Understanding The Transformation of “Non Aggressive” Prostate Cancer Into The 2nd Leading Cancer Causing Death in Males!

Hi guys,

In the not so far past, prostate cancer treatments had few options to extends ones life not much farther than 3 to 5 years once Metastatic. Today the new breakthroughs like Provenge, Zytiga,(abiraterone),  Xtandi, (enzalutamide),  Radium223, cabazitaxel and upcoming TOK-001 have provided us a much larger tool box to fight this cancer.

I have seen many men, (including myself) who has made in excess of 10 years with metastatic PCa by going “‘TORA- TORA- TORA” , (ATTACK-ATTACK-ATTACK”) on PCa cells. This is  thanks to our ability now to understand and attack the various pathways that fuel and block PCa cell reproduction.  We have learned a consolidation/maintenance strategy (as in acute leukemia) that will control minimal residual disease and prolong PCa remission (i.e., by keep the remaining cancer stem cells dormant).

So what makes a very slow growing cancer like PCa turn into a monster that becomes the second leading cancer causing morbidity in males?  After many years of Hormone blockage by desensitizing the GnRH receptors, it indirectly downregulates the secretion of gonadotropins luteinizing hormone (LH) and follicle-stimulating hormone (FSH), leading to hypogonadism and thus a dramatic reduction in estradiol and testosterone levels.  This works well for normally a handful of years thus reducing ones PSA and arresting the growth of PCa cells.  A few PCa cells have the ability live through the bombardment of fuel deprivation and AR blockage tend to morph or transform into a much more dangerous form of PCa cancer called : a small cell, neuroendocrine, or ductal/endometrioid carcinoma.  Unlike “standard” prostate adenocarcinoma, small cell tends to metastasize to “unusual” places – we are seeing much more of this since the advent of using abiraterone and/or enzalutamide –patients with liver, lung, and brain mets are becoming more common…. almost always with small cell characteristics. The reason is somewhat obvious: the adeno type is driven by T receptors, so if you are able to clamp down on those more, the cells that don’t respond to T-attack slowly become predominant.  Soon to follow is CRPCa, (Castrate Resistant PCa) that allows none of the new breakthrough drugs to react by reduce ones PSa or arresting PCa growth!

I hope this helps your understanding of the progression of prostate cancer and the mechanisms that drive this horrible disease.  It took (9) years for me to grasp how PCa can go along for several years, semi arrested and then blow up into an uncontrollable monster!  I know many men who once found their rising PSA, attacked it by a Radical Prostatectomy or other corrective means and have become totally PCa free! The key to survival is catching it early brfore the PCa cells go “CTCs”,  (Circulating Tumor Cells) and release their cells into ones blood stream.

Bottm line……….. Get your PSA checkups starting at age 40, be aggressive fighting PCa,  learn what new breakthrough drugs work for you and most of all keep HOPE in you back pocket!  Much thanks to Dr. Glode,  Division of Medical Oncology, University of Colorado Hospital and Shi-Ming Tu MD. Professor, Department of GU Medical Oncology @ UT MD Anderson Cancer Center for their words of wisdom.

I believe that we, in part, make our own destiny by our mind set.  Nobody succeeds in extending life by simply listening to the doctor and holding his breath.  We have to be proactive…be responsible for our self…become your own medical detective.

Craig Becker

The New Denver Men’s Club

Blog: https://newdenvermensclub.wordpress.com/
“Men Fighting Cancer To Win”

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9 thoughts on “Understanding The Transformation of “Non Aggressive” Prostate Cancer Into The 2nd Leading Cancer Causing Death in Males!

  1. Craig How are you doing?? I have missed talking to you and Suzanne at the spt meetings. I really appreciate your information bulletins and especially the caring you have for those of us around you. Know that you hold a special place in my heart and that my prayers are with you God bless Ron McGough

    Sent from my iPhone

    • Hi Dave, As you know I’m not a doctor, were just in the same boat. I do know of a man that had a Gleason of (9). After his RP and radiation, he’s been free of PCa. The key is to catch the cancer as early as possible before going CTC’s. Thanks for your comment. Craig

  2. Craig, Great report, I impressed with your knowledge of our disease.
    Another drug in the not to distant pipeline is ARN-509.
    Dan Jory

    • Hi Dan,
      Thanks for your comments on my blog considering you were one of my 1st mentors for learning PCa. I did miss ARN-509 as a new upcoming possible breakthrough for PCa. I’ll cover this next blog. I know the PCa community is high on ARN-509. Craig

  3. Very nice summary. Thanks for taking the time to bring this down to lay terms. I am 5 years into Lupron therapy and so much has happened and changed in those 5 years that it does give one hope for buying some time while the great research teams at places like CU do their work.

    • Hang in there Bob. With all the new breakthroughs and all the new ones in the pipeline, You will have many more years to fight your disease. Keep up a good fight! Craig

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