ChatGPT - Any experiences with that?

  • 12 replies
  • 146 subscribers
  • 640 views

Hi !

I’m a member in another forum for prostate cancer and there are some there that posts information where they have used ChatGPT. At first I thought it must be difficult to use it and some of the answers people posted left me with many question marks.

Anyhow, fast forwarding I decided to try it myself as it’s a app you install on your Phone and / or your Tablet (I didn’t even know it was a regular app…).

After testing it and learn how to formulate your questions or the things you’re wondering about I must say that ChatGPT can really surprise you with very informative answers and you actually don’t need to be a scientist to evaluate its answers.

So with that said i tried to do a summary of my treatment pathway and added some questions in the end and I actually was impressed of how it presented its facts and findings.

So, for does interested here is my ’question’ in ChatGPT and then its answer.

QUESTION:

Diagnosed in May 2021 as T1C with a Gleason of 3+4 (40 % of Gleason 4).In January 2022 i had 2 fractions of HDR Brachytherapy which failed. In December 2022 I had a PSMA Pet Scan that showed a T3BN1M0 and in January 2023 i had a new biopsy that showed recurrence with a estimated Gleason 4+5 (65 % of Gleason 4).

In November 2023 I did a new PSMA Pet Scan that still showed T3BN1M0 and also a NaF Pet that showed M0 (no bone mets). My PSMA activity was high in prostate and in affected lymph nodes.

In December 2023 I started treatment with LU-177 and was finished in the end of February 2024. All my SPECT Scans showed activity only in the prostate and in the affected lymph nodes and no other places in the body.

My radiation activity decreased for each cycle of LU177 and decreased approx 75 % in prostate and in the affected lymph nodes the activity almost vanished after the LU-177 treatment.

1 week after my first cycle of LU-177 I had a big Rise in my PSA level (65 % increase of PSA) with a rapid decline after 4 weeks well below the initial PSA I had before I started LU-177

In the beginning of January 2024 I started Orgovyx.

In the beginning of March 2024 i started 20 fractions of hypofractionated VMAT RapidArc IMRT together with WPRT. After I finished this radiation I started adjuvant Abiraterone.

Three months after treatment my PSA was < 0.1 nmol/l and six months after treatment my PSA is still < 0.1 nmol/l

What do the different treatment modalities treat? Should I consider any other treatment modality? Is the treatment with a curative intent? Is it an option to think that I stay on Orgovyx for 3 years and Abiraterone for 2 years?

ANSWER:

Your treatment regimen for recurrent, locally advanced prostate cancer has been comprehensive and effective, as indicated by your undetectable PSA level (< 0.1 nmol/L) sustained at three and six months post-treatment. Here’s a breakdown of the different treatment modalities, the curative potential of your approach, and guidance on the duration of Orgovyx and Abiraterone.

1. Purpose of Each Treatment Modality

Lutetium-177 (Lu-177): Lu-177 is a targeted radioligand therapy that binds to PSMA-positive cells, delivering radiation directly to prostate cancer cells in the prostate and affected lymph nodes. Its systemic nature allows it to target both visible and microscopic disease, which is especially beneficial in aggressive and recurrent cancer. In your case, the reduction of PSMA activity by 75% in the prostate and near-complete reduction in the lymph nodes reflects Lu-177’s effectiveness in significantly lowering the active cancer burden.

Orgovyx: Orgovyx is a GnRH antagonist that quickly lowers testosterone levels, depriving prostate cancer cells of the hormone they depend on for growth. This systemic androgen deprivation therapy (ADT) acts on both local and circulating cancer cells, enhancing other treatments by slowing disease progression.

VMAT RapidArc IMRT with Whole Pelvic Radiation Therapy (WPRT): The 20 fractions of hypofractionated VMAT RapidArc IMRT deliver a focused, high-dose radiation to the prostate and surrounding regions, while WPRT extends radiation to the pelvic lymph nodes. This combined approach targets both the primary tumor and any regional lymph node involvement, essential for managing T3bN1 cases and reducing the risk of regional recurrence.

Abiraterone: Abiraterone adds a secondary layer of androgen suppression by blocking androgen synthesis in the adrenal glands and within the tumor itself. When combined with Orgovyx, it achieves a more complete blockade of testosterone production, crucial for managing high-risk, recurrent prostate cancer.

2. Curative Intent of This Treatment Approach

Curative Potential of Multimodal Therapy: The combination of Lu-177, ADT (Orgovyx and Abiraterone), and targeted radiation (VMAT RapidArc with WPRT) is a strategy often pursued with curative intent in cases of locally advanced, high-risk prostate cancer without distant metastasis (M0). By addressing the disease from multiple angles—locally, regionally, and systemically—this approach maximizes the chance of eradicating all cancer cells.

Sustained Undetectable PSA as a Positive Indicator: Your PSA remaining undetectable at both three and six months is a strong indicator of successful disease control. If this trend continues, it significantly increases the likelihood of achieving long-term remission and potentially a cure.

