Okay Dr. Scholz. This is my favorite question to ask every prostate cancer expert I've talked
about because working in this field, we see a lot of fear. The word cancer is so scary.
We see a lot of really great situations when they find out maybe they think they have the
really scary type of prostate cancer and they have Gleason 6, or they have really advanced
cancer but they also have seen really great responses and those are my favorite stories.
So, can you share a story or two about people who you've seen have advanced prostate cancer
and it definitely wasn't the end?
Sure. Just the field of prostate cancer, in general, of course, is like a vacation for
your average medical oncologist. I was originally trained for the treatment of lung cancers,
pancreas cancers, bone cancers, and these terrible diseases can be fatal very rapidly,
and prostate cancer is like a holiday because the 5-year survival rate of all prostate cancers,
including the advanced ones, is 99%. So, the issue of impending mortality is greatly reduced
and in most cases altogether eliminated. To answer your question, the patients that I've
seen—or saw—early in my career, when we had relatively few treatment options (Lupron,
some bad types of chemo that we don't even use anymore) I have seen several patients
who came in with all the scary issues such as a high PSA over 100, bone scans with multiple
spots (we're talking about old-time bone scans that you had to have a big spot on the bones
to detect the metastatic disease), and back in that era patients were routinely advised
that, you know, get ready. You're going to die. This is absolutely going to become resistant
to hormone therapy and lead to early demise. But, patients, and I have a number of them
to this day, who presented in that fashion more than 20 years ago (high PSAs and metastatic
bone disease), a number of them went into complete remissions just with Lupron. That's
just with testosterone deprivation, PSA levels dropped to undetectable levels (that is, less
than .1), and with continuous therapy have remained at that level now for over two decades.
That was unexpected. Bob Each who was a Helpline counselor was one such individual. I can think
of a few others; I won't name their names, in my practice, that I've gotten to know very
well because they've been seeing me for 20 years and they continue to get Lupron injections
and their PSAs are undetectable. Another famous patient who has been more public is Michael
Milken who runs the PCF. He presented, I think almost two decades now, with known metastatic
disease in his pelvic lymph nodes. I don't know all the details of his case, but they—his
PSA also has been undetectable on Lupron for that extended period of time. So, here we
have examples of metastatic disease controlled indefinitely with Lupron. So, the old adage
that sooner or later everyone becomes hormone resistant is simply not true, and of course
now, with the discovery of these new second-generation hormonal agents like Zytiga, Xtandi, darolutamide,
Erleada, the patients get a second chance at going into a complete remission with these
more powerful hormonal agents. I would say those responses to hormone treatment have
been the most common form of miraculous remissions that I've seen in my career and, of course,
that's why the researchers are still trying to build off that technology and refine it
further and look for the ways to control those rare patients that somehow figure out how
to sneak around the Lupron and around the second generation of hormonal agents. I'm
hopeful that those discoveries are in the offing.
Thanks for sharing. I think one of the things, you know, you mentioned the 99% of, you know,
all prostate cancer and advanced cases that 99% survival rate. We get a lot of questions
where that comes from, so I just wanted to mention you can check out the link in the
description below this video. It's actually from the American Cancer Society, and they
do huge studies. I think even the SEER data, and you can look that up and see for yourself.
So, we appreciate your time. Thank you so much for watching us today and if you need
any information, any help whatsoever, we're here for you. You can visit PCRI.ORG and get
in contact with us.
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