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Mozzmo
Posts: 30
Joined: Mar 2004

I just learned that in the last 3 weeks my father's PSA went from approximately 5.05 to 8.2. Evidently he's considered hormone refractory. His doctor is getting ready to put him on Zometa for his bones. From what I know this helps strengthen his bones since he has spinal metastases. However it apparently does not affect his rising PSA.....is that correct? The doctor wants to wait to see how this medication works before considering the possibility of chemo, but if it's known that Zometa doesn't stop a rising psa, why wait? Does anyone know more about this? I would appreciate your info and comments. Thanks and God Bless.

Benji48
Posts: 117
Joined: May 2003

Hi,
Here's some info on Zometa. Perhaps you know but thought I'd send it anyway.At this point I don't know what effect it has/does not have on the psa reading, but that's irrelevant I believe because it's important to treat the symptoms, NOT the psa!
Prescription Name: Zometa

*NOTE* Zometa is a medication that should only be taken when prescribed by a doctor. Please note I don't recommend taking Zometa without a prior prescription from your doctor and cannot be held responsible for any problems that occur from taking Zometa. This information is provided for information purposes and is not intended as a substitues to professional advice *NOTE*

Active Ingrediant in Zometa: Ezetimibe

Uses for taking Zometa
Zometa is used to treat patients with high blood levels of calcium (hypercalcemia) caused by cancerous tumors. Zometa has not been studied in patients who have high blood levels of calcium caused by an overactive parathyroid gland or conditions not related to cancerous tumors.

Possible Zometa Side Effects:

decreased kidney function
fever
flu-like symptoms consisting of fever, chills, and bone, joint or muscle pain
nausea and vomiting
redness and swelling at the injection site
itching
chest pain
eye inflammation
low blood levels of magnesium, phosphorus, and calcium
Things to be cautious of while taking Zometa:
Do not use Zometa if you are allergic to bisphosphonates or to any of the ingredients in Zometa.

Tell your health care provider if you:

have or had kidney problems
have asthma and are allergic to aspirin
are trying to become pregnant, are already pregnant, or are breastfeeding
Tell your health care provider about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Some medicines may affect how Zometa works or Zometa may affect how your other medicines work.
Tell your doctor if you:

decreased kidney function
fever
flu-like symptoms consisting of fever, chills, and bone, joint or muscle pain
nausea and vomiting
redness and swelling at the injection site
itching
chest pain
eye inflammation
low blood levels of magnesium, phosphorus, and calcium
For more information on breast cancer, visit this Breast Cancer site to learn more.

As with most medications, do not drive until you are certain to how you react to the drug.

Drinking alcohol while taking Zometa is definitely not recommended.

P.S. These are not MY words but rather from Supplement-information.com
Good luck, Benji

Mozzmo
Posts: 30
Joined: Mar 2004

Benji,

Thanks for the response. I already have info on Zometa. Isn't it a bit naive to say "treat the symptoms, not the psa"? Seems to me the doctors have been monitoring my dad's cancer by keeping an eye on his psa all these years. Are you suggesting that at the point that someone becomes hormone resistant, that the doctors move to do just palliative care......ie treating symptoms alone because the cancer can no longer be controlled? My original question was out of concern that my dad's PSA seems to be escalating at a fast rate, and the doctor's only prescription was Zometa. Zometa helps with bone deteoriation but from what I read it does nothing to stop the PSA. Seems to me that the doctor would at least offer chemo since it could help ward off the cancer for at least a little while.

