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About the Prostate Cancer Lab PATIENTS

“Searching for an integrated short list of options in a treatment strategy I can bring to a conversation with my oncologist.”

These advanced prostate cancer patients have committed to go through a battery of tests to gather data about their disease, feed that into treatment matching services to identify treatment options, and engage in an open, public conversation with a diverse crowd of experts to guide them to their best treatment strategy. If you would like to join them, please contact Brian McCloskey, brian.j.mccloskey [at] gmail dot com

Brian McCloskey
Brian McCloskey
Brian McCloskey is a 56-year-old San Diego-based healthcare and tech. marketing executive, a husband and father of 3, a surfer, and a patient advocate. Professionally, Brian has spent 25 years building data-driven solutions to personalize consumer experiences. That background became pivotal in how he approached his cancer diagnosis in Aug. 2016. Quickly understanding how important his role as patient was in optimizing his treatment, Brian got involved in many efforts to advance the care of cancer patients. His first initiative was the development of a personalized medicine blue-sky concept, The Olson Cell (links to a Google Slide file), which he presented at the 2018 UCSD Health Industry/Academia Translational Oncology Symposium. That effort opened the door to a diverse cancer-fighting community that has helped him throughout his journey. Since then, he has worked closely with genomics companies to better understand his disease, advised companies on patient experience design for new applications that address complex cancer needs, and most recently initiated a project with a Boston-based company to identify FDA-approved drugs that can be repurposed to treat prostate cancer patients, A New AI Tool Identifies Generic Drugs with Anticancer Potential. Also, Brian provides patient advisory and motivational speeches to industry and academia such as at the 16th Annual Meeting for the National Alliance of State Prostate Cancer Coalitions. Here’s more on Brian’s cancer journey from UCSD Health, Mission: Search and Destroy Prostate Cancer, the December, 2021 issue of Prostatepedia, and a summary for this hackathon, Cancer Hackathon 2021-Brian McCloskey Summary.
    • Aggressive Disease: Despite five years and eight rounds of treatment for his prostate cancer, Brian still has therapeutic options that fall within the Standard of Care. However, Brian’s cancer is particularly aggressive and while his biomarkers were improving after chemotherapy this year, he is now seeing them regress.** Last PSA jumped 50% from prior reading (6 weeks earlier)

      ** In 2020, Brian’s condition changed from No Evidence of Disease state to the development of 6 lesions in his peritoneal cavity within 6 months.

       

    • Complex Cancer** Poor Prognosis: Brian is a polymetastatic cancer patient. With a history of multiple lesions that develop quickly, his prognosis is poor. 

      ** Breakthroughs Require Time: Complex cancers require N of 1 solutions. Healthcare approaches are not designed for N of 1 cases – They require deep insight and that necessitates time – a commodity healthcare systems don’t have. Brian wants a disruptive and safe approach that addresses his specific cancer

    • Conveyor belt of Death: The aggressive nature of his disease means that standard of care options don’t offer durable responses. It’s a matter of time before Brian succumbs to the disease unless he finds breakthrough treatments.

    • “Standard of Failure” Treatment Risks: Standard of Care treatments carry accretive deleterious effects on Brian’s health. For example, prolonged use of strong androgen deprivation therapy increases his risk of bone fractures, diabetes, dementia, coronary heart disease, and acute myocardial infarction (heart attacks). Brian has seen eight lines of treatment.

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Rick Stanton
Rick Stanton
Professionally: Rick Stanton is a 66-year-old southern California based family man with a passion to help cancer patients in need. He believes an integrated understanding of patient state, genomic state, immune state and trajectory will help inform clinical therapy decisions.

He is an engineer / data scientist with experience in complex physical and biological signaling systems. He has experience in genomics, transcriptomics, cellular pathway signaling, and immune signaling. 17 years Amgen, 5 years JCVI / Human Longevity, 3 years ThermoFisher Scientific. Technologies: AI, machine/deep learning, AWS hosted secure web applications, scientific programming.