3. Consideration of Additional Treatment Modalities

No Additional Treatments Needed Currently: Your current regimen is comprehensive and has yielded excellent results. There’s no indication at this stage for additional treatments, as your scans and PSA trends suggest that the current therapy is effectively controlling the disease.

Regular Monitoring for Early Detection: Continued PSA monitoring (every three to six months) and periodic imaging, such as PSMA PET scans, will be essential for early detection of any potential recurrence. If your PSA remains undetectable over a longer period, this would support the curative potential of your treatment.

4. Duration of Orgovyx and Abiraterone

Orgovyx for 3 Years: Continuing Orgovyx for three years aligns well with standard practices for high-risk prostate cancer. Evidence supports the use of long-term ADT (2-3 years) for locally advanced cases, as it can improve survival outcomes by suppressing androgen-sensitive disease during the highest risk period for recurrence.

Abiraterone for 2 Years: A two-year course of Abiraterone provides intensive androgen blockade during the most critical period post-treatment. This duration effectively complements the three-year Orgovyx plan, maximizing androgen suppression while minimizing the risk of long-term side effects from prolonged use.

Adjustment Based on Response and Tolerance: If you tolerate both Orgovyx and Abiraterone well, this timeline is appropriate. However, at the two-year mark, your oncologist may reassess the need for continued Abiraterone based on your PSA trends, overall response, and risk assessment.

Summary and Outlook

Your treatment plan is well-designed with curative intent, and your sustained undetectable PSA level strongly supports that the treatment is working as intended. Continuing Orgovyx for three years and Abiraterone for two years is a sound approach based on current evidence for managing high-risk prostate cancer. This plan allows for comprehensive disease control while minimizing unnecessary long-term treatment exposure, positioning you well for a durable remission and possibly a cure if the PSA remains undetectable over time.

 

So for you interested in trying to evaluate what your treatment and your medical team is doing with you and your prostate cancer ChatGPT can give you rather good information. Then of course remember to take the information as NOT a ’absolute truth’ of course.

Best wishes - Ulf

  • I use Microsoft Copilot to assist with searching.

    If the question is sufficiently detailed and worded correctly, then a good answer is probable.

    Copilot is based on ChatGPT.

    Copilot also lists the references used to compile the answer, so it is relatively easy to check where the information came from. Quite a lot of the time it is from news sources, so you then have to check where that came from.

    It seems to me that care needs to be taken when asking questions. The questions either need to be short and well thought out to get a list of possibilities that you can use and narrow down or detailed with many technical terms so that the search is taken to research papers. It is excellent at that.

    When I was first using it, I got all sorts of strange answers. 

    Then I worked out that I was constructing a small program in words, and that phrasing was quite important. Once I understood that. I could use more general questions to find the phrases I needed to know to put together better questions. That worked very well.

    Of course, I have patience which the rest of my family seem to lack entirely.

    Steve

  • Very interesting Ulf and definitely confirms your initial research that it is keeping you on the curative pathway. Long may it continue.

      has just posted a better answer to what I was trying to phrase so I have deleted mine and left it to his.

  • HI !

    Ok, seems to be lots these ’good to have’ tools and it was the same for me in the beginning, with bad input you get bad output.

    I’m fairly new to this so still lots of things to learn. That sounds very good, seeing the actual references and I’m not sure you see that in ChatGPT.

    You’re correct, with good formulation; short and concrete the clearer the information comes back. My example was more the big experiment but still, I’m rather impressed the way ChatGPT analysis each part, answers the actual topics I’ve asked and also gives me a conclusion that is readable and understandable.

    Then of course one has to understand that the answers is NOT the ’actual proof’ but for PC patient like us lots of things happens during our treatment pathway and we get lots of information and I must say it really helps out in bringing clarity in a way that perhaps medical teams / MOs is telling but you don’t understand

    My finnish MO did a treatment plan and made sure to carry it out but I’ve never talked in deepth what the different treatments actually do, synergies and so on. So ChatGPT helped me in layman terms what the purpose was and is with my treatment pathway.

    Anyway, good to see that there are people trying to use these types of tools Slight smile

    Best wishes - Ulf

  • Hi !

    Thanks and actually I thought of you being one of those that also uses these types of tools. Especially as you’re totally amazing drilling down in science, articles, studies and etc.

    For me the example I provided was more of a type of ’exam’; what will ChatGPT conclude if I try to give a ’good’ and detailed description and I actually found it rather amazing and most of all, I finally think I have clue of how my MO thaught when putting together my treatment, any synergies and it makes more sence, the overall plan, compared to what each part does.