Mozzmo

Benji48
Posts: 117
Joined: May 2003

Hi,
NO, what I'm suggesting is that elevated psa doesn't hurt! But pain certainly does so therefore treat the pain for example!
Whether or not current methods with chemo have any efficacy against the cancer cells is argumentative at best and is surely a major decision as to whether or not one wishes to undergo that hell for a few weeks longer to live!
I am sorry that your dad is in the situation that he's in and I'm only suggesting that he should select the treatment that he is confortable with.
God Bless, Benji

Mozzmo
Posts: 30
Joined: Mar 2004

Benji,

I never said my dad is in pain. Thankfully he is not in pain presently. My guess is that the Zometa treatments are being given on the assumption that bone deteoriation is occuring because when originally diagnosed my dads cancer had already spread to his spine. My understanding of things is that PSA does reflect cancer volume, at least for most. So it seems to me treating psa at least in most instances of prostate cancer situations means treating cancer. You are assuming wrong that my father has made the choice at this point to not take chemo. He's not being offered it. He's 73, and for someone of his generation, he tends to do as the doctor recommends without asking questions or realizing that often there are no sure paths of best care. I am just a little puzzled why doctors feel one should have to be in pain first before offering other treatments.....especially if there's evidence of exponential growth. I posted my question, in part, to see what other had heard and experienced at the point that they became hormone resistant with a rising psa.

Thanks for your interest,
David

Benji48
Posts: 117
Joined: May 2003

Hi,
For some reason I don't understand, why it is at times that my point is not taken correctly. I guess perhaps that it is because of the difficulty in interpreting what the written word is! I don't know.
Anyway, with that said, first of all I did NOT assume that your father had made the choice not to take chemo! I only wish to convey, that given the choice, one is faced with a most difficult decision.
Secondly, I don't know how effective it would be at this stage, BUT it is well known for example that if someone wishes to treat the psa, they simply can injest Saw Palmetto which will drive the psa down, but do nothing for the cancer!Would probably make someone feel good, but they'd just be fooling themselves.
Again I'm sorry if I was miss-interpreted.
Benji

Mozzmo
Posts: 30
Joined: Mar 2004

Benji,

There does seem to be a disconnect. I don't think I am misinterpreting you. I just don't agree with you. I don't know a reputable physician that would treat prostate cancer or a rising psa with Saw Palmetto. In my previous comment, I said in MOST case where there is a rising psa it reflects cancer spread. I have witnessed my father go through years of this at this point, and every doctor has looked at his psa, it's doubling time, and its velocity as a diagnostic indicators. In fact, in my yearly exams, my primary care physician checks my psa as a possible indicator for cancer. So I still believe that treating psa in most situations does in fact reflect treating the cancer. We don't have to agree on this. In fact, it is not even the question I originally posted. I am simply interested in learning what others know about treatment options at the point that a person becomes hormone resistant.

Good wishes,

David

Benji48
Posts: 117
Joined: May 2003

Hi David,
If I may say so, you've done it again! I don't intend this to become a "pissing war" but I agree no physician WOULD attempt to treat the cancer with Saw Palmetto as you suggested that I IMPLYED. Quite the contrary, you inferred that. What I was referring to is that some individuals think that by taking the stuff & their psa goes down they are attacking the cancer! They also don't tell their doctors they are doing this, which is a no-no.
Also, isn't hormonal treatment a palliative therapy by definition? Are you looking for a "majic bullet?
Sad to say, but at this juncture, there are none.
We just have to do the best we can with whats available.
Best wishes, Benji

Mozzmo
Posts: 30
Joined: Mar 2004

Benji,

I am not in a "pissing" war with you. Agreeing to disagree on points is not a competition. It's just disagreeing. I keep trying direct my comments back to the original question...which is a simple one. What have others experienced, or been directed by their physicians at the point that their prostate cancer becomes hormone resistant.

