How Does Prostate Cancer Chemotherapy Work? | Prolonged Survival & Improved Cure Rates | PCRI
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- čas přidán 26. 07. 2024
- Chemotherapy is typically thought of as a last resort in patients with advanced disease; however, new studies are showing that chemotherapy has greater benefits when it is used earlier in the course of advanced disease; moreover, chemotherapy can even enhance cure rates in men with newly-diagnosed unfavorable high-risk disease. Here, Alex asks Dr. Scholz about these recent revelations about chemotherapy, the side effects of chemo for prostate cancer (Taxotere and Jevtana), PSA monitoring, and more.
0:09 Why is chemotherapy different in prostate cancer compared to other cancers?
2:05 Which stages of prostate cancer may involve the use of chemotherapy as part of treatment?
3:03 Does PSMA allow patients to start chemotherapy earlier?
4:02 What are the side effects of chemotherapy?
4:58 Which is better: Taxotere and Jevtana?
5:57 How long does chemotherapy last overall?
7:38 What does the PSA decline look like with chemotherapy?
8:39 Can chemotherapy effect a complete remission? A durable remission?
9:08 Can you do chemotherapy again if you have already done it?
9:37 What is the timeline like for intermittent chemotherapy?
10:13 What tips do you have for mitigating the side effects of chemo?
12:18 How long do chemotherapy side effects last after treatment is stopped?
12:50 Summary of the two different indications for chemotherapy in prostate cancer.
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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.
The information on the Prostate Cancer Research Institute's CZcams channel is provided with the understanding that the Institute is not engaged in rendering medical advice or recommendation. The information provided in these videos should not replace consultations with qualified health care professionals to meet your individual medical needs.
#ProstateCancer #MarkScholzMD #PCRI
Thank you both! I have learned a lot extremely Educational! I Have (PSA 7.1 64 yrs old) requested a PSAM-PET SCAN from my Urologist. He wants to do a trans-rectal biopsy when I requested the PMSA-PET he adamantly argued with me. I requested a trans-perineum biopsy He then ordered the Pet scan ( waiting till October ) I am a 20yr Air Force Veteran it has been extremely difficult even getting an appointment through the VA. Thanks 🙏 again for your encouragement though your videos 🙏 I wish you were my Doctor 😊🫡🇺🇸
Three years ago at 75 I was diagnosed Gleason 7, 4+3 unfavourable high volume. The knowledge I receive watching PCRI has from the start helped me manage my treatment. When I was told early on that radical prostatectomy was possible I knew it was not a viable option, when ADT was prescribed I knew what to expect and that it was absolutely necessary. Later I was able to get Ultrasound-gland HDR brachytherapy followed by MRI guided Sterotactic Body Radiation because of what I learned on PCRI. What ever the future holds I hope that Alex and Dr Scholz will be there to help me and all Prostate patients. Thank You
I am just like you. Gleason seven high volume. But I feel like taking the prostitute to me.Because I do not want to take any medications. Let go
Along with Radiology.
My B a d. I don't want to take any medications.Which the radiology way wants me to go. That's why I am thinking about Prosetectomy . Any comments ....Please. So CONFUSED.
@@ricknowak4582 I completely understand your need to control your cancer to find answers, but each cancer is unique, and my experience has only limited value to you. All I can tell you man is to be realistic about your own situation open to what doctor suggest but know that you are the one ultimately making choices; find out as much as you can about your own situation and find your own peace regarding the benefits and risk of the options offered you by doctors. Heaven help me, but I found the whole subject of prostate cancer fascinating and I still do but I know that even dangerous cancer like my own can be controlled and even potentially cured. PCRI is a good source of info online and recently Mark’s Prostate Cancer Experience has returned to CZcams and is another source of useful help, just be open and carefully online. Finally I can only say good luck and all the best.
