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  1. An interesting account by Professor Michael Hofman at the Advanced Prostate Cancer Consensus Conference in Basel, Switzerland recently. He speaks of the Lutetium-177 (Lu-177) treatment his team and others have done or are planning: https://www.urotoday.com/video-lectures/apccc-2019-conference/video/1467-players-brightcove-net2019-09-10-14-49-08.html Below the video is a full transcript - all the words Professor Hofman says in the video. Thanks to Nev and Lorraine
  2. Guest

    LuPSMA 177 clinical trial

    Hi fellow advanced members Appreciate if anyone can assist with advice re this topic. I am 72 yo with advanced metatstis bones only.Over the past 7 years have had a radical, Radiation- 36 treatments, Chemotherapy - Doxetaxel, Enzuletimide and the whole time on Lucrine. Yep pretty well tried them all and with a rising PSA, now 47- still low compared to some I am faced with more Chemo -Cabazataxel. I have the opportunity to join the 177 LuPSMA pilot study ( 30 in Australia - no placebo) and will start tests next week to see suitability? Is there any member who is doing this trial or knows anything about it? One side affect ( generally well tolerated) is dry saliva and tear glands which I would like to know about? Any comments most welcome. cheers Roger
  3. 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.
  4. Several of our members have been participating in a clinical trial of Lutetium (Lu 177) being conducted at the Peter MacCallum Cancer Centre in Melbourne, Click here to read an article published in the Australian Financial Review about this clinical trial of Lutetium. A large randomised trial to test this treatment next year will be conducted in 2017.
  5. 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.
  6. The Prostate Cancer Foundation of Australia has posted a video on YouTube of the following talk on Advances in Prostate Cancer (Ga68 PSMA PET/CT Scans) given by urologist A/Prof Henry Woo at Sydney Adventist Hospital on 28 September 2015.
  7. PSMA The big thing in Australian prostate cancer research in 2015 was a little wiggly shape that sits on the wall of a prostate cell - PSMA. In normal prostate cells, PSMA is mostly on the inside of the cell wall. In prostate cancer cells, PSMA moves to the outside of the cell wall. So, if you want to find prostate cancer cells - look for PSMA. Researchers have found a key that locks onto PSMA when it finds it. On the free end of this key they can attach lots of things. PSMA scans One type of thing that is attached to the free end of the key is a thing that will show up on scans. Little bits of iron were the first thing that was tried on the free end of the key. It worked very well for the scan - the iron-ended keys gathered on the surface of prostate cancer cells and they stood out well on x-ray. However, other parts of the body were not happy with so much iron, so researchers looked for other things. The most successful thing to be added to the free end of the key for scanning is a radioactive metal - Gallium-68. A PET-CT scan using Gallium-68 at the end of the key can see much smaller prostate cancers than older technology. Several larger Australian hospitals offer these scans, but patients will find themselves a few hundred dollars out of pocket per scan. We can guess this will change in future if radiographers can show the government that the sharper view will extend life. PSMA treatment The free end of the key can have something attached to treat the prostate cancer cells. Radiation Radiation can kill cells, so putting a radioactive metal at the free end of the key has been tried. Gallium-68 is no good for this because it radiates mostly positrons which cause little damage. Another radioactive metal - Lutetium-177 - has mostly damaging beta radiation, and this is being trialled. Drugs Attaching drugs that kill cancer cells to the free end of the key is a promising approach. In this video, Professor Pamela Russell gives us an end of year report on the research she and her colleagues have done at the Australian Prostate Cancer Research Centre. Her team is particularly looking at attaching chemotherapy drugs to the free end of the key. If this works, instead of flooding the whole body with a chemotherapy like Taxotere (docetaxel), the key has the drug on the free end, and the other end attaches directly to the PSMA on the prostate cancer cell. This delivers most of the drug where it is needed, and spares the rest of the body. The video is 40 minutes long. If you can't clearly hear some of the technical terms Professor Russell uses, member Len Wise had kindly provided Cc (closed captions) of every word. (Click on Cc at the bottom of the video to turn them on/off.) See the video here: http://www.jimjimjimjim.com/video---research-report-dec-2015.html Or http://tinyurl.com/ja2rnkw Or Follow the link to our video list on the front page of: http://JimJimJimJim.com
  8. GALLIUM68 PSMA (Prostate Specific Membrane Antigen) PET/CT SCAN. or BE CAREFUL WHAT YOU ASK FOR. Having recently undergone the above scan due to the alarming rate of my PSA recurrence, and to perhaps qualify for a current Oligometastatic trial in Melbourne, I got, perhaps, more than I bargained for. Hoping to identify possible activity in the para-aortic lymph node region, which has been mentioned since diagnoses (and later ruled unlikely), which then perhaps was able to be treated with targeted radiation. https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=363885 Indeed, this was found-“Malignant PSMA avid small left common iliac node,” but also “small or tiny left distal common iliac nodes (beneath iliopsoas muscle) {left hip} and enlarged left inguinal {groin} node.” {red italics are my interpretations} Unfortunately, it also identified four other sites of PCa activity in my bones, which puts me right into the metatastic club, not somewhere I wanted to be. I personally am comfortable with what I now know, but suggest that this level of knowledge may not suit all who are travelling this path. The Gallium68 PSMA scan, is, I believe the best tool I have seen for identifying areas of PCa activity with great accuracy, and is not limited to areas of bone degeneration, as is the current bone scan. However, until these areas can be treated in Australia (as in the above trial) as they have been able to in the US for the last 15 years, the knowledge is perhaps, wasted.
