Eligard for 2 yrs complete. Cycling helps.

VascodaGama said:

"Give the animals a rest"
Patrick

Thanks for sharing your story.
I hope your status continues its path successfully and that you enjoy a return to normal levels of testosterone.

Though it seems that the condition (hypogonadism) has not affected you much, you can always recur to TRT patches if you want to get that needed energy back for cycling at the speeds of your friends. Quality of life in you seems to be related to the ability of maintaining a presence in a cycling society.

I wonder why you believe that the hormonal treatment (HT) has damaged the cancerous cells' DNA. This is a fact in radiotherapy but not in hormonal manipulations.
In HT you may expect the kill to happen due to “starvation”. Prostatic cancer cells feed on androgens (testosterone, DHT, etc) and by blocking it from reaching the cells receptors (mouths) one can expect the cell to die or become in a dormant status.
Nevertheless, this theory has been based on facts in cases with low grade Gleason cancers. Your Gleason 9 is made up of more aggressive types and you should consider a more aggressive form of HT (eg; ADT3) to get a grip on any advance of the cancer.

You have not shared any other info on your diagnosis of 2009 (symptoms that took you to get an initial PSA, etc), or the biopsy results and clinical stage, or the reason for your doctor’s choice for not recommend you a radical treatment (surgery or radiation) with intent at cure, which would have been logical in a patient of your age. You seem to be fit and healthy enough to go through a radical or a combination of HT plus RT.
Can you share any other test results like T and DHT levels, and image studies, etc.

In my opinion your assertion that; “…. the cells might change to an even worse form of cancer which is harder to treat later…”, is not correct. In recent studies it has been found that cancerous cells become refractory to traditional hormonal drugs because they are not affected by the hormonal manipulation that lead to a lower testosterone level circulating in our body (Eligard) or testosterone bio-structures fakes (Casodex), or similar.
In a clinical castrate environment (T lower than 0.3 ng/mL), some cancer cells manage to survive in very low levels of testosterone and even mutate to “fabricate” their own androgens. This is what it is known as Intratumoral Testosterone Effect. Cancer manage to produce its own feeding process to survive. One can verify such happening through tests. When T is low and PSA increases (condition of refractory cancer), intertumoral expression may be considered to occur for the continuing progression of the disease.

HT will not cause cancer to become more aggressive. One should try to continue the manipulation by increasing drugs power (mg) or changing to similar drugs (Eligard to Zoladex and Casodex to Cyproterone, etc). Once failure is verified then one should start using a second line of HT drugs to address the intratumoral effect, such as Abiraterone acetate and MDV3100. An older drug not as efficient as the newer ones but also excellent is Ketoconazole which addresses the intratumoral effect but it is not FDA approved for the treatment of prostate cancer.

I would suggest you to discuss the matter with your doctor and do research the net if you are interested in more detailed information.
A good book on Hormonal Treatment is; “Beating Prostate Cancer: Hormonal Therapy & Diet” by Dr. Charles “Snuffy” Myers, which describes well the "parameters" of the treatment.

I also recommend you to get a bone densitometry tests to ascertain for bone health. HT causes bone loss and you may have to start taking a bisphosphanate similar to Fosamax. In any case your cycling experiences and vitamin D supplements may have counter any effect.
I absolutely agree with your opinion on the diet. Where are you from?

Welcome to the board.
Wishing you a continuing positive look in your journey.

VGama

Hi Vascoda and hi to all
Hi Vascoda and hi to all other readers.
I reply with my text ** within Vascoda's post of 28 April 2012.

Patrick

Thanks for sharing your story.
I hope your status continues its path successfully and that you enjoy a return to normal levels of testosterone.

**There is more on my more recent condition at my website page http://www.turneraudio.com.au/Patrick-other-concerns.html
This is now up to 23 October 2102, but since then there have been other things worth explaining to all.

Though it seems that the condition (hypogonadism) has not affected you much, you can always recur to TRT patches if you want to get that needed energy back for cycling at the speeds of your friends. Quality of life in you seems to be related to the ability of maintaining a presence in a cycling society.

**Last August, my hot flushes ceased and my cycling speeds began to rise. Over the last 2 years I've mainly cycled alone without the company of a bunch. I rode 11,000km over the last 12 months, right through winter and summer, as has been usual since 2006.
The "cycling society" in fact isn't very social at all, and not wonderfully convivial, and its just wall to wall men who I find I don't need to be with, and most average a younger age and I can't keep up with them, and basically there isn't much in common that I have with bunches of fellows.

I wonder why you believe that the hormonal treatment (HT) has damaged the cancerous cells' DNA.

**I'm not so sure I said that, but docs gave me Eligard for 7mths, then I had RT, and I continued Eligard for another 17mths. Last August, PSA went down to 0.08.

This is a fact in radiotherapy but not in hormonal manipulations.
In HT you may expect the kill to happen due to “starvation”. Prostatic cancer cells feed on androgens (testosterone, DHT, etc) and by blocking it from reaching the cells receptors (mouths) one can expect the cell to die or become in a dormant status.
Nevertheless, this theory has been based on facts in cases with low grade Gleason cancers. Your Gleason 9 is made up of more aggressive types and you should consider a more aggressive form of HT (eg; ADT3) to get a grip on any advance of the cancer.

