Had an interesting conversation with my MO at Memorial Sloan-Kettering this morning. Using an archaic Navy term, I brought up scuttlebutt on the web about the new generation of GLP-1 receptor agonists and treatment for cancer. I brought up exendin-4 and PCa. I asked if MSK was doing any work along these lines. His response surprised me. He said that so many people were now using GLP-1s, it would be very difficult to design a gold standard controlled study, because there were so few likely candidates who were not already on GLP-1s. I am not on a GLP-1, but my wife is and has experienced a number of benefits. I am fortunate — great blood work and no known health issues other than PCa. Ok, that is a big no other. Just wondering about GLP-1s, when I get to the clutching at straws stage. Best regards to all on this summer weekend… Bill
Age 80. Gleason 8
Surgery ‘09
Move case to MSK ‘11
SRT + ADT ‘11-12
Undetected 3 yrs.
Jan '15 PSA .06
Jan '21 PSA 19.58 T 503.
Jan '21 ADT Nadir .16.
July '22 PET F-18; one met near rectum
Sept ‘22 SBRT.
Jan ‘23 PSA 11.4
Feb ‘23 PET Gallium. Clean.
April ‘23. PSA 18.6. New round ADT
Nov ‘23 PSA .19. Pause
June ‘24 PSA 10.3. PET Gallium clean. Begin XTANDI mono.
March ‘25 PSA .68 T70
I am overweight according to BMI and have been taking low-dose Zepbound for several months. I decided to start this GLP-1/GIP combination drug as much for its heart benefits as for the weight loss
Reduced rates of of cardiovascular events
Anti inflammatory effects
Reduced oxidative stress
Improved endothelial function
Improved blood pressure
Improved cardiac function and structure
Reduced buildup of plaque
Reduced rates of of cardiovascular events
Anti inflammatory effects
Reduced oxidative stress
Improved endothelial function
Improved blood pressure
Improved cardiac function and structure
Reduced buildup of plaque
Tim, did you get approved based on BMI alone? I didn't know that was possible, and in fact, a cardiologist I met with who is a metabolic specialist said I would not get approved.
I am not a doctor, just a guy without a prostate
Dx Age 64 Nov 2014, PSA 4.3
BX 3 of 12 cores positive original pathology G6
RALP Jan 6, 2015
Post surgical pathology G7 (3+4), - ECE, - Margins, -LN, -SV
PSA @ 6 weeks 2/15, <02, remained <0.02 until 1/2017, .02, repeat 2/2017, still .02. 5/2017-.033, 8/August 2017- .033 8/17 .046, 3/2018 .060. 6/2018 .068, July 2018 - .08, 8/ 2018, .078, Start ADT+SRT.
Sept 2018 thru May 2022 –PSA = <.05
Decipher test, low risk, .37 score
My story.... tinyurl.com/45w7789x
Every day’s a bonus – Sonny3
I am not a doctor, just a guy without a prostate
Dx Age 64 Nov 2014, PSA 4.3
BX 3 of 12 cores positive original pathology G6
RALP Jan 6, 2015
Post surgical pathology G7 (3+4), - ECE, - Margins, -LN, -SV
PSA @ 6 weeks 2/15, <02, remained <0.02 until 1/2017, .02, repeat 2/2017, still .02. 5/2017-.033, 8/August 2017- .033 8/17 .046, 3/2018 .060. 6/2018 .068, July 2018 - .08, 8/ 2018, .078, Start ADT+SRT.
Sept 2018 thru May 2022 –PSA = <.05
Decipher test, low risk, .37 score
My story.... tinyurl.com/45w7789x
Every day’s a bonus – Sonny3
No, I'm paying for Zepbound out of pocket through Lilly Direct--$ 500 monthly for 5 mg dose. Weight loss is slow and steady with no side effects. Food noise and appetite are slightly diminished. With a high Lp(a) and its associated increase in cardiovascular event risk, I'll accept all the drug-based help I can get. LDL is around 40.
Yes. I've heard these drugs are good for everything under the sun. If I remember correctly, folks are tending towards less smoking, drinking/substance use, better mental health, etc. while using these meds. If these things are true, is it due to a better self image (psychology) from losing weight, or does this class of meds really affect all these biological pathways, or both?