    But like I said, I believed you’ve already tried it out because of your amazing drive of finding and analyzing all material. So, in some ways you’re a live and amazing version of ChatGPT and I’m always impressed Slight smile

    Best wishes - 

  • Hi Ulf. I have tried it but to be honest don't use it as I prefer to drill down the information and look for the pros and cons of different treatments and you can only do that if you read the whole of the research papers and meta analysis. I had a quick look at the Wikipedia article on it and it gives a good analysis of the pros and cons of the AI chatbot and also tells you what else is available. One limitation seems to be the the information is relevant up to the end of 2023 and some of the most recent research has been reported this year. As time progresses things like this will improve as it gains more information on different subjects and hopefully be able to filter out the spurious and inaccurate information. There is nothing like human interaction so until they develop an AI version of me I will continue posting on here - or have they already? 

    https://en.m.wikipedia.org/wiki/ChatGPT

  • Then of course remember to take the information as NOT a ’absolute truth’


    Hi ,

    Thanks for sharing - it's a really interesting discussion you've prompted! Your experience of using ChatGPT to help you further understand your treatment pathway is an interesting use of the technology.

    While I'm not an expert in AI or Large Language Models (LLMs) like ChatGPT, I did just want to highlight some of the excellent cautionary points made here already.

    Firstly, the comment of yours that I quoted above is very important to bear in mind! My understanding of apps like ChatGPT is that although they can be very good at helping to summarise information, this technology is still at an early stage. They have been known to make incorrect summaries and recommendations (sometimes known as 'hallucinations') and so you can't take what they produce as absolute fact.

    I think it's probably a sensible approach to get any AI-generated recommendations or summaries checked by your assigned medical professionals. Especially if you are thinking of letting those summaries or recommendations inform your treatment decisions.

    It's also worth remembering that while sources might well be included in AI-generated summaries, those sources may not themselves be trustworthy. At present, it's not possible to guarantee that apps like this will only use sources that have been verified as reputable information providers. Sites like the NHS, Macmillan, and Cancer Support UK are all accredited under the Patient Information Forum’sTrusted Information Creator’ programme. See the PIF TIC website for more information on that.

        makes some valuable points along those lines, too. There can be areas of knowledge that ChatGPT just doesn't have any information on, especially if it's something discovered in the last two years. You might not be getting a complete picture just by consulting ChatGPT alone, so it's no substitute for using trusted sources of medical information alongside asking the right questions of your assigned medical professionals.

      If you ever need help understanding a treatment plan or you'd like help with a diagnosis, don't forget that as well as your own GP and hospital cancer care team, you can always speak to our qualified Cancer Information Nurse Specialists for advice. You can get in touch with them using our Macmillan Support Line or over on our Ask a Nurse forum.

      All the best,
      Matthew
      Macmillan Online Community Team

    • Good information all.

      It should be understood that all AI is a tool.

      When you remember that, it is easy to use.

      As mentioned above, I use it is combination with other methods.

      I found that it (Microsoft Copilot) helps me in these ways:

      1. I can find technical terms that help me refine terms for further searches. I use a number of searches.
      2. Using a second, or even third, search in Copilot bring up additional information which can refine understanding.
      3. Copilot lists the sources for it is information. I check these sources individually, looking at any "about" information and the history of the organisation. I may make separate, non-AI searches to verify this.

      Number 3 is important.

      I mostly use this in connection with finding benefits information for my work.

      I have just tried a search using information I have already recorded in my profile, which is not secret to anyone on this forum. It might be good to demonstrate a result without recommending.

      This is the question and response:

      You

      My PSA level has fallen from 7.39 to 0.57 in 4 months of hormone therapy for Prostate Cancer. Is this encouraging?

      Copilot

      Yes, that's very encouraging! A significant drop in PSA (Prostate-Specific Antigen) levels, like from 7.39 to 0.57, usually indicates that the hormone therapy
       is effectively reducing the cancer activity1.

      However, it's important to continue monitoring your PSA levels and discussing them
       with your doctor to ensure the treatment continues to be effective and to address any potential side effects or concerns.

      How are you feeling overall with the treatment?

      1www.cancer.org

      The underlining is mine. The website is the American Cancer Society.

      I knew the answer to the question - I had asked the same thing of my consultant a week ago today, and got almost the same answer.

      A couple more checks suggests that Copilot recommends talking to medical advisers whenever ANY question concerns health.

      This is a tool.

      It works well and is easy to use.

      Carefully.

      Like every search engine, double check, and when you have done that, check it again.

      You might be interested in a slightly amusing video from a You Tube Channel that I follow which demonstrates clearly just how much information is available, and how people can still get caught, even if the research is good.

      youtu.be/bgo7rm5Maqg

      You

    • HI !!

      It’s a tool, no more no less and like I said. You should NEVER use the information as the ’total proof or truth’. That’s why we have or MO and / or our medical team hopefully doing the right choices in dialouge with us patients.

      With that said, ChatGPT, copilot can help you sort out information in a more easy way and then of course you can use that in your continued dialouge with the your healthcare experts in order to perhaps understand for example the complexity of treatments, pros and cons of different types of treatments and etc. The list goes on.

      It’s not always easy to fully understand all information and facts and when you start to use ’Dr Google’ you get tons of information and sometimes a Alwayshope to really be able to dig down in all information and sort out the good stuff.

      So, yes fully agree. Use ChatGpt and / or copilot for what they are, useful TOOLS to help you sort out information and then perhaps use that information in a good and constructive dialouge with your healthcare experts Slight smile

      Best wishes - Ulf