Interview with Chris Sweeney on ESMO2018 conference

[stevecavill]

I came across this interview on Urotoday.  A good short synopsis of the current state of research on treating metastatic disease.  I've found Urotoday to be a great source of science/research based information.

https://www.urotoday.com/video-lectures/prostate-cancer-foundation-scientific-retreat/video/mediaitem/1074-embedded-media2018-11-10-04-08-11.html

 

You should not need to register to see the video.  I have registered (it's free) and receive an informative weekly email.  I have not received any spam.

[alanbarlee]

Thanks Steve - UroOncToday is indeed a great site to monitor, along with a number of others like it. It's becoming clear that the name of the game  nowadays is stratifying patients and intelligently customising their treatment, based on their individual histories being matched to the appropriate clinical trial outcome.   

 

Towards the end of his interview, Chris Sweeney also mentioned something that had previously escaped me, viz after having achieved an abiraterone/prednisone or an enzalutamide  PSA <=0.02 (as in my case), consider switching to intermittent treatment (or possibly lower dose?) in order to avoid or minimise long-term co-morbidities like hypoglycemia, loss of bone density and muscle mass, abi-specific risks like hypertension and hypokalemia, and steroid-related risks, including liver enzyme issues.    

 

My medonc recently agreed to me halving my frequency of 0.5 mg/day dexamethasone steroid to 0.5 mg every second day, while maintaining 3-monthly testing of liver function, and adding ACTH (to monitor adrenal sufficiency with the lower corticosteroid in conjunction with the abiraterone). As far as I know there's no trial data on intermittent or lower dose abiraterone (other than with food), but with close monitoring the trade-off of risks in giving it a go seems worthwhile. I'll therefore raise with him the possibility of intermittent or lower dose abiraterone with continued close monitoring. I might even save the government some serious money!

 

Cheers,

Alan           

[stevecavill]

Thanks Alan, 

is your PCa castrate resistant?  Mine is still hormone sensitive, but I see the trials are showing evidence for early abiraterone being beneficial for overall survival even in the hormone sensitive setting.

Steve

[alanbarlee]

Steve - the micromets after RP eventually showed up via a steady PSA rise (to 33) and FDG PET/CT a a string of affected lymph nodes. I went on the usual journey of ADT (3 in my case) via intermittent treatment to eventual castrate resistance, but pre-chemo abiraterone and prednisone, with continued Zoladex and Avodart, brought my PSA down to its present level of 0.01. It's been hovering at 0.03 or less for many months now. 

Alan