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Dr. David
Dr. David, Board Certified MD
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Experience:  Board Certified Physician
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Best treatment metastates prostate cancer

Resolved Question:

best treatment for bone metastates prostate cancer
Submitted: 10 months ago.
Category: Medical
Expert:  DrRussMD replied 10 months ago.

Hello

Medications that stop your body from producing testosterone are used.

Lupron for example.

Also, there are medications that stop testosterone from reaching cancer cells.

Casodex for example.

These drugs are often given together.

There are other medications if an when these are no longer effective.

You must be working with a Hemetologist/oncologist doctor at this point. [Heme-onc].

OK, so you might have more questions or want to give me more information: Please use reply to expert if you have further questions. When you are ready, please click a positive rating [hopefully excellent—that’s how we are paid, per rating]. If you forgot something, come back. I am here http://www.justanswer.com/medical/expert-dr-thomas/

Customer: replied 10 months ago.
what about radium 223 or Lu-177- anti PSMA. And what can these be used with? Enzalutamide? etc
Expert:  DrRussMD replied 10 months ago.

Radium 223 is still in trials. So far looks good.

AS is lu-177.

Not enough data to replace current drug regimens, and you would have to be part of a trial.

Enzalutamide is another anti androgen [one of the classes I told you about above].

In fact, the drug regiment has to be tailored to you, your exact cancer type, etc.

So there is no "best" one size fits all.

Again, the need for a heme-onc doctor to examine you and review pathology, etc.

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Customer: replied 10 months ago.
Is genetic profiling available in the UK to determine what course or combination of treatment is best for an individual?
Our consultant is very good but we feel like he's just doing trial and error to see what will work. It's frustrating. My father is worried that he will soon reach a point where the doctors won't be able to stop any further spread to the bones.
Expert:  DrRussMD replied 10 months ago.

There are genetic markers [preliminary data] that predict the outcome of the cancer course and treatment to some degree.

This would be available in some laboratories.

However, they do not show what combination exactly to use.

We are a ways away from that yet.

please click a positive rating [hopefully excellent—that’s how we are paid, per rating]. If you forgot something, come back. I am here http://www.justanswer.com/medical/expert-dr-thomas/

Customer: replied 10 months ago.
Thank you so much. My father may have more questions. We will get in touch. Thank you
Expert:  DrRussMD replied 10 months ago.

Please click a positive rating now. That is how I am paid.

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Expert:  Dr. David replied 10 months ago.

This is Dr. David

I am a cancer doctor.

radium 223 or xofigo has had its trial

http://www.nejm.org/doi/full/10.1056/NEJMoa1213755

it was shown to improve survival over placebo in men who had bone mets from prostate cancer.

you have to find out if your prostate cancer is hormone refractory or not

that means if it is sensitive to hormone ablation taking away testosterone with lupron or zoladex.

if your PSA and cancer are progressing even though your testosterone levels are very low, there are second line anti-androgens you can use such as xanti or zytiga which can help lower your PSA and slow down the growth

also taxotere chemotherapy has been shown to improve survival if your prostate cancer is hormone refractory.

also provenge can be used, but is expensive, not sure if available in europe.

let me know if you have other questions.

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