Sorry it's been a while since I've updated this. I've been trying to be healthy and live my life. I have had a number of significant developments, mostly positive this time.
For starters, the bone biopsy that was done on the single spot (sacrum) that was suspected to be a metastasis was negative. Assuming the bone biopsy did not miss that is a BIG deal and suddenly gives me a lot more hope. Also the pain I had been having in the sacrum area in September seems to have vanished. We are now wondering if the "hostpot" could be from a bike crash I had back in August 2016. I didn't break anything in the incident but it was a very hard fall and I had terrible bruising near the sacrum area.
Then I got the results back from genetic testing and I was confirmed to have an inherited BRCA2 mutation. That is something that nobody wants but having that knowledge is a good thing and can be a possible treatment advantage. It could also be related to why my father died of prostate cancer at a younger than normal age. One of the genetic cancer tests I took was by Color Genomics ( https://www.color.com ). My experience with them has been quite good and anyone can take that test.
Because the biopsy was negative and the BRCA2 was positive, my treatment plan changed. The situation now was I no longer had any definitive evidence of spread but because I was Gleason 9 with perineural invasion, I would be treated as if curable but very suspicious for a spread.
University of Washington had a trial where I would go on a PARP inhibitor (Olaparib aka Lynparza) for 90 days and then on day 90 have a prostatectomy. The Olaparib is very, very expensive and not FDA approved for prostate cancer yet. It is FDA approved for ovarian cancer though and prostate cancer trials have been showing a lot of success with BRCA mutation folks. The Olaparib in theory should have less side effects than normal chemotherapy because it tries to target the BRCA defect healthy cells don't have.
Since I was suspicious for a spread, I opted to do this trial. It seemed like a good opportunity. My thinking was that this could be a good alternative to chemotherapy or hormone therapy. There was a part of me that was thinking why not go to prostatectomy right away.
Well now it has been thirty days on the Olaparib. My PSA at day 1 of the trial was 11.58. Now on day 30 my PSA was 13.47. I'm not too happy with that. I thought it would go down but the oncologist I am working with seemed to downplay this increase as a small one. I'm not sure if how much, if at all, he is biased to complete trials though. My surgery is scheduled for Feb 25th but I am now debating if I should try to move it up. If anyone has any thoughts on this latest decision, I would love to hear it.
49 yrs old
PCa DX 9/17/18 at 48 yrs old, 5 cores cancerous, 2 are Gleason 9. Perineural invasion identified.
Tested positive for BRCA2 mutation.
1 hotspot on bone scan but negative on bone biopsy. Still suspicious for spread.
PSA History: 7-20-16: 3.28 | 7-11-18: 8.4 | 9-5-18: 10.1 | 11-20-18: 11.22 | 12-28-18: 13.0
Father died of PCa at 61
Post Edited (bobmars) : 1/6/2019 10:58:43 AM (GMT-7)