Personally: family man, loves life, dogs, hockey, skiing, music in general, and guitar specifically.
Aggressive Metastatic Prostate Cancer primarily driven by unfavorable CDK12 mutation leading to short duration of control by therapies outlined by NCCN guidelines. Currently on chemo (docetaxel)

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Mike Yancey
Mike Yancey
Mike Yancey is a 66 year old living in Northeast Oklahoma on Grand Lake of the Cherokees. Retired in 2015 from 35 years in the data and telecommunications industry with responsibility for product development, marketing and sales. In spite of diagnosis, Mike continues to travel extensively enjoying his passions of boating and motorcycles.
Diagnosed with de novo metastatic prostate cancer in July 2021 with innumerable bone metastasis. Further testing revealed he has the Aggressive Variant Prostate Cancer with mutations to 3 specific genes that form this diagnosis. They are PTEN (loss), RB1 (mutation), and TP53 (mutation) in addition to 5 other mutations. Therefore this version of prostate cancer is resistant to most drugs with very short duration of benefit. Also, I have very low PSA expression, therefore PSA cannot be used as a reference for what my cancer is doing; the only option are scans. Historically this variant has a prognosis of 2 years from diagnosis, but there are recently approved treatment options which may prove beneficial.

Mike Yancey's cancer journey to date:

2019/2020 - Annual physical exams always showed PSA numbers to be well within the acceptable range. 2019 June PSA was 1.2, and then 2020 September my PSA had increased to 2.3.

2021 – 1st Quarter - Only other symptoms in early 2021 was burning when I urinated. Was referred to Cole Davis, Urologist on May 20, 2021. Prescribed Tamulosin (Floxmax) and Finasteride. Saw urologist again June 1 when significant amount of blood was passed while urinating. Scoped to my bladder and commented that he saw some irritation in bladder but nothing that appeared to cause concern about cancer.

2021 Mid-June, developed fevers and intense body aches. Mis-diagnosed by a rural hospital in northeast Oklahoma where I live with Lyme disease on June 21 and given two weeks of Doxycycline. Was bedridden with intense pain and fever. Returned to hospital on July 5, 2021 and was given two more weeks of doxycycline. July 6, 2021 pain had intensified to a point that I could not stand and was transported to a major hospital in Tulsa OK and was admitted followed by numerous tests over several days.

2021 July 16, PSA was at 47, and following a bone marrow biopsy and bone biopsy was diagnosed as Stage IV prostate cancer that had innumerable bone metastases (no prostate tumor specific biopsy has been done to date). Was referred to a general medical oncologist that treats all cancers where I had a bone scan and began 10 radiation treatments to the pelvis and right femur to address pain beginning August 3.

2021 August - Received my first Lupron shot on August 5, and began the 1st of 6 Taxotere chemo treatments, administered every 3 weeks on August 12, 2021. Responded well to these treatments with PSA nadir of 0.07 on November 29, 2021, also the day of receipt of my last chemo treatment. My local Tulsa OK oncologist who treats all cancers was supportive and encouraged my pursuit of finding a GU oncologist at a major cancer center who would have the latest treatment options.

2022 February - Pursued a second opinion at MD Anderson, Houston, on February 8, 2022, but no additional tests were done, other than a genetic test which returned negative. Discussion only addressed possible treatments that could be pursued upon becoming CRPC. I pursued discussion about the PEACE 1 study that showed benefits of taking Abiraterone while still hormone sensitive, and the response was that we could do that. So began Abiraterone April 13, 2022. Inquired about somatic testing but was told that was not necessary until I became CRPC.

2022 March thru May - My PSA had risen from the 0.07 nadir in November 2021 to 0.12 on March 3, 2022, and then to 0.43 on May 11, 2022 and was told by my local oncologist as well as the oncologist at MD Anderson that these increases were not significant. My desire was for a more aggressive and creative approach to treatment which resulted in a referral to Houston Methodist GU Oncologist Elini Efstathiou on May 24, 2022 and by that time my PSA had risen to 0.6 and my alkaline phosphatase had gone from a nadir of 159 on March 3, 2022 to 232 on May 24, 2022. Had a Pylarify PSMA-PET scan and prostate specific MRI done with the result showing active cancer and new bone metastases. My cancer is one that does not produce a lot of PSA but does express PSMA, so currently pursuing scheduling to begin treatment with Pluvicto which was FDA approved in March.

2022 June - Oncologist acquired my bone biopsy taken July 14, 2021 in order to see if somatic testing is possible, which it was showing 5 mutations, 3 of which form the diagnosis of Aggressive Variant Prostate Cancer (PTEN, RB1, and TP53).