  9. An article posted on the ABC news site (12 May 15) has revealed a Gamma Knife Radiation Treatment System is being installed at the PA Hospital. While the article focuses on it's capability to more safely treat brain cancers, it does note the following-"The machine can also be used on benign and cancerous tumours in other parts of the body" Here is the link - http://www.abc.net.au/news/2015-05-12/radiation-machine-will-turn-brain-surgery-on-its-head-oncologist/6463294 EDIT-(2hrs later) Unfortunately, from further research It appears that this machine (as pictured) is not capable of full body treatment, as it is not a full tunnel through the back, so may not be much use for other parts of the body. The Hospital press release does not mention 'other parts' http://www.health.qld.gov.au/metrosouth/news/150512-pah-gamma-knife.asp Geoff.
  10. Found an interesting video by A/Prof Henry Woo of the Sydney Adventist Hospital addressing a local support group on the latest scanning and treatment techniques (recorded October 14), highlighting the great leaps forward in disease imaging occurring at the moment. Aggressive Treatment of Aggressive Prostate Cancer ~ A/Prof Henry WooPublished on Oct 19, 2014 A peek into the cutting edge of treatment for advanced or aggressive Prostate Cancer, with information on the next wave of diagnostic scans about to break. Here is the link- //www.youtube.com/watch?v=g-5NXyKo-t8
  11. Paul Edwards (not a doctor) says: For some time I’ve been wanting to gather together all the bits and pieces in the forum on PET Scans. Whatever you do have a look at the amazing video at the end of this post. A positron emission tomography (PET) scan is an imaging test that uses a radioactive substance called a radiotracer to look for disease in the body. Before carrying out a PET scan, a radioactive medicine is produced in a cyclotron (a type of machine). The radioactive medicine is then tagged to a natural chemical. This natural chemical could be glucose, water, or ammonia. The tagged natural chemical is known as a radiotracer. The radiotracer is then inserted into the patient’s body, normally through a canula which has been inserted into the patient’s arm. When it is inside, the radiotracer will go to areas inside the body that use the natural chemical. For example, the 18F-FDG (fluorodeoxyglucose) is a radiotracer that is tagged to glucose. The glucose goes into those parts of the body that use glucose for energy. Cancers, for example, use glucose differently from normal tissue - so, an FDG PET Scan can show up cancers. The 18F-FDG PET Scan is probably the commonly used PET Scan in hospitals. Because prostate cancer is slow-growing, it does not take up glucose as much as other cancers. For this reason researchers have been looking to develop radiotracers that were more suitable to use for imaging prostate cancer. For several years the 11C-Choline PET scan introduced at the Mayo Clinic has been regarded as leading the way in the imaging of prostate cancer. The major limitation of 11C-Choline is that it has a 20-minute half-life (The half life is the time required for one half of the atoms of a given amount of a radioactive substance to disintegrate). This means that 11C-Choline must be used very quickly after it is produced. For this reason, it must be produced on site very close to where it is administered. Normally radiotracers are produced off site for safety reasons. 11C-Choline has shown limited sensitivity in men with very low PSAs. One study showed a 5% detection rate where PSA levels were less than 1. 18F-Fluorocholine is another radiotracer that has been trialled in Europe and Australia with good results. However, it is less sensitive than 11C-Choline and requires a higher PSA level in order to get an effective image. A PSMA PET scan is one that uses a radiotracer which is targeted to a protein (Prostate-Specific Membrane Antigen) that is found in prostate cancer. There are different types of radiotracers are being developed for PSMA PET Scans. For example, in the United States Johns Hopkins University has developed a 18F-DCFBC radiotracer and Memorial Sloan Kettering Cancer Centre has developed a Zr89-J591 radiotracer. In Australia we are now using a Gallium(Ga68) radiotracer which was developed in Germany. The Gallium PSMA PET Scan produces a sharply defined image at very low PSA levels. Because the Gallium PSMA PET Scan targets the Prostate-Specific Membrane Antigen protruding from the outer membrane of the cancer cells, the radiotracer “lights up” on the PET images showing clearly metastases to lymph nodes as well as to bone. [in my case with a very low PSA of 0.58, the Gallium PSMA PET Scan detected 4 metastases that were not visible on other scans.] Seeing is believing. Memorial Sloan Kettering Cancer Centre has produced an excellent video showing the difference that a PSMA PET Scan makes: http://www.mskcc.org/videos/prostate-specific-pet-scans Whilst radiology oncologists are predicting that the PSMA PET Scan will revolutionise the treatment of prostate cancer, that revolution is some time away. At the moment the technology is still being trialled in Australia. There is limited availability of these scans: only a few hospitals in Australia are offering them. The scans are expensive and are not covered by Medicare.
  12. Had a meeting with Patrick Bowden (rad onc Epworth Melbourne) after MRI due to rising PSA. Result negative, but he offered a PSMA PET scan at Peter Mac in about a month. Hoping this will find the problem. It is a full body scan and shows metabolic activity as against structural change. This is very new and has only been available in Melbourne for 3 weeks as of late Sept 2014
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