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  1. I noticed a few minutes ago that the JimJimJimJim YouTube Channel has clicked up 50,000 views. That's a lot of help and comfort that men and their partners have found in understanding advanced prostate cancer - their disease, their treatments, and the journey of others. The top topic - Gleason score in advanced prostate cancer Click the picture to view the video. Closed captions Cc for the hard of hearing. The top story - David's story - 7 years with metastatic prostate cancer Click the picture to view the video. Closed captions Cc for the hard of hearing. The top doctor - watch time - Dr Mark Moyad Click the picture to view the video. Closed captions Cc for the hard of hearing. The top doctor - views - Dr Alicia Morgans - Bones and advanced prostate cancer Click the picture to view the video. Closed captions Cc for the hard of hearing. Click the picture to view the video. Closed captions Cc for the hard of hearing. Click the picture to view the video. Closed captions Cc for the hard of hearing. Click the picture to view the video. Closed captions Cc for the hard of hearing. Click the picture to view the video. Closed captions Cc for the hard of hearing. Please continue to Like, Share and Subscribe to our YouTube Channel. It helps others find the videos they need. Jim
  2. A new video every day for five days. Prostate cancer that moves away from the prostate (metastasises) prefers to settle in bones. This second video (in a series of five) tackles the most serious issue of metastases in the spine. In videos in this series , expert medical oncologist Dr Alicia Morgans deals with: metastases to bone and bone scans; prostate cancer in the spine; treatments for prostate cancer metastases; issues with hormone therapy treatment; and in a last very short video, Dr Morgans wishes to give men a special message about pain. Subscribers to our YouTube channel are notified earlier than others. My special thanks to: Dr Alicia Morgans who kindly donated her time. Member John Dowling, who got me and my gear to Melbourne, and was a very efficient Production Assistant. Member Len Weis, who provided English Closed Captions (Cc) for the hard of hearing. Anthony Lowe, CEO of the Prostate Cancer Foundation of Australia (PCFA), who both invited us to interview Dr Morgans, and arranged a PCFA Education Grant to cover our expenses.
  3. No-one told me about metastatic spinal cord compression. I want to warn men with advanced prostate cancer about the risk of metastatic spinal cord compression so that you don't end up like me. What is metastatic spinal cord compression? This happens when cancer cells grow in or near to your spine and press on your spinal cord. It's not common, but it is important that you’re aware of the risk, what symptoms to look out for and how to get help. What is my risk of developing metastatic spinal cord compression? You need to be aware of it if you have prostate cancer that has spread to your bones or has a high chance of spreading to your bones. Your risk of metastatic spinal cord compression is highest if your prostate cancer has already spread to your spine. What are the symptoms of metastatic spinal cord compression? Prostate Cancer UK has published an excellent fact sheet on metastatic spinal cord compression. The symptoms of metastatic spinal cord compression are listed in this fact sheet. Click here to read the Prostate Cancer UK fact sheet on metastatic spinal cord compression. [If that link has stopped working, go to prostatecanceruk.org and use the Search box to search for: spinal cord ] What should I do if I get symptoms of metastatic spinal cord compression? If you get any of the symptoms listed in the fact sheet, you should get medical advice straight away. Don’t wait to see if your symptoms get better and don’t worry if it’s an inconvenient time, such as the evening or weekend. The sooner you have treatment, the lower the risk of long-term problems. Take the Prostate Cancer UK fact sheet with you to the doctor or hospital as many doctors are not aware of metastatic spinal cord compression. My story I had metastatic prostate cancer which had spread to my spine. I was living at home. I was able to walk and drive a car. On 16 December 2017 I contacted my medical oncologist with symptoms of metastatic spinal cord compression. He admitted me to hospital immediately. It was too late in the day to get an MRI done at that hospital so I was transferred to another hospital for an emergency MRI during the evening. I saw the neurosurgeon at 9am the next morning and he operated on me at 1pm that afternoon. Despite the operation, my knee and ankle muscles have been damaged. As a result I have limited mobility. I only stand for short periods and can only walk short distances with a walking frame. I need assistance in getting dressed. I need someone to wipe my backside when I have a shit. I use an electric wheelchair and get transported in Maxi Taxis (disability taxis). To get the nursing care that I need, I am now living in a nursing home where most of the other residents are elderly and demented. What a change in my quality of life in a very short period!! In hindsight, had I been aware of the symptoms and risk of metastatic spinal cord compression, I would have sought medical advice much earlier and received early treatment which most likely would have avoided the problems that I am now suffering. The purpose of my post is not seeking sympathy or complaining. It is what it is. The purpose of my post is to make other men with metastatic prostate cancer aware of the risk.