I'm 74-years-old. I had my prostate and four lymph nodes removed in April of 2019. My PSA was undetectable for about six months. At that time my urologist put my back on lupron. After about 12 months my urologist put me on erleada (along with the lupron or eligard). My PSA became undetectable for about a year or so, then slowly started to rise (I had a PSA test every three months). When My PSA rose back to 0.38 my urologist decided to stay ahead of the game and referred my to an oncologist who then ordered up a PSMA/PET scan that showed widespread prostate cancer in my bones. My oncologist (tested my PSA at 0.55) put me on six cycles of chemo (taxotere). I completed one cycle almost three weeks ago and will start my second cycle tomorrow. It is my understanding that I must have a few cycles of chemo (if chemo doesn't work) in order to be considered for Pluvicto (Lutetium-177). My first round of chemo wasn't bad (no nausea, not much weakness, although I'm losing my hair quickly, beard growth negligible), it was the neulasta shot that caused uncomfortable bone pain for about 5-7 days. I'm still on lupron by my oncologist stepped my erleada (maybe to see if the chemo is effective).
Godspeed, I hope alls well
Taxotere helped?
@@koof1776 Nope. I had four cycles of taxotere and my PSA kept rising to 4.65. I was then switched to jevtana. My PSA, after about 7 cycles dropped to 2.86 and my hair (on head) grew back. I was then put on pluvicto (lutetium-177). I had six cycles (6 weeks apart). However, my PSA only dropped to 0.184 on 4-24-2024. By 6-13-2024 my PSA had risen to 0.274. I read that even though pluvicto is the best prostate cancer (metastatic) treatment there is (each treatment cost my health insurance company $48,000), it doesn't work on about 1/3 of the patients that get it, and about 1/3 of patients get some benefit (I feel I'm in this w/3), and the other 1/3 of patients get excellent results. Right now I'm still on lupron, and also on xtandi.
Hope you are doing better.
@@schmingusss I feel fine at the moment. Just turned 76 today. Hope to see 77.
Thank you for the great info! My doctor covered some of this but definitely not this in depth. As a 49 year old male, I was diagnosed stage 4A about a month ago with metastasis throughout my lymph nodes in my left leg, pelvis, abdomen, chest and neck. I started 2nd generation hormone treatment (Firmagon & Zytiga) almost immediately. Chemo starts tomorrow, been very nervous and anxious as to how my body will react. Your video has been very reassuring. Thank you!
With hormonal therapy my psa became.
.033 with in 5 months. No problem till today. What will be doctors next Step?will they prolong same or chemotherapy?
@k.p.ashokmenon4627 after 3 chemo sessions plus hormone therapy my psa went from 699 to 4.56 so iam moving in the right direction. Per the Doc after chemo I will be just on hormone which they did change from firmagon to lupron plus zytiga due to the excellent response. I have 3 more chemo sessions. Hoping to be back in that low psa range. Side note I had some high ALP numbers in my liver related to bone metastasis and those have also come down in proportion to my psa. Keeping my fingers crossed and following doctors orders.
@@Bezhighow high were yr alp numbers? Thank u. Good luck 👍
@@perfectly22smith38 alp numbers were good.
I am one of those who got dramatic benefit from ADT and chemo. Enrolled in the CHAARTED2 trial, and was selected for the chemo arm. A little lingering neuropathy two years later, but it's not bad.
Thank you. I had no idea that chemotherapy could supplement hormone therapy. : )
Great interviewer. She asked the right questions at the right timing. With no interrupting the interviewee; where as he expounded his views on the subject to all of us at great length. Which I highly appreciated I needed this information. Thank you both. God bless you with glowing health and prosperity if your reading this.
Diagnosed with Stage IVB T3b, N1,
M1b two months ago. Only treatment so far is Eligard. My MO is willing to put me on triplet therapy (Eligard, NUBEQA, docetaxel) after a bone biopsy. Cancer throughout all prostate lobes, seminal vesicles, neuro blood bundle, with mets in pelvic lymph node, acetabulum, sacrum, and lumbar spine.
Could you discuss if/how/when radiation treatments would fit into this disease and treatment profile?
Your channel has been such a rich resource for learning about this disease. Thank you so much for all your videos.
How are you doing?
incredibly useful questions and answers ,tks
For the finger and toe numbness, my chemo team had me dip my fingertips and thumbtips in ice for the duration of treatment. They also rigged up little ice gelpack caps that they slipped over my toes. The reasoning being the same as the ice chips on the tongue (constrict the blood vessels with the cold so that the Taxotere doesn't make it to the fintertips and toes).
Urologists should be heavily promoting low carbs and low-sugar diets as a prostate cancer prevention and even cure.