Your responses tend to get off onto other tangets such as the Saw Palmetto or treating symptoms, not psa. My point in saying that no reputable physician would prescribe Saw Palmetto, is that my question seeks to learn what other's have been advised by their physicians. In your latest response you questioned if treating psa with hormone therapy was in and of itself palliative. This is again a tangential question and not the one I asked in my original posting. I am well aware that there is no "cure" for metastatic prostate cancer. However hormone therapy does DIRECTLY delay cancer progress for most at least for a while, maybe even years. That seems to go beyond palliative. Palliative treats symptoms and not the direct cause. Hormone therapy seems to treat the direct cause in that it robs the cancer of the primary agent facilitating its growth. Pain management or other symptom management seems to be more palliative. My dad's recent Zometa treatment as an attempt to strengthen his bones is palliative since it apparently has no impact on the progression of his cancer and this is reflected in it having no effect a patient's rising psa.

Because there is no "magic bullet".....I am seeking other's in similiar situations as my dad so that I can learn and compare what other physicians do in his situation as to try to make sure my father receives cutting edge treatment.

Good Wishes,
David

Benji48
Posts: 117
Joined: May 2003

Hi David,
Have you researched the info on Provenge? Seems promising.
If not check out www.Dendreon.com
Best wishes, Benji

Mozzmo
Posts: 30
Joined: Mar 2004

Thanks Benji.....never heard of it. Is it experimental? Will look it up.

David

lindatn
Posts: 233
Joined: May 2003

There is no proof at all that saw palmetto lowers psa, there are many opinions both way depending on what websight you read. That is all Lupron does also so don't put your life in the hands of that expensive drug. As for your Father I would consider at this point alternative Drs. Haiving had chemo for breast cancer and knowing it only increased the odds of living by 8 percent or less I'm rather sure I would not do it again knowing what it does to the heart and bones.I was told none of this before I started the chemo. Considering what little good it is in prostate cancer don't rush your Father into it. My husband started with a PSA of 60, had radiation and alternatives and his PSA is very low at present and that by the way is all we have! Good luck to your father but don't expect a cure from any MD at this point. Linda

Mozzmo
Posts: 30
Joined: Mar 2004

Linda,

Thanks for your comments. You are confirming what my intuition is telling me. I don't mean to seem like I am rushing my dad to chemo, I saw my mother suffer with chemo's effects and my dad is losing strength over time and as the cancer progresses. I am aware that there may be an "end of the road" approaching where there really isn't any treatments left that significantly impact my dad's cancer. I had mentioned chemo only because I am not aware of any other options at the point he is at.

May your husband and you have blessed health.

David

spouse
Posts: 2
Joined: Aug 2005

My husband is now having a recurrance of his cancer as defined specifically by the rising PSA. At this time he has no visible (scans etc) of spread but the dr. indicates that it is probably in the bone but too small to see - the only psa treatments at this point are hormone related first (casodex or lupron) and chemo when that no longer works. There are no specific numbers that will stage you by psa - what happens when you become refractory is that psa goes up and you are able to see the tumors. Prostate cancer has greatest probability of spread to bone but also can spread to the liver or brain. Rising PSA after treatment means it is scan time. Scans will show where it has spread. Chemo only extends the time you have and the side effects are severe. So, a man makes a decision based on quality of life vs quantity of life after getting good info on what he can expect . Some men do nothing - but as tumors grow, will have to get pain medication - others opt for chemo. There is a trial ongoing on a vaccine which is supposed to be available in the next year. It will be used for men for whom treatment no longer works and may give more than just life extension. Here is hoping. My husband is only 57 and he would like to see my son get to college and my daughter get married. So now he is on casodex because the side effects of the lupron are so negative to him. Not only does he 'turn into a menopausal woman' but the anti androgens cause clinical depression - and many docs will not recommend a anti depressive, but they should be. Don't know if this is helpful at all at this point in time - you probably have learned it all in the last couple of months.

Zinda
Posts: 3
Joined: May 2004

Linda

My husband started with a PSA of 113 and bone mets too numerous to count. That was one year ago.

He did lupron for 8 months and his PSA began to rise. He is now on chemo and his PSA is 4.4. He was due for another chemo treatment but told his doctor it would probably kill him, so they are giving him a break.

What alternatives is your husband doing? Any information would be greatly appreciated.

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