ATLANTA

"A trial comparing different treatments for prostate cancer that has spread (IP2 ATLANTA)"

https://www.cancerresearchuk.org/about-cancer/find-a-clinical-trial/a-trial-comparing-different-treatments-for-prostate-cancer-that-has-spread-ip2-atlanta

5 trial is open to 912 men diagnosed at stage T4 who have not previously been treated.

It's a very important trial, so do keep us informed.

I did look at this but am not eligible to enter the trial as I am on enzulatimide as well as 6 monthly hormone injections

I have signed up but do not expect much of it. Radical treatment of the primary, be it surgery or strong RT, is controversal but gained some recent interest. If it prolongs life, they would like to know for how long and if this extension is worth the temporary or, in some cases irreversible, side effects. One may ask if it is worth to be leaky for 6 months if your outlook is 2 years on average. 

I hope to be in the RT group, but here too, side effects can be worse than the potential benefits, like possible lo ger survival or less prostate/urinary issues in in tbe course of disease.

I have signed up but can always step back if I change my mind or I don't like the arm after randomisation.

Good luck with it!

There is some evidence that treatment of the primary can slow the spread, on the "Mother Ship" principle. I don't think it works for all prostate cancers, but where it does work, the benefit can be worth having.

I think the point of the research is to see whether 'non curative' treatments like HIFU have a role in slowing stage 4 cancers with fewer side effects.

Do keep us in touch, it may turn out better than your hopes!

I have just completed 20 sessions of RT to my prostate, is that the same as the one offered in the trial ?

Hi Paul,

The trial's schedule will be 60 Gy in 20 fractions I was told yesterday. The plan of my Addenbrookes' oncologist was 55Gy in 20 fractions so the trial's is a little stronger. The RT and RP in Atlanta is aiming at radical treatment but still, the pilot group would be assessed for that by biopsy. I know the pilot has finished now but I do not know if 60 Gy over 20 fractions proved to be radical.

Thank you Bruxist, I have just checked and I received 60Gy to my prostate over the 20 sessions. I just wasn't sure if it was a different type of radio therapy offered on the trial. I have also just learnt by a letter which has just come that my cancer is adenosarcoma NOS ?? Do you or anybody know what this is/means

No idea Paul. Mine is intraductal which is not great. 

Re Atlanta Trial,

Did you go ahead with Atlanta? 

I've been in touch with them and am likely to be eligible they say. My bone Mets are in the spine ribs and pelvis and I like the idea of early intervention to them with surgery and or radiotherapy.

I started radiotherapy to prostate recently but stopped after three sessions only because peeing became dangerously close to zero. I have a stricture on or near the bladder opening that is difficult to successfully operate on and my peeing and retention have been high for years. For that reason I frankly am scared of taking a risk an going back to prostate radiotherapy.

That's why I'm thinking cryotherapy to the prostate or prostatectomy offered in Atlanta might work better for me ?

Pete

Hi Pete,

Yes, I have signed up for Atlanta and this is all going according to plan. Two weeks ago I have finished my sixth and last chemo session. Next to that I am on Zoladex since October 2021.

Last week I had an MRI in King's Lynn. I live in Cambridge but my hospital there did not participate in Atlanta for reasons unknown to me. So that is why all of my chemo did happen in King's Lynn as well as this MRI that was requested by Imperial College in London, where from the Atlanta is organised. 

King's Lynn would now send the MRI to London and then they will decide if, when and how the treatment will happen. I was randomized in the heat/cold arm, so no radiotherapy or surgery. If tumor is still left then theu will look at its position. Has to do with posterior and anterior. One of the two is close to the rectum, in which case they cannot use cold if I'm mistaken as it will damage the rectum. So they will go for heat treatment then. Or the other way around. But things are definitely happen, and soon I will hear from them and be invited.

Is it not sure they will do anything, said my oncologist. There is still a chance my tumor in the prostate has gone in which case they won't do anything. But secretly I hope there is a tiny bit left because then they will treat it anyway and this might increase the chances all of the culprits in my prostate have gone.

I only have one worry/disappointment about Atlanta. Since I am polymetastatic they will not treat any metastatic sites by radiation (SABR). It's them who decide that, it seems particpants have no say in this.

How are you going by the way? I'm doing well I believe. I can still exercise ,the chemo and Zoladex keep all well in check. Only have some hot flushes and of course occasional mental issues when you realise it is very unlikely to be cured forever.

Please share you story and we can keep in touch if you want you. I'll let you know any progress on my Atlanta. I am an answer from them soon. They will be looking soon at my MRI and let me know next step.

Best regards,

Gert