That's What?l.I am doing exactly. I am refusing so far.The ... Operation or the radiologis🎉. I lowered my PSA by four points!!!!! by juicing and drinking combination of lemon juice and cayenne pepper And bacon soda. Steam tomatoes. E t c. And of course no carbohydrates. Doctor didn't say anything about it. Was 13 now the PSA is 8 !..!!!!! Any comments ..... please. high volume Gleason 7
Thank You!
I’m the study you discussed at 4:00 - early discovery mets on PSMA that didn’t show up on bone/MRI/CT scans and PSA 53. Mets are on peri aortic lymph only. Started with 1st gen hormone and chemo - PSA undetectable by 4th (of 6) round of chemo. After chemo, started second gen hormone therapy and radiation. I’m just 3 days into rad, so ask me in 2 months how it goes.
BTW - side effects of chemo are way more manageable for me than radiation.
Please. Tell me more about your side effects with radiation. I thought radiation was a breeze. In fact I talked to a few people and it was nothing. A few hot flashes that was it. But they weren't taking chemotherapy. Not even or more treatments. So can you please tell me why you said that?The radiation was worse than the chemotherapy. Thank you. I am deciding on radiologist or surgeorgie. So confused. I think about this...... every moment of the day.
This is great information.75 year old man has reoccurring prostrate cancer with using 1st gen hormones treatment and 6 cycles of Taxatere was given. The treatment did not include 2nd generation hormone treatment and after 6 cycles the bone mets have actually increased and now Xtandi has been given. It sounds to me that he may have better results if both the chemo and hormone treatment he may have done better. Would it be reasonable to do another round of chemo along with the Xtandi at this point?
Reading all this makes me think that they have no idea what works or not.With these medications they give out like candy. It makes me disgusted. And it looks like they come up with a new hormone treatment PILL every other month!!FDA approve medications. So thats PROOF that nothing (hardly) works. Just makes you sicker. Why can't they just do radiation?And that's it.!!! MONEY!! THATS WHY. this is making me so depressed and um... CONFUSED ,!
Thanks again for your informative information.
What are those exact studies please? Thank you!
Very informative dr very helpful with my questions.
Thanks to the Dr. and his team for very good information. From his great knowledge and experience. These informations helps the deadly cancer patient to have hope and treat the disease.
I request the Oncology Doctors please kindly upgrade the knowledge and help patients effectively and economically.
Thanks a lot it is of great help to us.
I have PSA 12.18
G.S 4+3=7
Lymp node 7mm slightly increased.
Three lisons in proastate. Please kindly what is the best way to treat.
Brilliant. Clear. Concise. Thanks so much
Thanks for all the info. I am a very healthy and active 72 year old except two yrs ago metastatic PC detected, PSA 28. 4-5 Mets from bone scan. Hormone treatment has PSA undetectable. One year in had radiation to the prostate as an extra measure. Stopped Extandi after one year due to pain and tiredness. Resistance exercise daily for the entire time. Two PSMA Pet scans this year show no active mets. I want a more aggressive approach rather than waiting for the PSA rise. What can you recommend? Insurance and travel are not an issue. Thanks again
It sounds to me that your doing good! Your PSA may not rise,and Doctors may not do any Further treatment, unless there is a rise in the PSA, which would then indicate something going on. Just my thoughts, I am constantly researching this.
9 Chemo sessions remission for 6 months now a spot on a rib getting a targeted radiation that will be number 46 not looking forward to more chemo. No cure yet.
how many months on average does cemo add to life span?
Repeated "scans" are mentioned often. Are these always with / and without contrast. Are there risks to using these Gabapentins repeatedly?
Was diagnosed 17 months ago with metastatic on lymph nodes and psa 83. Had hormone therapy and SBRT and now psa is 0.17 Do you think now is a good time for chemo? Note psa went down to 0.12 and then up to 0.15 and 0.17 in the last three months
Hello, we have a free helpline that might be able to help with your question. You can find our contact information here: pcri.org/helpline.