  4. Jim Marshall (not a doctor) said ... Metastases (mets) are cancers growing away from the original cancer. In prostate cancer, metastases are often found growing in bone. This can become very painful. A common treatment for a painful met is a strong dose of radiation (X-rays) focussed on the met. A special problem arises at the end of life. No one wants to give a treatment that won't work in time. So Rachel McDonald and her colleagues looked at how quickly radiation to one or two mets gave pain relief and a better quality of life. The answer: Men who responded (around 40%) reported significant pain relief at day 10, and a greater quality of life at day 42 in a number of ways. The authors conclusion: ... end Jim The link below is to a page or document that we do not control. Parts of it may be wrong or misleading. Check with your doctor if something interests you. You may need to subscribe to the site to view the article. If it is temporarily or permanently unavailable, you may receive an error message. http://jamanetwork.com/journals/jamaoncology/article-abstract/2601221
  5. Update Lutetium177 Trial. Peter Mac - Treatment for advanced metastatic prostate cancer. At the start of the trial in February 2016 my PSA level was 86.5, a week ago my PSA level had dropped to 26.3 Prior to the trial - scans showed I had a lot of bony metastases. Comparison of the gamma scans taken after each of the three prior Lutetium177 infusions showed the bony metastases and tumors are progressively shrinking. An accurate determination of just how effective the treatment has been will be carried out in approximately 10 weeks time using a variety of sophisticated Pet Scans. I will post the results. During the course of the trial I found that my eyes, not unexpectedly became quite dry but eye drops have solved this problem. Unlike many others on the trial, I developed quite a sore throat. It has recently been established that this is an oral Thrush infection. I developed a similar problem when on Enzalutamide. It is not an uncommon problem when being treated with Cancer drugs,(as the immune system is compromised) but this can be treated with an over-the-counter pharmacy line. Not unlike most other treatments for Prostate Cancer there are some side-effects caused by the treatment but nothing of a major nature. I am in touch with some others on the trial and from what they have said,my experience (with the exception of the continuous sore throat ) seems to be reasonably representative.
  6. "Traditionally, a newly diagnosed man with distant metastasis is not offered the opportunity to have the prostate gland removed since the cancer is ultimately terminal and the treatment itself will cause significant side effects. However, there has been an accumulation of data that shows that the removing the gland and the primary tumor(s) does slow down cancer progression and more importantly extend survival." Joel Nowak of Malecare reports on recent studies. Click here to read the article.
  7. Some men who are diagnosed with prostate cancer have metastases at the time of their diagnosis. Until recently the primary treatment for these men was Androgen Deprivation Therapy (ADT). Since the CHAARTED and STAMPEDE trials, ADT + Chemotherapy (Docetaxel) has become the standard of care for these men. What about ADT + Chemotherapy + Radiotherapy for these men? Maybe. Removal of the primary cancer has been used effectively in other cancers, either using radiation or surgery to increase cancer-specific survival time. "Whether radiotherapy or surgery is of any benefit after early chemotherapy is still very much an open question" for prostate cancer. Mike Scott and Allen Edel of the New Prostate Cancer Infolink suggest that it's something that a patient who is diagnosed at the outset with metatastes should discuss with their radiation oncologist. Click on this link to read the article.
