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Husband diagnosed today with bone mets

User
Posted 17 Oct 2022 at 21:37

Today we received the confirmation. It's in his spine, ribs, hips.

So numb and terrified. We have two small children.

 

Trying to read up as much as possible.

I'm reading about triplet therapy. Is this available in the UK?

User
Posted 17 Oct 2022 at 22:09

Sorry you are here.

I just looked up triplet therapy. I have not heard it called that in the UK. But the short answer is yes it is available, but is it appropriate?

In short triplet seems to mean, standard ADT, chemo, and enzalutamide. All given at once.

All of these are sensible treatments for metastatic PCa. Giving them all at the same time on first diagnosis is rare, the usual approach would be ADT first for a number of years, and then when this starts to fail, add on one of the other two, and when that fails, add on the other treatment.

Giving all three at once would probably shorten the overall effectiveness. You would basically be teaching the cancer how to survive against enzalutemide long before the cancer needed to see that drug, and when the ADT was doing a fine job.

It would be very surprising if OH did not survive at least five years, though sadly we have had a few die within two years recently. It would not be impossible for OH to still be here in 15 years. By which time other treatments may exist.

 

Dave

User
Posted 17 Oct 2022 at 22:18

Are any of those hormonal therapies?

User
Posted 17 Oct 2022 at 22:20

I have had some bad experiences of receiving care in the NHS and am hoping and praying that he gets good care and treatment.

User
Posted 17 Oct 2022 at 22:31
Yes it is possible in the UK on the NHS although some NHS trusts will only offer it as part of a trial. The thinking is that if you hit the cancer hard and fast at the start, the treatment will be more effective for longer. The downside is the potential impact on quality of life. Talk to the onco about it and if they are reluctant, ask for a referral to another hospital (perhaps one of the leading cancer centres) for a second opinion.

Also, if you had hoped to have more children, ask about sperm freezing before he starts treatment.

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

User
Posted 17 Oct 2022 at 22:45

Originally Posted by: Online Community Member
Giving all three at once would probably shorten the overall effectiveness. You would basically be teaching the cancer how to survive against enzalutemide long before the cancer needed to see that drug, and when the ADT was doing a fine job.

It's the opposite - giving all together at once increases the overall effectiveness.

User
Posted 18 Oct 2022 at 00:06

Thanks Andy, I'm always learning.

Dave

User
Posted 31 Oct 2022 at 21:32

That’s really interesting, OH has oncologist appt this week. Now added on to the ever growing list of questions. 

 
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