2022 July – Had a liquid biopsy performed to see what additional mutations may have occurred since my original diagnosis. Only 3 additional mutations were found and do not appear to be significant to future decision making on treatment

2022 August – Began the first of 6 Pluvicto treatments on August 9th. There will be 5 more treatments 6 weeks apart, ending in March 2023

Discussion on potential future treatment options are planned with my oncologist.

My cancer journey continues.

There are very few Standard of Care (SOC) options for my aggressive cancer. Using medical knowledge as well as artificial intelligence and databases, we need to identify treatment options that may be outside of the normal prostate cancer treatment options including the potential to use multiple drug combinations simultaneously based on information from somatic testing including mRNA analysis data.

I hope to identify possible recommendations and then in conjunction with my oncologist, evaluate potential risks and benefits in order to pursue one or more of these “out of the box” treatments.

Ken Anderson
Ken Anderson

Personal Interests
Love family, the outdoors, hiking and fishing. Have always had an interest in the southwest (Arizona) and recently fallen back in love with the Pacific Northwest.

Hiking Mt Townsend was difficult, such activities 3,090 ft of elevation gain in 4.25 miles provides some fuel for your immune system - it must!

Future

Interested in finding the best direction to treat this disease and in living my best life.  At times obsessed with our lack of interest in treating the whole body.  Too often we only treat the disease and miss the part about mental health.

At 56 diagnosed with stage IV prostate cancer. Gleason 9 (4+5), bone mets, back pain and PSA at 516. Started Lupron in March 2017, six rounds of docetaxel in April, psa dropped to 1.1 in May. Radiated my prostate in August of 2017. By June of 2018 lowest psa was 0.4 but by the end of Dec I had become castrate resistance with a psa of 1. Started Provenge on the 29th of July 2019 and another 27 cycles of Docetaxel starting in Jan of 2021 with my psa hovering around 20 for all of that year plus a little. Many standard of care options have been tried and now in my 5th year with a new treatment plan using PSMA targeted Lu-177-617 or Pluvicto. At present my psa is 111 and rising - labs in a week and with any luck my psa will drop.

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Robert Ellis
Robert Ellis
Robert Ellis has over 35 years of experience working with global companies—spanning startups, mid-stage, Fortune 500 giants, and non-profits— guiding leaders to take their impact to the next level at any stage of growth. As an executive coach, he’s helped entrepreneurs and CEOs to become better leaders, think more strategically, create high-performing teams, foster future-friendly cultures, and deliver compelling presentations—including several high-profile IPO roadshows. Robert has taught leadership and coached entrepreneurs at Singularity University, and developed Level UP, the leadership curriculum for the Global Startup Program. He was one of the original coaches for the Nasdaq Milestone Maker program, helping late-early to mid-stage entrepreneurs grow their businesses to the next level. He also taught Facing Challenge, Navigating Change: Leadership and The Hero’s Journey, an 8-week course at Stanford University using Joseph Campbell’s Hero’s Journey as a framework to explore mindsets and skillsets for leading yourself and others on a heroic journey in business and in life. He’s the founder of Coaching From Essence, a training program for life and executive coaches. Though he’s never practiced, Robert studied Japanese acupuncture and was licensed in California. He has a keen interest in alternative approaches to health, including diet and supplements. Robert lives with his wife in Carmel Valley, California.
Robert was diagnosed with Stage IV prostate cancer in November 2017, with mets to his ischial tuberosities. He began a clinical trial (Lupron, focal radiation, and pembrolizumab) at UCSF in February 2018 and responded well. His PSA was fractional a year later when the trial ended, and all treatments ceased. He relapsed after a few months and resumed ADT. In 2021, he became castrate-resistant. He underwent Provenge, had radiation to his left ischial tuberosity, and began Orgovyx. Pain in his right ischial tuberosity and rising PSA were the catalysts for beginning chemotherapy in September 2021 (combination of docetaxel and carboplatin). He's been responding well, but know that it’s only a matter of time before he becomes chemo resistant.