  8. Xofigo (radium 223) has changed the treatment of prostate cancer metastatic to bone. Xofigo is chemically similar to calcium, so tissues that uptake calcium uptake radium as well. That means principally bone, especially in highly metabolically active sites like bone metastases. Lutetium-177 (Lu-177) is a radioactive substance which scientists have attached to an antibody found on the surface of at least 95 percent of prostate cancer cells and called prostate surface membrane antigen (PSMA). Unlike Xofigo, which only attaches to bone metastases, Lu-177-anti-PSMA attaches to any metastasis — bone, lymph node or visceral. It can potentially treat systemic micrometastases as well. Click on the link to read an interesting article in the New Prostate Cancer Infolink.
  9. "Perhaps the answer to curing cancer is not finding new drugs but finding better ways of delivering the existing drugs that we already have." - Dr Mauro Ferrari, President, Houston Methodist Research Institute Researchers at Houston Methodist Research Institute have invented a method that makes nanoparticles inside the cancer cell and releases the drug particles at the site of the nucleus of the cancer cell. At this stage there have only been trials in mice. They're just about to start clinical trials in humans. Whilst the research involved breast cancer which had metastasised to the lungs, the researchers hope that the drug could cure lung metastases from other origins (eg prostate cancer). Click on this link to read about this research. Nanoparticles are particles between 1 and 100 nanometers in size. One million nanometers equal one millimetre!
  10. Exercise is good. But what exercises are suitable? The table contained in this post may help you when discussing exercise with your doctor. In recent clinical trials by Edith Cowan University exercise therapy has been shown to be beneficial for men with advanced prostate cancer and bone metastases. In particular, aerobic and resistance exercise is safe and effective for men with bone metastases when supervised and individually tailored to avoid direct loading of bones with secondary tumours. It is essential that you consult with an accredited exercise physiologist who specialises in cancer management so that a special program can be developed for your unique condition and personal circumstances. The researchers at Edith Cowan University have prepared a table to show the way in which exercises need to be modified depending on the location and severity of bone lesions. This table may be useful when discussing exercise with your doctor. To view the table, click on this link. To help you understand the table, as an example, if you have a lesion in your Pelvis (which is very common in men with advanced prostate cancer which has metastasised); you are able to perform any resistance exercises involving the upper-body and trunk, with modified resistance exercises involving the lower-body to only allow knee movements while avoiding hip movements. Similarly, you would not perform weight-bearing aerobic exercise, but could perform any non-weight-bearing aerobic exercise and any flexibility exercises. To read the table, you find the location of the lesion (in this case Pelvis), and trace along the row to determine what is permissible and what is to be avoided. Before beginning an exercise program, you should discuss it first with your doctor and your accredited exercise physiologist to determine whether it is suitable for you based on the location and severity of your bone lesions. Your exercise program may need to be modified if there are changes in your condition. You should review your exercises on an ongoing basis with your doctor and your accredited exercise physiologist. This Community does not give medical advice. You should not rely on anything in this post without first getting advice from your doctor.
  11. Paul Edwards

    How Prostate Cancers spread

    With prostate cancer, traditionally it was thought that metastases formed as a result of cancer cells spreading from the primary tumour. Two separate studies looking at how prostate cancers spread have just been published. Both studies found evidence that cancer cells from metastases can migrate to other body parts and form new sites of spread on their own. A science writer with the Cancer Research UK organisation has written an interesting article “Migration, settlement, and more migration: how prostate cancers spread” which looks at both these research studies. You can read that article by clicking on this link. The full text of one study “Tracking the origins and drivers of subclonal metastatic expansion in prostate cancer” can be found by clicking on this link. This study looked at the direction and timing of metastatic spread. They found that the cancer cells in some metastases had spread from earlier metastases, rather than from the primary tumour. They found one case where a local recurrence in the prostate bed was seeded by a distant bony metastasis, rather than the other way around. The researchers also observed that over time multiple waves of metastasis occurred from the primary tumour and suggested that surgical removal of the primary tumour might be warranted even from men with advanced cancer. By ultra-deep sequencing of blood samples, the researchers detected the presence in the blood of both metastatic and primary tumour clones, even years after removal of the prostate. By clicking on this link, you can read a news report in Science Daily on the second study “The evolutionary history of lethal metastatic prostate cancer” .
