All Systems Go

 Worriedwife & Stevecam 

Yes you are both correct. Moderate celebrations tonight. Chicken gruel (Sunday's chicken carcass boiled up with beans, pulses, potatoes and carrots) and the odd glass of dry white wine (chilled of course) for my birthday tea!

I have more interest in celebrating 6 December which will be 6 months to the day after my last HT injection. And then just how long will 3 years HT takes to get out of my system!

Thanks for all the good wishes.  Brian.

Brian, I will be 69 in 9 years (ish).

Hi Brian

My husband is now 6 months out of 18 months of HT. He is proudly showing me that the hairs on his legs are growing back!!! 

A big WOO-HOO from me!

We have just had a productive meeting with the oncologist discussing 'What next'. My husband has had 3 recurrences in 4 years so we are also working through the options but one thing that was stressed today is that every persons cancer is different and can react well to some treatments but not so well to others. In his case the cancer appears to be particularly sensitive to radiotherapy but not so sensitive to chemotherapy so any further chemo will be left until other therapies have been exhausted. We discussed challenging with a different form of ARPI such as Abiraterone and steroids as well as rechallenging with Enzalutamide. Then there were the options of radioligands such as Lutetium 177 (this is his preferred next step if and when a recurrence occurs). Another radioligand Radium 223 is not suitable as my husband doesn't have bone mets. My husband originally had EBRT to the whole pelvic area in 2020 which remains successful. In April 2024 he had SBRT to distant mets and adrenal glands mets which have now either disappeared or reduced significantly. More targeted SBRT may be possible provided the area has not reached the maximum dose. The results from his genetic testing should be through in the next few days so the oncologist will let us know whether treatments like PARP inhibitors might be suitable. He is also leaning towards immunotherapy. In the meantime we are to keep monitoring PSA, Testosterone and bloods every 3 months and then a 3rd PSMA PET CT scan in April to check on progress and that no new mets have appeared (but this will be brought forward if the PSA starts to go up). We had a brief discussion about Bipolar Androgen Therapy BAT but he would prefer to continue with therapies to kill the cancer at the moment rather than those which just put it into hibernation, although there may be some merit to using combined therapies which are showing a longer time before progression. 

At the moment the oncologist is very pleased with the way the SBRT is working and repeated that it will continue to do so for another year. He intends to continue to hit any new mets which appears with targeted therapies but has basically given us the winter off now to go and enjoy ourselves. Oh - the pain in the bum which hubby has been having is arthritis based and not cancer related.

At least the positive thing is that the Oncologist is pleased with the way the SBRT is working.

That all seems great and still with options.  I need to challenge why SBRT wasn’t being used for me, as at my last visit I was shocked to hear about the bone mets and neither of us can remember why the oncologist dismissed it.
 I imagine you are at a decent temperature this time of year, have a great weekend.  David

What great news for you both and I hope you can do as he says and enjoy the Winter

Brilliant news! lots of love from me

Dafna

Hi David. I think there are two criteria for SBRT, one being the number in that they will only normally treat oligometastatic disease (3-5 mets). The other is position and I think you have said it is in the sternum which appears to be more difficult to treat with SBRT. They also take into account what previous treatment you have had, particularly to the bones as this can affect your ability to fight off infections due to the effect it has on the bone marrow as well as the red and white blood balance.