Robert Ellis' oncology journey to date:

  • 2017, Nov Stage IV with bone mets to ischial tuberosities, PSA
  • 2018, Jan PSA 48.589—Began ADT
  • 2018, Feb Began clinical trial including ADT (Lupron), plus focal radiation and pembrolizumab
  • 2019, Feb PSA 0.385, trial ends, all treatment ends
  • 2019, May PSA 0.384
  • 2019, July PSA 17.873, resume ADT (Lupron)
  • 2019, Sept PSA 28.73, began Care Oncology protocol (atorvastatin, mebendazole, doxycycline, metformin)
  • 2019, Dec BRCA-2 positive
  • 2020, Mar Abiraterone, prednisone
  • 2020, Sep PSA 1.64 (nadir)
  • 2021, Feb Began Orgovyx and prednisone
  • 2021, Apr PSA 6.2, began Provenge
  • 2021, Jun PSA 12.64, began radiation to the left ischial tuberosity
  • 2021, Aug PT/CT AXUMIN, “disease progression…uptake now seen within a left external iliac chain lymph node”
  • 2021, Sep PSA 24.75, began chemo (docetaxel, carboplatin)
  • 2022, Jan PSA 4.98, levels off between 4.98 and 5.55
  • 2022, Mar PT/CT PYLARIFY BODY, “Progression of osseous metastatic disease…left external iliac chain lymph node.”
  • 2022, Apr PSA 4.46, switch from docetaxel to cabazitaxel (hoping to improve side effects)
  • 2022, Jun PSA 2.3, switch back to docetaxel
  • 2022, Jul PSA 2.64

 

Suggestions for Robert’s next therapies after chemo:

  • Pluvicto—waiting for availability
  • Olaparib—advised to wait for potential clinical trial with next gen PARP inhibitor
I’m grateful for the care team I’ve worked with on this journey, but they’re risk averse. I want a more creative approach. It’s disheartening to think I have only two realistic options in the wings (Pluvicto and Olaparib, or a next-gen PARP inhibitor). I want to experiment with different strategies with existing treatments  (e.g., BAT)  or explore more personalized medicine made possible by the plethora of new tests. I’m agnostic when it comes to approaches; I’m also very interested in alternative medicine, supplements, etc. I’m hoping to be an early adopter of more innovative treatments, and I’m excited about what’s being created here. I also want to offer my support in any way I can.
Kevin Fordney
Kevin Fordney
Kevin is a 74 year old Vancouver, WA based retired educator. The last 21 years of my career I served as an elementary school counselor and an elementary school principal in the David Douglas School District in S.E. Portland, OR. Upon retiring in 2011, I worked part time as a Leadership Coach in several Oregon elementary schools under the direction of Education Northwest. I fully retired in 2019. I am married to Nancy (46 years) and have two children who are both married and live in Vancouver,WA. In December 2021 our first grandchild was born. Life has taken on a whole new meaning as we move into the grandparent role. I love to read, garden, bike (e-bike), spend time with family and friends, travel, and am active in our local church.
In January of 2020 I was diagnosed with Stage 4 prostate cancer metastasized to the bone and was given a prognosis of 4-6 years to live. Since that time I was first under the care of Kaiser doctors and currently am under the care of Dr. Jacqueline Vuky at OHSU. At OHSU I have been afforded all the resources available at the Knight Cancer Clinic and am currently participating in the FORS46 clinical trial.
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I was made aware of CancerHackers/Prostate Cancer Lab through a friend of mine who knows Brian McCloskey. Upon reviewing the vision/mission of this group, I became highly interested in learning more. Brian and Brad reached out to me quickly and helped me understand at a deeper level what CancerHackers is about. This is the first group I have encountered since my diagnosis that I have wanted to participate in.

What do I hope to experience through joining CancerHackers/Prostate Cancer Lab?

1) Be part of a group that has a passion to see that every cancer patient receives the best possible treatment currently available.

2) Be part of a group that is building a diverse team of experts who will look at my data and suggest possible treatments that could benefit me and my oncologist as we seek to treat my cancer most effectively

3) Pay it forward - that by participating in some small way my experience may benefit someone(s) in the future

4) To receive support and encouragement from other men who are going through the same/similar journey as I am