  12. Thanks to Chuck Maack for drawing our attention to the report of a recent presentation by Dr Oliver A Sartor who was the principal North American investigator for the clinical trial that led to the approval by the United States Food and Drug Administration (FDA) for radium 223 (brand name Xofigo). In 2013 the FDA approved radium 223 for treatment for patients with castration-resistant prostate cancer, symptomatic bone metastases, and no known visceral metastatic disease. Dr Sartor said that determining whether or not a patient had symptoms of bone metastases could often be a grey area. He considered the extent of bone metastases was more important than the presence of pain in determining whether to treat a patient with radium 223. Dr Sartor was treating patients with metastatic castration-resistant prostate cancer who had a significant burden of bone-metastatic disease, even though they might not be considered symptomatic. After nearly a year of clinical use, Dr Sartor said that the optimal setting for radium 223 appeared to be in combination with new hormonal therapies such as Abiraterone (Xytiga) and Enzalutamide (Xtandi). At present a large multi-country Stage III clinical trial is about to start recruiting in Australia: Radium-223 Dichloride and Abiraterone Acetate Compared to Placebo and Abiraterone Acetate for Men With Cancer of the Prostate When Medical or Surgical Castration Does Not Work and When the Cancer Has Spread to the Bone, Has Not Been Treated With Chemotherapy and is Causing no or Only Mild Symptoms Dr Sartor said large clinical trials would be needed before radium 223 could be considered for use on patients who did not have metastatic disease or were not castration-resistant.
  13. Paul Edwards

    Statins may stop bone metastases

    For a number of years Dr Mike Brown and other researchers at Manchester University have been investigating how Aarachidonic Acid (from animal fat in meat and fish) stimulates bone metastases in prostate cancer patients. In a new study which has just been published in the British Journal of Cancer Dr Brown and his colleagues found that, when prostate cancer cells were exposed to Aarachidonic Acid, the cancer cells changed shape, becoming rounder and also sprouting projections that helped them to squeeze through the gaps in the surrounding tissues and become established in the bone marrow. The researchers also found they were able to stop the cancer cells developing these characteristics by treating them with statins, which disrupted their ability to manufacture cholesterol. More information about this study "Aarachidronic Acid Induction of Rho Mediated Transdothelial Migration in Prostate Cancer" can be in found in this press report Does this trial mean that we should all add statins to our prostate cancer medications? No - more research is probably necessary before doing this. Dr. Iain Frame, Director of Research at Prostate Cancer UK, commented: “It’s too early to tell conclusive results about the links between cholesterol and advanced prostate cancer from this study ....... We will watch the next stages of the research with great interest.” Remember all drugs have side effects and may interact with other medications. Always proceed with care, caution and consult with your doctors.
  14. A retrospective study (The Prognostic Importance of Metastatic Site in Men with Metastatic Castration-resistant Prostate Cancer) has been published in the journal European Urology. The study examined data collected in the TAX 327 phase 3 trial to investigate the impact of the site of metastasis on overall survival (OS). The study found that the pattern of spread confers a differential prognostic impact in men with metastatic castration-resistant prostate cancer: Men with liver metastases with or without other metastases had the shortest median OS in the study; men with lung metastases with or without other metastases had 2nd shortest median OS in the study; men with bone-plus-node disease came next in terms of median OS then, men with bone-only metastases; and men with lymph node-only disease had the best median OS in the study. The authors indicated that their findings needed to be validated against further data.
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