I'm grateful to have come across you Dr Osoria youtube , I'm now free after I used the medicine you sent me , having cancer almost ruined my life but I'm happy today after I used your treatment
#drosoria you're one of a kind I'm forever grateful. you're really a great man
Please advise: I have enlarged Prostate 71cc volume diagnosed as BPH for almost 10 years, however this time PSA came up to be 4.56. along with UTI, Semen tests etc came normal .....I am almost 59 . My Dr advised MRI and the MRI showed PiRAD 4 with dwi/adc score 3.... but at the same time MRI couldn't determine cancer . Further every other organ shown to be completely normal in MRI with no evidence of Breach of Prostatic Capsule ... No bone damage etc ,,, meaning by that Everything is limited to Prostate .... MRI advise of Repeat PSA or Biopsy .....My Urologist after taking all relevant test ruled out cancer and didnt go for Biopsy etc ....and put me on Antibiotics for UTI... and a repeat of PSA after completion of Antibiotics course ..... I am still on AntiBio ....... I would request for your opinion ...
PIRAD 4 means High risk. Clinically significant cancer is likely to be present.. I hope you went for a biopsy.
I have had metastatic prostate cancer since September 2012 no chemotherapy treatment as yet PSA jumps about between undetectable to 4.2 then back to undetectable
Can you speak about what treatment you have had?
Everything from surgery to remove the prostate ,radiation to lymph nodes ,cyber knife radiation to isolated node, full hormone blockade with Xtandi , PSA past three months has risen a bit -I reckon another isolated lymph node - CT scan shows no mets to organs , although the psma pet scan 18 months ago showed multiple lymph nodes . The Xtandi knocked the mets out to undetectable-I’ve been lucky in a way considering it was a T3 tumour found by chance -no symptoms
@@paulmartin2429 glad your doing well, wishing you continued good health.
Do u have bone mets???
@@paulmartin2429 glad you’re doing well, Paul!
diagnosed 6 months ago with metastatic disease, Xtandi and Eligard working, so is it too late for me to add chemo into the mix to really hit it hard? Or prophylactic radiation of lymph system?
My husband was diagnosed with metastatic disease almost 2 years ago now, he is on Firmagon and Xtandi, and was given the six rounds of chemotherapy from the very beginning. His oncologist thought that hitting it hard was the absolute best thing for him, his PSA has been undetectable. He is doing very well and is completely plant based
@@Mary-bx8gd Thank you for the reply Mary, I’ll bring this up with my doctors: presently my PSA is undetectable so they may say there’s no need for chemo. I’ve also gone plant based (but also include fish), having fun with it, lots of new recipes.
Tell me, did your husband experience significant side effects?
@@lefcoe yes! Very fun learning new recipes! My husband had mild side effects from the six rounds of chemo, he did lose his hair, but he never felt sick and only took off from work the day he had chemo. It sounds like you’re doing quite well! Good for you! Keep on going that way! did you have bone metastases? This is what I love about these videos, we can learn from each other as well as from PCRI ☺️
@@Mary-bx8gd yes I had bone metastasis as well as lymphatic, but termed “low volume.” No one has given me a very optimistic prediction, I’m youngish (61) with Gleason 9. But I’m doing everything I can to get on the long end of the curve, all of the lifestyle choices that may help: workout, walk/run, mindfulness, diet. I’ve taken my retirement and am really enjoying being here, plan to stay as long as possible.
@@lefcoe well it sounds like your doing great! My husband is 64, his is low volume also, more and more studies are showing that all of the things that you are doing show great survival! I think you will be just fine! You will also have the option of chemotherapy if you should need it! I like your attitude! 😊
I am bout four months post op surgery psa was 0.1 after doing the diet thing psa is now 0.0 I am azure what should I do now watch or go on some type of therapy
Hello, we have a free helpline that might be able to help with your question. You can find our contact information here: pcri.org/helpline.
What about for a diabetic, is the danger worse on the aggressive treatment?
Good question confusing
I'm disappointed that you haven't addressed insulin potentiation therapy with high dose vitamin C and ozone therapy. IPT was patented in 1930 has been in use in the US for 42 years.
Insurance doesn't cover IPT therapy. So sad
@@andrewwhite7188 Unfortunately, I know that, the success rate is infinitely higher with ipt. I'll come up with the money. I'll worry about suing the insurance company later, as cost is cheaper than a couple of conventional chemo treatments. A conventional treatment course of chemo runs 5% successful, whereas IPT is running a success rate of over 80% with none of the side effects. People should be aware of this.
@@karlkascha1261what is the ipt therapy .i didnt find it.