Eric Hall headshot
Eric Hall
Eric Hall is 50 years old, currently living in Chapel Hill, NC, after stops in CA and IA, and growing up in IL. He is at Digital Product Manager at John Deere and has been with the company for 22 years. He is supported by a great family with his wife Stephanie and sons Andrew (25) and Owen (13) and is very involved in their activities. He is very active with a number of other hobbies including mountain biking, weight lifting and being a maker in many mediums including photography, woodworking, home diy, 3d printing, sewing and bike repair.
Eric was diagnosed with de novo oligio-metastatic prostate cancer in July 2022 at age 50 with a PSA of 146, Gleason 10 disease with a tumor involving the whole prostate and extending to 4x5 cm outside the prostate capsule involving the seminal vessels and touching his rectum and pelvic floor with 1 lymph node metastasis and 0 bone metastasis. Further testing has revealed a very unique genomic profile for prostate cancer with CHEK2 mutation and an ALK fusion (ALK:DTNB) along with high expression for AR and FOLH1 (PSMA) proteins. Eric's cancer presentation is very unique with a high PSA of 146 and only 1 nodal metastasis and ALK fusion is extremely rare in prostate cancer, yet is notable in other cancers, especially lung.

July 2022: Dx of Prostate Cancer at UNC

  • 7/5/22 - PSA 146 
  • 7/8/22 - DRE, large tumor, prostate fixed in place. 
  • 7/11/22 - Blind biopsy 14 cores, all 70-100% with Gleason 9 & 10.
  • Pelvic CT, Nuclear Bone scan, PSMA: 7/22/22 all show Tumor 5.5 cm x 4.5 cm outside prostate abutting the rectal wall and pelvic floor with seminal vessels involved with perineal invasion. Cancer cells are suspected in those organs / soft tissues. Metastasis to 1 pelvic lymph node and 0 bone sites. 1 cm mass on adrenal gland.
  • Official Dx is T4bN1M0
  • Surgery not an option due to large tumor escaping prostate capsule
  • Dx result of random PSA test at annual physical, no known symptoms at the time.
  • Looking backwards he did have some urination frequency symptoms that was not attributed to prostate cancer
  • Switch to Vegan diet, mostly WFPB. Stop alcohol and caffeine and start mushroom supplements 6000 mg daily plus other immune boosting supplements (calcium, vitamins, lycopene, etc)
  • Ramp up previous exercise routine to 3 days mountain bike alternating with 3 days weight lifting

 

7/28/22 Start ADT with Duke

  • Relugolix (Orgovyx) 120 mg daily, Abiraterone (Zytiga) 1000 mg daily, Prednisone 5 mg daily
  • Liquid biopsy genetic test at Mayo
  • Guardant 360. Results: MET A354A, 0.4%, Synonymous Alteration, IDH1 Y139Y, 0.4% Synonymous Alteration, EGFR D256D, 0.2%, Synonymous Alteration, TMB: Not detected, MSI-High: Not detected

7/28/22: Germline genetic testing

  • Color.com (thru PROMISE study) saliva test
  • Results: CHEK2, C.1100del (p.Thr367Metfs*15), heterozygous. Later found out this was inherited from my mom. CHEK2 stands for Cell cycle checkpoint kinase 2 gene and is a key component of the DNA damage pathway. The CHEK2 gene helps to repair or eliminate incorrect gene copies, thus a patient with CHEK2 deletion has a higher risk of developing several types of cancer including prostate, colon, kidney, breast and thyroid. Someone with CHEK2 deletion should do preventive exams earlier and more frequently (PSA, colonoscopies, mammogram).

 

August 2022

8/24/22: PSA 6.3

8/26/22: Colonoscopy

  • Removed 5 precancerous polyps, Tubular Adenoma
  • Concerned about colon cancer with CHEK2 and with the tumor touching the rectum

 

September 2022
9/2/22: DEXA bone scan.

  • Results -1.2, Osteopenia. This is a baseline test 1 month into starting the ADT meds to compare against in the future.

 

9/22/22: PSA 3.6

  • Start Tudca for liver support 1000mg daily as liver enzymes ALT & AST rising from ADT meds, start high dose melatonin 300 mg daily and infrared sauna 5x per week

 

October 2022
10/2/22: Tumor Genomic Whole Exome Sequencing at Atrium Health

  • Caris Life Sciences
  • Results: CHEK2, Exon 11 | p.T367fs, DNA Tumor; ALK:DTNB fusion, RNA Tumor; AR, Positive | 1+, 95%, IHC Protein; BRAF: Not detected; MSI: Stable; Mismatch Repair Status: Proficient; NTRK1/2/3: Not detected; Genomic LOH: Low; Tumor Mutational Burden: Low, 1 mut/Mb
  • Eri's cancer presentation is very unique with a high PSA of 146 and only 1 nodal metastasis but with ALK fusion translocation.
  • Emma Shtivelman: “A very unusual constellation of mutations for prostate cancer! In my mind at least, the main culprit is the DNTB-ALK fusion. ALK fusions are encountered in about 15 % of the major type of lung cancer, NSCLC, but also in a variety of other cancers (thyroid, some lymphomas etc). The most common translocation is EML4-ALK, but there are others like NPM1-ALK, KIF5B-ALK and more. ALK translocations are the MAJOR DRIVERS of cancers where they are found. There are several targeted drugs that work very well in ALK-altered cancers.

