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Trials - Prostate cancer and Metastatis - Metastasis

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User

Posted 18 Nov 2015 at 13:25

Hi,

My father is his his 70's and had radiotherapy around 5 years ago, but unfortunately is appears that this has more recently led to metastatic cancer. Trying to obtain information regarding treatment from him and my mother is somewhat difficult, my sibling and I have both tried to obtain information, and I cannot go into it too much, but there seems to be, understandably, an element of denial, fear of the unknown, complete trust of those he is under (again a good thing) and the want to protect of my sibling and I (despite our ages).

He has been accepted on a trial. To date he has had injections of pellets close to his belly button, other injections (vague, apologies) and will shortly be given patches which I understand the body will absorb women's hormones. He was unsure in reagrd the the reason for the pellets, but looking at some internet sites, these seem to be radioactive.

We have 2 children (15 and 10) and some sites suggest that they are to be kept away from those injected, however the sites I have seen this information on have been in the US. Does anyone know if we need to take similar precautions? If so, for how long for and any other guideance would be appreciated. I would ask my father again but do not wish to distress him or my mother.

Thanks in advance

User

Posted 18 Nov 2015 at 15:44

Hello RB1 and welcome.

I'm sure that if there was a necessity to keep your children away the hospital would have told him and he certainly wouldn't want to risk their health.

I wouldn't be able to comment on metastatic disease but there are a number of people on here with that experience and knowledge and I know that somebody will be along to advise you.

Old as you and your sibling are,you are still their children and they will want to protect you from this for as long as possible, in much the same way you would with your own children.

Anyway, hang in there and wait for advice

Sandra

Edited by member 18 Nov 2015 at 15:45 | Reason: Not specified

We can't control the winds - but we can adjust our sails

User

Posted 18 Nov 2015 at 16:11

Hi RBI,

Understand this might be difficult for you but it could help if you were able to post the name(s) of all your dad is being treated with and the name of the trial. Injections which lodge a pellet in the stomach could be 'Zoladex' but this is often given before, during and quite often following RT so is not new. These injections are given either every 28 days or 12 weeks if it is Zoladex. It is more likely that it is the addition of the patches and maybe any other injections to which you refer, that could be being studied.

The purpose of a trial is to ascertain whether what is being trialed gives a better outcome than standard treatment. Sometimes this becomes apparent quite early on and is then adopted for regular use. In other cases the benefits can take a long time to establish. Some trials include other arms, one of which may be a placebo. The good thing for the patient is that he is more closely monitored than would normally be the case but is able to withdraw from the trial at any point if he so wishes.

Barry

User

Posted 18 Nov 2015 at 19:18

Thank you Sandra, you reply is much appreciated

User

Posted 18 Nov 2015 at 19:42

Thanks for your quick and informative reply Barry.

I will see if I can obtain the name, but my Dad did mention it would last for 12 weeks so Zoladex seems to fit the bill. After this injection he has tablets for 2 weeks, then a meeting with the hospital after which he hopes he will then have the patches (or hormone injections). Would I be right in thinking the tablets contain female hormones?

Do you know the timetable of events after this? I appreciate by the nature of the trial it is likely to be very flexible, but would I be right in thinking that a further injection would be likely, if, when monitored, there are no reasons identified to discontinue?

Also, are there limits as to how many Zoladex injections could be given in a certain period of time?

I agree in regard to your monitoring and flexibility comments, that had crossed my mind too.

Once again thank you for your help.

User

Posted 18 Nov 2015 at 21:46

RB1,

Sorry that without a name I am unable to tell you what the tablets are and what they are designed to do. I do know that tablets that are sometimes given with Zoladex - if indeed this is the injected pellet - are often Bicalutamide or Cyproterone acetate (sometimes called Cyprostat) - usually given early on to compliment it. The objective of these drugs is to reduce the testosterone to castrate level, often referred to as chemical castration, as this deprives the cancer of the testosterone it needs to grow. The injected Zoladex pellet is replaced with another at 28 days or 12 weeks and in some cases continues for a number of years if necessary, until it is felt that the patient can take a temporary holiday from it or be taken off it. However, after varying times men eventually tend to become what is termed hormone refractory, that means the cancer gets round the chemically caused deprivation of testosterone. Often a different form of HT is switched to or given to supplement Zoladex as it loses effectiveness. Well that is what is usually the case but we don't know what is being given here or the trial protocols which would be trying another way(s) of dealing with the cancer. The HT can also help shrink the cancer whilst it works well.

There are at least 27 types of prostate cancer and the responses of men to various drugs can vary very much. Your dad will be monitored to ascertain how well he is doing with what he is being given on the trial, the length of which we don't know also. Should he respond poorly, I would expect that he might be removed from the trial and other treatment given.

Let's hope it goes well for him and do try to give as much histology and information as you can obtain.

Edited by member 18 Nov 2015 at 21:53 | Reason: Not specified

Barry

User

Posted 18 Nov 2015 at 21:51

I think you have googled and maybe got the wrong end of the stick. It is unlikely that he is being given the radioactive seeds as his cancer is too advanced so there will be no risk to your children. The hormone treatment is not injecting female hormones, the injections stop the production of testosterone which starves the cancer. The tablets disguise whatever testosterone remains so that the cancer can't find it.

In your dad's case, he will probably stay on hormone treatment for as long as it works. Some men can stay well on HT for years this way - sadly, others find that the HT only lasts a few months or doesn't work at all. Then they have to hope that alternatives such as chemo will slow the progression.

He won't be only having the one injection - unless it clearly isn't working.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 18 Nov 2015 at 22:50

Thanks Barry, I appreciate the information, I wasn't aware there were so many versions of prostate cancer, and indeed combinations of treatments. I will see if I can get more information which will hopefully bring more clarification.

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