Part I 2015, Age 54. Age now 65
PSA: 20.8 Bx: All cores G7 (4+3)
RALP & Adjuvant RT
Pathology: G8 (4+4)+5
PSA nadir: 0.1, steady increase
Part II 2019
Lupron/Xtandi, PSA: <0.01
2021: Reclast
2023: Prolia
Part I 2015, Age 54. Age now 65
PSA: 20.8 Bx: All cores G7 (4+3)
RALP & Adjuvant RT
Pathology: G8 (4+4)+5
PSA nadir: 0.1, steady increase
Part II 2019
Lupron/Xtandi, PSA: <0.01
2021: Reclast
2023: Prolia
Mattam, Several docs have used decidedly un doc words like “great drug” in my wife’s office visits. My wife has had several benefits, weight loss, better, actually excellent blood panels, feels better. Definitely eats less. She still, however, does not agree with all my opinions… Bill
Age 80. Gleason 8
Surgery ‘09
Move case to MSK ‘11
SRT + ADT ‘11-12
Undetected 3 yrs.
Jan '15 PSA .06
Jan '21 PSA 19.58 T 503.
Jan '21 ADT Nadir .16.
July '22 PET F-18; one met near rectum
Sept ‘22 SBRT.
Jan ‘23 PSA 11.4
Feb ‘23 PET Gallium. Clean.
April ‘23. PSA 18.6. New round ADT
Nov ‘23 PSA .19. Pause
June ‘24 PSA 10.3. PET Gallium clean. Begin XTANDI mono.
March ‘25 PSA .68 T70
Age 80. Gleason 8
Surgery ‘09
Move case to MSK ‘11
SRT + ADT ‘11-12
Undetected 3 yrs.
Jan '15 PSA .06
Jan '21 PSA 19.58 T 503.
Jan '21 ADT Nadir .16.
July '22 PET F-18; one met near rectum
Sept ‘22 SBRT.
Jan ‘23 PSA 11.4
Feb ‘23 PET Gallium. Clean.
April ‘23. PSA 18.6. New round ADT
Nov ‘23 PSA .19. Pause
June ‘24 PSA 10.3. PET Gallium clean. Begin XTANDI mono.
March ‘25 PSA .68 T70
A good question: Are the beneficial side effects of GLP-1/GIP drugs occurring independent of the weight loss or because of them?
I read an interesting book about these new wonder drugs by former head of the FDA, David Kessler—“Diet, Dopamine and Drugs”. There are some claims that these drugs, while quieting food noise, specifically reduce cravings for junk food and ultra processed foods. Food manufacturers and restaurants are already jumping on the bandwagon to profit from this trend. Once prices come down and pills are readily available they’ll be prescribed as commonly as antidepressants are now.
I read an interesting book about these new wonder drugs by former head of the FDA, David Kessler—“Diet, Dopamine and Drugs”. There are some claims that these drugs, while quieting food noise, specifically reduce cravings for junk food and ultra processed foods. Food manufacturers and restaurants are already jumping on the bandwagon to profit from this trend. Once prices come down and pills are readily available they’ll be prescribed as commonly as antidepressants are now.
Atorvastatin (Lipitor) has so many benefits that my BLueCross 'gives' it for free to suitable patients. Perhaps one or more of the GLP-1 drugs will end up in that category.
DOB 1940
Dec 2012: GP felt a nodule and hardened prostate; confirmed by urologist
PSA: 11.9 ng/ml
Biopsy (3/1/2013): Several Gleason 4+5 loci (prostate=45 ml)
Stage: T2c
Transferred to RO
Casodex 1 month; then Lupron 5/13 through 12/14 (18 months total)
Jul-Sep 2013: SBRT (CyberKnife; 3 x 6.5 Gy) followed by IMRT (25 x 1.8 Gy)
Lowest PSA thereafter: 0.1 (3/20/15)
Latest (10/24) PSA = 0.93 ng/ml
DOB 1940
Dec 2012: GP felt a nodule and hardened prostate; confirmed by urologist
PSA: 11.9 ng/ml
Biopsy (3/1/2013): Several Gleason 4+5 loci (prostate=45 ml)
Stage: T2c
Transferred to RO
Casodex 1 month; then Lupron 5/13 through 12/14 (18 months total)
Jul-Sep 2013: SBRT (CyberKnife; 3 x 6.5 Gy) followed by IMRT (25 x 1.8 Gy)
Lowest PSA thereafter: 0.1 (3/20/15)
Latest (10/24) PSA = 0.93 ng/ml
Sr Sailor said...
Atorvastatin (Lipitor) has so many benefits that my BLueCross 'gives' it for free to suitable patients. Perhaps one or more of the GLP-1 drugs will end up in that category.
I started a statin last year much to my chagrin, and as I researched statins to find a good reason to stop taking it I was shocked to read that there is compelling evidence that statins seem to be beneficial for men at a certain juncture on their PCa journey. That being where I am right now: post primary treatment recurrence (I think have that right -- damned ADT brain).
Knowing this, I have no issue with taking my daily statin.
