Boosting immunity

[Chask]

I was diagnosed in July 2013, prostatectomy and radiation by Feb 2014.

 

ADT (Zoladex) for 12 months then a break until March 2017, when PSA had risen to 2.6.

 

PSA nadir .07, then gradual rise to .46 when I then started on Aberaterone/Prednisone. PSA has hovered around the 1 mark since then.

 

Point is I have been on continuous first line ADT for 2.5 years and 2nd line just over one year.

 

My problem is that for the last 3 months I have been suffering a variety of minor infections, throat, chest, stomach, mouth.  Am sick of anti biotics.

 

Are there any ways to boost my immune system in the face of these immunity reducing hormones?.  Should say I have generally only suffered mild side effects, though my strength has diminished.  I eat reasonably healthily, and exercise regularly - 3km walk daily, golf twice a week and light weights.

 

During my last mouth infection, Onco actually told me to stop the Aberaterone for a couple of weeks. Was nervous about that and only suspended for 1 week by which time the infection had largely cleared up.

 

Appreciate any suggestions.  Thanks

[Dave]

Hi Chask,

I have been on Abiraterone for a couple of years and I too have suffered with mouth and chest (problems?) in the form of a cough.  My Onco thinks it is a fungal thing caused by the Prednisone.  I am now on my second course of Fungilin.  The first course cleared up the problem but now it has returned a couple of months later. 

David

[alanbarlee]

Hi 'Chask',

(On your apparent susceptibility to infections, have you considered your proximity to the contaminated hot air emanating from Parliament House?)

Seriously though: 

Abiraterone (plus prednisone) is associated with a 4.4% increase over placebo increase in upper urinary tract infections and a 2.9% increase in upper respiratory infections - low odds, but you might be one of the unlucky ones, in which case your oncologist's advice to drop abi for several days might well be worth following.My guess that the risk of doing so with a stable PSA of 1 is likely to be low. You might also quiz him about steroids - and in any case be careful to taper off the prednisone very gradually, to avoid an auto-immune attack on your joints and elsewhere.

 

There are heaps of unproven claims about 'strengthening the immune system' out there -  but supporting the massive and highly profitable supplements industry is still a choice that too many people nevertheless make. It takes more than a few anecdotes, testimonials, recommendations from paid 'doctors' or unscientific 'trials' to prove actual efficacy and safety.

The only proven way to modify the human systemic immune system is with vaccinations that target specific bacterial infections. Topical antibacterials are effective in preventing infections from skin wounds.

 

The most likely lifestyle factors to prevent and and to minimise the impact of  infections are well documented. They include - 

Plenty of fresh fruit and vegetables

Cook meat well

Wash hands often

Avoid infectious people

Plenty of aerobic exercise

Maintain a healthy weight / BMI

Moderate alcohol

Don't smoke

Eliminate chronic stressors

Plenty of sleep

Don't age! (Bone marrow function and T-cell production tend to decline with age - but that's life).

 

Good luck -  and keep up that great response to abi.

 

Cheers,

Alan

 

 

[Chask]

Thanks David and Alan, I actually thought hot air would be good for me, though I do agree the stuff from PH is pretty foul air.  That said, Canberra probably generally has the best air of all the Capital cities.

 

At the moment I am only on one (5mg) Prednisone tablet per day, but as my bloods have always returned very good readings I have been thinking of suggesting to my Onco reducing that to half a tablet (2.5mg) per day.  That may also help my strength a bit.

 

As for your lifestyle factors, while not fanatical, I think I am pretty much in line with your suggestions, though at 74 I would be very happy to stop ageing.  Problem is the only way I know to do that is to die, and I’m not quite ready for that!

 

Chas

 

 

[alanbarlee]

Chas - be a little careful about reducing the prednisone. Corticosteroids are potent ant-inflammatories that can reset your immune system - which can pounce on you when you stop using them (as my recent personal experience and post illustrates).

 

Also, a recent piece of clinical research showed that, for prednisone,  5 mg / twice per day is better than 5 mg /once per day in terms of slowing PCa in the context of ADT plus abiraterone. (Dexamethasone was a bit better still, but is an even more potent anti-inflammatory, and harder to come off).

 

Either way, keep a close eye on serum potassium level and blood pressure.

 

Alan

   

[Chask]

Thanks Alan.  Wise words.  Will discuss with my Onco.

 

Do you have a link to the research advocating more rather than less Pred?

 

[Patrick Turner]

Everyone is different and some men find experience of Pca and its treatment to be a series of frequent major or minor health side issues. Age and fitness also come to play so if you are doing exercise, it should boost your immune system and the amount of wellness you experience.

Alan Barlee's advice is on the ball. I found cycling 100km a week+ keeps me in good form but occasionally I have had mouth ulcers but use Savacol which works well. I'm 72, but if I was 82, maybe I'd have many other minor health issues besides the fight against Pca.

