) an event under medication (CoDiovan). The heart is in shape biting well but BP has gone crazy when in stress testing (cholesterol is good at 146 mg/dL). I have to slow down in emergencies or risk a heart attack. This is not the best status for a young 69 years old that will be under the effects of ADT for life.

Thanks for the interest.

Best wishes,

VGama

I want to thanks for the opinions and links provided by everyone above. I have read all and added a fewer more researches into the data presented in the articles.
The subject of the studies is not new to me and for sure I fall into one of the groups presented in the articles (and so are the many reading this thread in similar situation).

In any case, I would like to point out that the concept involving the terminology of “oligometastases” or “oligometastatic treatment” has changed nowadays from its initial meaning (2010) where one would refer the condition to metastases found post salvage therapy. The meaning used today by the many refers to the fewer number of mets identified via the sophisticated PET scans, independently of the time when the detections has taken place. It could be before a prime therapy (surgery or radiation) or at the timing of the first recurrence for a salvage therapy or after that.
In such regard, those studies do not fully serve cases of rads over rads or rads before one succumbs to systemic treatments.

My present situation is not unique to me. Many guys are confronting recurrences after salvage treatment and would like to know how far they can go with a sort of oligo treatment, in particular if such involves spots at the same areas previously radiated. Medical associations do not recommend rads over rads but independent radiologists see no trouble in rads over rads if the time lag is sufficiently long to guaranty recovery of tissues. For instance, my radiologist commented to be 5 years (similarly to DougS’s above comment on Dr. Rossi). This is the main theme of my researches but as of today I have no concrete answers. DougS’s story with proton over IMRT helps in understanding the benefit of controlled rads over rads.I wonder about the results if instead of the proton one uses the common IMRT again. Will RT free us from the cancer or is it just a palliative result providing few extra months of additional survival?

Fortunately to me that the metastases are localized and the cancer has been slow growing, giving me time to wait for newer therapies (a mixture of nuclear pharmaceuticals) and modalities (combination therapies). Cancer was never diagnosed in bone and the last PET exam revealed existing abnormalities only at the prostate bed and at one close lymph node (disease confined to the pelvis).My worries go to the infested lymph node which is usually the first stop of the cancer before it travels and spreads to distant places. Palliative approaches with ADT may not be enough to hold the bandit for long time and I wonder if radiation would do any good too.
Quality of life is in my mind but the side effects from a palliative ADT would also create scars. This is a difficult time in my journey. I can follow the experiences of Jerry’s (Old-timer) with HT monotherapy or follow an aggressive approach with added radiation. I am not ready to throw the towel yet.

Thanks G53, Georges, Lighterwood67 and Doug.

Best

VG

xNTP,

I do not understand your post. I wonder what makes you hesitant of talking about. Is it on your experience with supplements or techniques in combinations of chemo therapies? I believe that many here would like to read about the benefits of certain supplements in PCa affairs. Unfortunately, some guys have in past named holistic therapies but none has so far provided results.

I recall some of your past threads where you demonstrated to have reservations in getting a diagnosis via a biopsy. I wonder if you have become a member of this club. Can you tell us more details about your case and any treatment you have chosen and about its outcome?
Please let us know of your experiences and researches.

Survivors in this forum are not against suggestions related to nutrition, diets or supplements. We are against those who post in the forum with sales intent.

Best

VG

xNTP,

Thanks for the explanation. I understand your concern in regards to the discussions on supplements or medication not labeled or supplied via dubious sources. Anything that has not a feasible probe of its claimed benefits is subjected to questioning by the many. Some do it by curiosity and some by suspicious. It is logical that in a cancer forum such a subject is highly delicate. There are unscrupulouspeople out there trying to take advantage from cancer patients. In such regard, the conversation can become sour and everybody must accept to agree to disagree.

