Cancer found in Lymph and tissue afer DaVinci surgery

VascodaGama said:

Anti-agonists could do the trick
Hi Jack

Welcome to the board.
Sorry to hear about the positive extra capsular extension and metastases. There are a series of ways to deal with the problem. The info Dave requests is essential to determine on a good choice.

Lupron shots are advisable if you present or are at risk of systemic disease. This LHRH agonist is the “heavy duty” drug on the hormonal protocol. It influences the body to stop manufacturing Testosterone. Sex can continue but the low level of testosterone in the body will tend to diminish the appeal for sex (low libido). You will have to work harder for a satisfying accomplishment.
I am on HT since November 2010 with an agonist shot (Eligard = Lupron), got the lowest level of PSA since I took my first test in 2000, and are active in my “lovely nights” but with a low quality in achievements (3-4 o’clock pointed mark).

The good in your treatment is that surgery did not cause you permanent ED. Lupron shots will superimpose but usually all returns to normalcy once one stops taking them and the shots lose its effectiveness action (approximately 2 to 3 months).

Another drug in the hormonal protocol known as anti-agonists (Casodex, Cyproterone, etc.) are less implicated with the libido side effect, hot-flashes or fatigue, because it does not induce the testes to stop manufacturing testosterone (low levels in the body). They can control cancer advancement in considerable long periods by simple closing down the “feeding ports” receptors at the cells, therefore avoiding cancer cells from feeding on testosterone. These anti-agonists mimic the structure of testosterone and attach to the receptors closing the cell’s “mouths”.
In the process some cancer is killed by starvation and other become dormant. Patients can regulate the period on anti-agonists through periodical PSA tests.

The problem with a solo anti-agonists effect in the control of cancer advancement is that after a long period on the drug, cells adapt to the condition and mutate to feed on the anti-androgen itself (hormone resistant prostate cancer).
This “behavioural adaption” of cancer cells is due to random genetic mutations which occur within its genetic code, the beneficial mutations are preserved because they aid survival. This is a process known as "natural selection" from Darwin’s theory. If low testosterone is persistent, the cell to survive will mutate to adapt to the new environment and continue its proliferation uncontrolled.

A treatment with such approach would do better in a protocol of intermittent modalities, to avoid mutations.
I would recommend you to discuss with your doctor the above possibility in your case so that you would not surfer with less sex at your young age.

Wishing you the best.

VGama

tarhoosier said:

Terms
In order to clarify the information from VdaG above, the term used in the US for bicalutimide (Casodex), Cyproterone, and similar drugs is Anti-Androgen, sometimes called AA, or A-A. The metaphor used commonly for such drugs is that each cell has a "lock" which allows androgens such as testosterone to enter the cell and complete the cell division cycle. Anti-Androgens (and anti-femogens for women) put gum in this lock and the androgen is unable to "open" the pathway to the cell nucleus.

Lupron is an "agonist" drug in the sense that it causes the release of a flood of hormones that swamp the messaging system of the body and thus causes the cessation of testosterone production until this swamping effect declines as the drug effect subsides. There is a newer drug called Degarelix that is a true "antagonist' because it switches off the production of testosterone by interfering with the chemical messaging system directly and does not swamp the system.
It is true that some doctors and patients prefer, or require the use of both an Anti-Androgen and a hormone agonist (Zoladex/Lupron/equivalent). Occasionally the newer antagonist Degarelix is preferred, usually in recently diagnosed patients with metastases and symptoms because it works almost immediately.
I also wish to make clear that it is my opinion that the mutation of the cells as VdaG explains is not caused by the application of any drug. It is a natural occurrence and will take place with or without any medication.