 

10/5/22: Abdomen CT Scan to look at adrenal gland mass at UNC

  • With and Without contrast
  • Inconclusive, biopsy needed to confirm if cancerous
  • Mayo 2nd opinion on adrenal gland is not a concern right now, follow up with another scan in 3 months

 

10/17/22: PSA 2.3

  • Begin CBG 40 mg daily

 

November 2022
11/1/22

  • PSA 1.81
  • Duke surgeon DRE says prostate feels normal and I am a surgical candidate

 

11/4/22

  • MRI shows significant shrinkage of tumor and normal lymph node
  • Mayo surgeon says I'm a surgical candidate with a curative intent thru Open Radical Prostatectomy and Lymph Node Dissection

11/8/22

Treatment Options at this point are

  • (1) Open RP w/ Lymph Node Dissection followed by 20 fractions of IMRT 6 months later
  • (2) High Dose Brachytherapy + 20 fractions of IMRT
  • (3) Open RP w/ Lymph Node Dissection and wait and see PSA/Scans to determine next steps

My journey is ongoing and evolving.

Family Cancer History

  • Father, Lung cancer at 56, partial lung removal surgery, Pancreatic Cancer at 72 (died from)
  • Mother, No cancer, Still living age 74, CHEK2 genetic mutation found after Eric's positive test
  • Brother, no cancer, Still living age 48
  • Paternal Grandfather, Esophageal cancer at 62 (died from)
  • Paternal Grandmother, Breast cancer at 41, double mastectomy, Lung cancer at 80 (died from)
  • Maternal Grandmother, Kidney cancer at 68 (died from)
  • Maternal Grandfather, No cancer died from heart failure
  • Paternal Uncle, Prostate cancer at 51, surgery, chemo, radiation, still living

  • I want to learn the process of identifying and receiving targeted and personalized treatments along with providers who will execute the treatments.
  • I want to be part of and give back to a community of like-minded men who are always searching for a better way for their own care.
  • I want to stay abreast of the latest developments in prostate cancer care so that I'm informed when my decision-making moment comes.
  • I want to assist with growing the Prostate Cancer Lab so that more men and their families can be educated and helped.

Chad Magnussen headshot
Chad Magnussen
Chad Magnussen is 50 years old and has lived his entire life in rural Minnesota. Chad married his high school sweetheart and together they have 2 young children (Bryce 12, Leah 9). Chad has been working for Lyon County Public Works for 27 years. He started his career as a Surveyor, worked his way up to be a construction inspector, designer, construction manager, and is now the assistant to the County Engineer. Chad’s passions include the outdoors, hunting, fishing, but most of all spending time with his family.
Chad was diagnosed in May of 2021 with advanced metastatic prostate cancer. A bone scan identified over 25 mets and lymph node involvement. No genetic mutation were found.

April-May 2021

  • Diagnosis

June 2021

  • 6 cycles of Docetaxel Chemotherapy

Sep-Dec 2021

  • Abiraterone. PSA rising (Castrate resistant)
  • 6 cycles of Taxotere with Carboplatin chemotherapy
  • LU177

 

  • Continue to learn about current treatments to better guide treatments in the future.
Chester Allen
Chester Allen
Chester Allen is an 82 year old retired college professor living in Santa Rosa California. He taught business finance at both the graduate and undergraduate level. Diagnosed with advanced cancer in April, 2022, he reads, plays chess online, and enjoys visits from his family.
Chester was diagnosed with stage 4 metastatic prostate cancer in April 2022 after an MRI at an emergency room found enlarged lymph nodes in his neck led to a CT scan and blood tests. After 6 months of hormone therapy, his PSA rose rapidly although his testosterone level was undetectable. Now he is mCRPC and looking for a treatment option.

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