In any case, for the many reading this post and not participating, I want to say that nobody would impede someone from coming forward and telling us about his experiences. These experiences are rarely read in this forum maybe because the speaker does not like or doesn’t want to be subjected to coerced comments if the results were not the best. However such is not the motto of our comrades. We want to help the many talking about our experiences or findings done on researches along our survivorship. We discuss any matter is it shameful or inconvenient or holistic. Our amateur opinions are not to be followed but to be studied further by the listeners.

xNTP, your story is very interesting. What surprises me is that you have used supplements for a cancer that you do not know if it even exists. It seems to me that what you tried may have had some sort of influence in the source producing the PSA as it got down. It could have done some good to prostatitis or knock down the androgens (dihydrotestosterone) causing the increase in the volume of the prostate (from 45 to 72) in two years which easily can represent the increase of the PSA from 8 to 12.7 and then 9.7. The control is not complete and you do not know yet if the issue is cancer or simple BPH.

You are asymptomatic, got a negative DRE and lower PI-rads. The high PSA is the only feasible data that makes you suspicious of cancer. I think you doing well in waiting for that “sophisticated” fusion biopsy you comment about. However, you need to be vigilant and get a biopsy if the PSA increases at the same volumetric of the gland. I wonder about any urination issue you may have experienced in the past.

Those interested in your story they can follow it in this link;

https://csn.cancer.org/node/317761

In regards to your interest in discussions on add-ons to chemo, I think that you may find interesting discussions at chemo specific forums. Here is the link to Macmillan cancer support group;

https://community.macmillan.org.uk/cancer_experiences/chemotherapy/discussions

I am curious about what you know regarding the use of Fluorouracil in PCa affairs. It is used in breast cancer which shares the same genes of prostate cancer but I never read anything about its use in PCa. At Macmillan site you can find details of several chemo substances, including this Fluorouracil. The influence of nutraceuticals in cancer has been studied. The environment has been linked to initiation of cancer but so is the chemo or some carcinogenic minerals we ingest in diets. Some affect the other for good or for the worse Balancing seems to be the best approach so that supplements tend to be low in grade or less beneficial as you found out (1%). Japanese diets tend to be well balanced leading to a neutral conclusion after a meal.

I do not know of any trustful CAM on chemotherapy. Famous oncologists (like my hero Myers) use to group at the annual PCRI symposium (https://pcri.org/#welcome) where several opinions on the effects of drugs (new and old), treatments and diets were presented and discussed. Most of the participant speakers were specialized medical oncologists in PCa affairs.

I recall your input in my past thread on renal insufficiency that led me into one of those CAM sites. The Life Extension site was very helpful for my understanding on the kidney problem. It is educational. You may find something on chemo add-ons there too.

 https://www.lifeextension.com/magazine/2010/5/innovative-strategies-to-combat-kidney-disease/page-01

Please let us know the details. Can you list the nutraceuticals of your experience? What did you find out?

Best wishes.

VGama

Georges,

I think that all we cancer patients at some time in our journeys have looked into supplements or holistic ideas to fight the disease. We change diets and commit to healthy life styles thinking that by doing so we may revert the situation. However, our building blocks do not change that simple and the cancer got its ways inscribed for surviving any destruction if such is permitted. Not all are affected by the chemo mixtures and those supplements beneficial in the survival of cells are also contributing for the survival of the cancer.

In 2001, when I recurred from RP, I become a believer in Selenium and Vitamin E (stop taking it in 2005 before RT). I also drunk lycopene every day took grapefruit and omega tablets. Even today I try to include in my diet products found to be helpful in the fight against cancer or otherwise good in body functions, but I never gave up with the things commented to be hazards, such as dairy or meat. I started giving more importance in balancing what I ingest. Instead of drugs I try substitutes mainly from life style chsnges.

XNTP above is looking into further deep ways to prevent or treat the cancer. He seems not to believe in those traditional supplements, giving preferences to combination therapies involving nutraceuticals (dietary compounds). I wonder if in his researches he has included the lycopene, punicalagins or resveratrol. Several nutraceuticals have had its ways into medicine from ancient times and can be found into herbalists (Asian medicine shops) or the Japanese and Chinese Kampoyaku. Here are listed some of those nutraceuticals and the purposes of its use;

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4336979/

Some more details in here;

https://www.ncbi.nlm.nih.gov/pubmed/16866016

Best,

VG