I eat a bowl of raw green vegies every night and take some vitamin C when I remember to.

After Zytiga I weaned myself off prednisolone over about 6 weeks.

After chemo, Lu177, and more EBRT to a hip I had a bout of sore right gluteous max muscle and a tendon trouble maybe caused by total slow side effects of all things plus maybe arthritis. The pelvic area has many things that interact in ways docs don't understand.

So I rested in winter, then returned to cycling 6 weeks ago, got some good massage and cycled 59km yesterday at fairly good speed average 22.5 kph without any increase of pains that occurred back in April. With luck, speed will rise by at least 1kph by Xmas. I'll seek more treatment as I  need it. 

I had Zytiga that gave me 8 months Psa suppression but mets grew bigger. Chemo failed. Lu177 has been good, Psa 25 to 0.4, so far, PsMa scan report says Pc is lessening. I am now also on Xtandi, which appears to work, but I don't know whether Lu177 or Xtandi is producing most of the Psa reduction but research doc says they work together. It appears I am not having any of the heart rate bothers caused by Zytiga. No immune system bothers, all blood test items good.  

So I am not taking any medications now except Tamulosin to keep prostate urethra free of constriction and the Xtandi. No medical appointments now for awhile, just follow-ups, Lucrin injects, and docs are waiting to see wot happens.

I had Dx Gleason 9, inoperable in 2009. It would have been Gleason 5 in 2004 when Psa was only 3.

Si it looks like I will survive maybe 3 more years at least, so maybe I get 18 years since Pca began. But I did know men who got only 3 years. One played tennis through all his 10 cycles of chemo, and dieted, lost 20Kg, did all the fitness thing he could, but his Pca mutated faster and grew faster than the docs could apply remedies that worked.

BTW, I ate lots of button mushrooms and English spinach to boost potassium during Zytiga.

This drug also cause heart rate bothers in hot weather, so I'd be up at 6, on bike at 6:30, and home by 10am before it got hot. Those symptoms lasted for 2 months after quitting Zytiga, and starting chemo, and I cycled every day during chemo. 

The only time my immune system quit was in days after first chemo. I spent 3 days in hospital.

But then I had one injection of Nulasta within 24 hours of getting chemo to boost immune system and no more troubles. I survived the Lu177 without any immune system boost, did not need Dexamethazone or prednisolone or have low platalets, so side effects with Lu177 were extremely low. Neuropathy from 5 chemo shots ending in about October last year continue, slowly getting better, but av speed on bike is down 1kph due to long term chemo effects. I kinda feel I just won't get anywhere if I just spend all my time sitting down and it does not matter if I am  a bit slow on bike because if I cycle far enough then I still get all the benefits. 

 

Canberra's air quality is the finest in Oz but only if you are up-wind of Parliament House. I have fitted BS deflection panels to ward off the foul airs of men arguing and lying when wind blows this way. So far, I've lasted 43 years not getting Pollyticanitis, which in worst cases makes you a zombie. There's a special drain under Parliament house to Lake Burley Griffin nearby where the very worst of policies can be disposed of. Its the one type of edible junk that the carp like to eat, so please be careful sailing or swimming on LBG because carp can grow to 2 metres and chomp a man's foot off. 

During winter, one reason why Canberra's air is so good is because the germ laden airs from other major cities has become so cold it kills all germs.  

Patrick Turner. 

[alanbarlee]

Good one Patrick!

Alan

[Chask]

Patrick,  thanks for your comments.  I always read your posts with great interest.  I think we are on similar paths, though you are a bit ahead of me on this journey.  I also accept that while I am reasonably happy with my level of fitness (for my age), I have no doubt you are also well ahead of me on that front.

 

It is very encouraging to see your great results with Lutetium.  I only know one other person who underwent Lu treatment.  He had 4 sessions, at great personal cost and regrettably it was not effective and he died fairly recently.

 

Also interested to see that you are now on Xtandi having previously had Zytiga.  I thought that was not allowed under PBS guidelines, but then I am on Zytiga prior to having Chemo, and that is also not permitted under the PBS, but the Onco’s seem to be able to plead special circumstances.

 

I see my Onco in 4 weeks time and although my PSA has remained low, I think I may ask for another scan, CT at least, and maybe also PSMA.  Had the last one 12 months ago and it showed one met on my scapula and a likely one on a lymph node.  I am presently experiencing pain in my right hip, but only after I have walked about 1km.  GP suggests arthritis, but Physio says my pelvis is misaligned.  My wife who has much experience with arthritis thinks it might be sciatica as it extends down my leg.  A scan may reveal the truth.

 

Thanks again for your comments.  I have an archeologist friend who was commissioned to study the rock formations under Parliament House.  I will ask him if he has seen the drain.

 

chas