Small Cell Prostate Cancer

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MichaelP - 20 Jan 2006 23:26 GMT

Does anyone have knowledge or experience with this type of prostate cancer?
Was diagnosed in early October and am getting chemotherapy only - Carboplatin
and Etoposide. Main side effect is hair loss. Had lots of problems with
pelvic pain, rectal spasms and urinary difficulty before the chemo started,
but the chemo has taken these problems away.

Have had 4 cycles of chemo and expect to have a CT scan in about 10 days and
then at least two more cycles of chemo. Oncologist now says that the chemo
is only to hold back the cancer, but that eventually the cancer will
probably overcome the chemo.

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jhhtexas@ieee.org - 20 Jan 2006 23:32 GMT

Did you get one or more PSA readings and a Gleason score as part of
your diagnosis?

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MichaelP - 20 Jan 2006 23:42 GMT

>Did you get one or more PSA readings and a Gleason score as part of
>your diagnosis?

Yes, the PSA was 8.2 and the Gleason score was 5.5

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ron - 21 Jan 2006 01:04 GMT

Michael...Small cell PCa has little in common with the more typical
prostatic adenocarcinoma. It is fairly rare, generally aggressive,
metastasizes to the brain rather than bone and is generally treated
like other (lung) small cell cancers. The chemo regimen you are on is
one often used with small cell cancers. Small cell clinical studies
are examining the following chemo options, you might want to discuss
these with your oncologist.
ACE (Adriamycin, carboplatin, etoposide)
CODE (cisplatin, vincristine, doxorubicin, and etoposide)
VICE (Vincristine, Ifosfamide, carboplatin, etoposide)
Also there are drugs available to lessen the side effects of the chemo
you are on...Best wishes and good health, Ron

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J - 21 Jan 2006 02:19 GMT

> Michael...Small cell PCa has little in common with the more typical
> prostatic adenocarcinoma. It is fairly rare, generally aggressive,
[quoted text clipped - 8 lines]
> Also there are drugs available to lessen the side effects of the chemo
> you are on...Best wishes and good health, Ron

That seems to neuroendocrine.
You've two other posters here - the fella from Pakistan who'se father
passed away and one that I referred here from alt.support.cancer, some
time ago.
This Adobe acobat seems to be fairly recent
http://www.cancer-therapy.org/volume3_2005/42_Daneshmand/42._Daneshmand.pdf

Whereas mixed small cell carcinomas and adenocarcinomas usually are
aggressive recurrences of a
primary adenocarcinoma, pure small cell carcinoma of the prostate often is
associated with early metastatic disease because of its aggressive nature.

Like adenocarcinomas, small cell prostate cancers arise in the periphery
of the prostate gland and hence can occur without urinary symptoms. The
disease has a propensity to metastasize to visceral organs, including the
liver, bone, lungs, central nervous system, and pericardium, and
regionally to the
pelvic lymph nodes, rectum, and bladder. In addition, small cell prostate
cancers have been reported to produce paraneoplastic syndromes associated
with the production of adrenocorticotrophic and antidiuretic hormones.

Despite treatment with chemotherapy, the prognosis of small cell prostate
cancer is extremely poor, and the
median survival is 7 months (Rubenstein et al, 1997). Because of the
rarity of the condition, no standard
therapeutic regime has been developed. Small cell carcinomas of the
prostate are generally unresponsive to
hormone therapy. Reported cases have generally been managed by
chemotherapeutic regimens similar to those recommended for small cell lung
cancer. Small case reports have shown poor responses to etoposide and
cisplatin or cyclophosphamide (Debras et al, 1994; Steineck et al,
2002)./quoted text/

So indeed it seems more like SCLC (small cell lung cancer) in its
progression and prognosis.
We have one patient who is 2 years out from his limited stage lung cancer.
he had more radiation than chemotherapy. He had whole brain RT and then
IMRT for another lesion in his brain.

If I recall correctly, one lady had prophylactic brain RT. (preventative).

There are others on newsgroup, who have not responded to chemotherapy and
had awful times with side effects and whole oncologists have decided it
would do more harm than good to continue. (mostly females).

He may wish to come over (to alt.support.cancer) and ask questions of
Steph about RT and small cell prostate cancer. Perhaps even stay with us.

J

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