Part I 2015, Age 54. Age now 65
PSA: 20.8 Bx: All cores G7 (4+3)
RALP & Adjuvant RT
Pathology: G8 (4+4)+5
PSA nadir: 0.1, steady increase
Part II 2019
Lupron/Xtandi, PSA: <0.01
2021: Reclast
2023: Prolia
Post Edited (mattam) : 8/10/2025 7:42:43 PM (GMT-4)
Tim G said...
No, I'm paying for Zepbound out of pocket through Lilly Direct--$ 500 monthly for 5 mg dose. Weight loss is slow and steady with no side effects. Food noise and appetite are slightly diminished. With a high Lp(a) and its associated increase in cardiovascular event risk, I'll accept all the drug-based help I can get. LDL is around 40.
Thanks Tim.
I am not a doctor, just a guy without a prostate
Dx Age 64 Nov 2014, PSA 4.3
BX 3 of 12 cores positive original pathology G6
RALP Jan 6, 2015
Post surgical pathology G7 (3+4), - ECE, - Margins, -LN, -SV
PSA @ 6 weeks 2/15, <02, remained <0.02 until 1/2017, .02, repeat 2/2017, still .02. 5/2017-.033, 8/August 2017- .033 8/17 .046, 3/2018 .060. 6/2018 .068, July 2018 - .08, 8/ 2018, .078, Start ADT+SRT.
Sept 2018 thru May 2022 –PSA = <.05
Decipher test, low risk, .37 score
My story.... tinyurl.com/45w7789x
Every day’s a bonus – Sonny3
I had RALP surgery in 2013 and am grateful that I have had ultra low PSA tests since then. I have been bothered by stress incontinence ever since. Some days not so bad and other days the pad I wore was pretty full. My BMI was up around 29, my Hemoglobin A1C was pre diabetic at 6.1 and I had coronary bypass surgery in 2021. BTW, I'm 75.
My cardiologist and I discussed going on a GLP-1 so in January 2025 I started Mounjaro. My starting weight was 194 lbs and now (October 2025) I'm 150 lbs and feel great. The reason I relate all of this is that my stress incontinence is basically gone! I still wear a pad but at the end of the day it's basically dry. Sometimes problems are solved in the most unexpected ways.
Age at dx: 63. Initial PSA 3.9 Biopsy 10/16/13 5/12 cores, 2 cores 3+3 50%, 1 core 3+4 20%, 1 core 3+4 5%, 1 core 3+3 10%, T1c
RALP 11/26/13. Post op staging t2c, N0, Single focal point on right margin. Final Gleason 7 (3+4). Tumor volume 5% right side and 10% left side. Post op PSA 1/8/14 <.1, 3/12/14 <.1, 6/11/14 <.1, 9/10/14 <.1, 12/3/14 <.007, 12/21/16 <.007, 6/7/17 ,.007
My cardiologist and I discussed going on a GLP-1 so in January 2025 I started Mounjaro. My starting weight was 194 lbs and now (October 2025) I'm 150 lbs and feel great. The reason I relate all of this is that my stress incontinence is basically gone! I still wear a pad but at the end of the day it's basically dry. Sometimes problems are solved in the most unexpected ways.
Age at dx: 63. Initial PSA 3.9 Biopsy 10/16/13 5/12 cores, 2 cores 3+3 50%, 1 core 3+4 20%, 1 core 3+4 5%, 1 core 3+3 10%, T1c
RALP 11/26/13. Post op staging t2c, N0, Single focal point on right margin. Final Gleason 7 (3+4). Tumor volume 5% right side and 10% left side. Post op PSA 1/8/14 <.1, 3/12/14 <.1, 6/11/14 <.1, 9/10/14 <.1, 12/3/14 <.007, 12/21/16 <.007, 6/7/17 ,.007
I've been on victoza and Ozampic for a couple of years and have lost around 70 pounds and dropped A1c two points.
I have to say that the weight just came off with no real effort.
I'm a fan for sure
Glen
PCa history by memory.
Biopsy was around 2019 G6 in 6 cores no second opinion OncotypeD X listed as very low risk
Second biopsy showed increase but all still G6 but second However second opinion at John's Hopkin's showed one of the now 8 positive as G7
One core was 50% one core was 25% the rest low
Started radiation but 4th caused retention to paraphimosis
Settled on SBRT Sept 2021
I have to say that the weight just came off with no real effort.
I'm a fan for sure
Glen
PCa history by memory.
Biopsy was around 2019 G6 in 6 cores no second opinion OncotypeD X listed as very low risk
Second biopsy showed increase but all still G6 but second However second opinion at John's Hopkin's showed one of the now 8 positive as G7
One core was 50% one core was 25% the rest low
Started radiation but 4th caused retention to paraphimosis
Settled on SBRT Sept 2021
Keeping some strength work going alongside the loss changes what you keep and what you lose, and it is the easiest thing to drop when you are tired. Has that been part of your plan?