I never heard of I p t therapy. I will google it right now. In the meantime can you please give me some more information on it. I have a gleason of seven. And our doctors are scrambling to get my business. I am eating healthier. I don't wanna do anything.
@@karlkascha1261can you tell me more about this pls
Do the prostate cancer cells produce testosterone beyond normal cells ? Would one expect to have elevated serum testosterone from the cancer cells :beyond normal levels?
That's a great question.
I don't understand: A PSA of 0 represents "a cure". A PSA of 0.02 or 0.05 is disease in remission?
My understanding is that a cure could only be considered if the PSA remains negligible and there's no sign of disease for a period of at least 5 years after treatment has stopped. Any PSA value less than 0.1 is considered being negligible, or essentially zero.
Very interesting.
I had no idea that there can be combination therapy with ADT and chemo.
Our first patient had a 14 psa. He did one gram of Rick Simpson oil a day for 60 days. His "walnut" sized prostate disappeared. His psa level was less than point one. 9 years later, he hasn't had a reoccurrence. Do yourself a favor, and do your research. You won't be sorry.
I will Google it in the meantime.Can you please give me some information on rick simpson oil. Thank you so much. I have a gleason of seven and the doctors are scrambling to get my business like vultures!!!
@@ricknowak4582 The oil we make is 62% THC. We are located in Michigan. Trust me, it has been successful in 93% of the cases we have treated. Make the oil yourself if you can. Then you will know it's pure. Or let me know, I will help you. I promise
@@ricknowak4582 it is cannabis oil .
❤✌️🙏🇺🇦
What can you do when you just have a miserable life with hormone treatments. I don't have any time when I am not soaken wet.
I suffered, as you are, from horrendous hot flashes.
I also have every side-effect listed for Zoladex.
My doctor prescribed a 100 mg of Pristiq (venlafaxine). It improved my situation by 90%.
I am now sleeping 8 hours.
It is, in my case, a game changer.
My mood has also improved.
Did you suffer from anxiety attacks as well with the hormone treatments?
@@schmingusss yes. My psychiatrist told me it would have dual benefits. It's working for me.
@@simondumoulin2254 dual benefits? I wouldn't consider anxiety a benefit.
Multiple clones. Multimedia therapy early is the best shot.
Does the pretty woman have an Instagram account????
My god what's the purpose of it if you need to keep taking it..with all the side effects just to live a year or more in missery..wouldn't a death with dignity pill be better
EXACTLY. DOCTORS NEED THE BRIBES FROM BIG PHARMA
THE WHOLE FUCKN TRUTH
CHEMO IS LIVING DEATH
I a really curious which studies show that "if you jump on it aggressively" like you describe, there is a benefit, especially regarding the use of Zytiga and Lupron? I am 60 years old and recently diagnosed Gleason 8 and metastatic, and my oncologist tells me there is only one study in Japan, which combines Lupron with Darolutamide /Nubeqa that shows a small percentage higher cure rate. Meanwhile, with Zytiga, he tells me there is no proof of any benefit when add Taxotere on top of it. Note, my doc also is the main author of the CHAARTED trial that shows exactly that. Since my HMO will not pay for any second gen drugs but the generic Zytiga, it is much a non-option. At $13k+ per month for 2 years, Nubeqa iisn't an option for most of us. So my question is if there are any trials that can be cited for the benefit of Taxotere in combination with Zytiga? In the videos with Dr. Scholz, all the second gen drugs are used interchangeably, but when it comes to doctors authorizing care based on established trials, Zytiga is usually a non-starter when it comes to adding Taxotere on top of the treatment. Insurance will not pay, doctor will not authorize. All in all, I am in a pretty up-to-date treatment program, with PSMA-PET, Brachy HDR and other tools readily available. But when I asked if I could get Taxotere as well, I hit that brick wall with the explanation there there's only a marginal benefit when used with Darolutamide.
That's why I really truly believe that all the added medications combined with radiology means it's all about the... Money. Why wouldn't radiology work by itself. I just don't get it. Your body needs testosterone. It's a healthy thing. So why do they wanna make you sicker?When they take the testosterone away from you.
#drosoria you're one of a kind I'm forever grateful. you're really a great man
I'm grateful to have come across you Dr Osoria youtube , I'm now free after I used the medicine you sent me , having cancer almost ruined my life but I'm happy today after I used your treatment