You have not shared any other info on your diagnosis of 2009 (symptoms that took you to get an initial PSA, etc), or the biopsy results and clinical stage, or the reason for your doctor’s choice for not recommend you a radical treatment (surgery or radiation) with intent at cure, which would have been logical in a patient of your age. You seem to be fit and healthy enough to go through a radical or a combination of HT plus RT.
Can you share any other test results like T and DHT levels, and image studies, etc.

**After diagnosis in Dec 2009, my specialist doc said I had agressive cells, maybe young man's type, and suggested robotic radical surgery for PG removal ASAP.
But I also had a constricted ureter, and the decision was made for open surgery instead because a number of other things would be done while they had me opened up.
The op was in April 2010. But afterwards docs explained to me they could not risk PG removal because of the risk of "spill", ie, cancer spread and they said PC had just gone to seminal vescicles, ie, come out of the capsule, and that I needed HT and radiation instead or surgery.


In my opinion your assertion that; “…. the cells might change to an even worse form of cancer which is harder to treat later…”, is not correct.

**Well, I'm only repeating what a an oncologist told me later. Seems possible to me. There ARE some cancers which just cannot be cured by any known means. And I may die sooner rather than later. The 30% of cases where men die of PC probably were all treated and a most would have put up a fair fight, - then lost. **** happens, no?

In recent studies it has been found that cancerous cells become refractory to traditional hormonal drugs because they are not affected by the hormonal manipulation that lead to a lower testosterone level circulating in our body (Eligard) or testosterone bio-structures fakes (Casodex), or similar.
In a clinical castrate environment (T lower than 0.3 ng/mL), some cancer cells manage to survive in very low levels of testosterone and even mutate to “fabricate” their own androgens. This is what it is known as Intratumoral Testosterone Effect. Cancer manage to produce its own feeding process to survive. One can verify such happening through tests. When T is low and PSA increases (condition of refractory cancer), intertumoral expression may be considered to occur for the continuing progression of the disease.

**I'm not an expert on PC terminology. Anyway, my last PSA 18 September 2012, just 1mth ago, showed PSA has risen from 0.08 to 0.50 in just a month. I was warned that when I came off Eligard, there would be a PSA rise.
I had another PSA test taken today, and I hope it has not risen to say 6.0, another 6 fold increase. After results come back next week and including testosterone levels, I'm sorting it out with docs and oncologists to see what treatment if any is necessary. Maybe I'll need another PSA test in another month. Maybe I will go back onto Eligard, or intermittent treatment, but right now I don't have a clue if I have cancer which is untreatable, ie, resistant to RT. I may have to live the rest of my life without testosterone. I'm in no-man's land where I don't have a clue who is winning.

HT will not cause cancer to become more aggressive. One should try to continue the manipulation by increasing drugs power (mg) or changing to similar drugs (Eligard to Zoladex and Casodex to Cyproterone, etc). Once failure is verified then one should start using a second line of HT drugs to address the intratumoral effect, such as Abiraterone acetate and MDV3100. An older drug not as efficient as the newer ones but also excellent is Ketoconazole which addresses the intratumoral effect but it is not FDA approved for the treatment of prostate cancer.

**I'll have to srt that out with docs when I know more about my exact condition. Perhaps PC spread someplace else BEFORE I had RT, even though no scans or other biopsies from lymph nodes inside stomach yielded a positive result back in April 2010. I just don't know what my real status is, and it will take time to find out.

I would suggest you to discuss the matter with your doctor and do research the net if you are interested in more detailed information.
A good book on Hormonal Treatment is; “Beating Prostate Cancer: Hormonal Therapy & Diet” by Dr. Charles “Snuffy” Myers, which describes well the "parameters" of the treatment.

**I'll look that up.

I also recommend you to get a bone densitometry tests to ascertain for bone health. HT causes bone loss and you may have to start taking a bisphosphanate similar to Fosamax. In any case your cycling experiences and vitamin D supplements may have counter any effect.
I absolutely agree with your opinion on the diet. Where are you from?

**After a year on Eligard my BD went down about 8%. So I began vitamin D + calcium. I was told I still had well above average BD.
I'm from Australia, and I live in Canberra, the nation's capital. Irish-English-Euro ancestors. I've been here since 1972, and the environment is about the cleanest one in Oz. I gave up smoking at 34 when I reached 1/2 a pack a day, I hardly drink. I eat just enough to maintain weight at 85.6Kg, BMI = 25. I could be 3 Kg lighter, and maybe by Xmas I could be because weather is warming into summer and food intake goes lower, and I have testosterone back again. But then additional treatments might wreck such ideas.
I eat a diet full of fresh vegetables, fresh fruits, huge salads with little dressing, adequate protein, and never high GI carbohydtrates. I thought Nathan Pritikin was about right about diet, and of course most western nation people just cannot bring themselves under control, and they mostly secumb to the marketing BS by Big Food. I will never eat at McDonalds, or drink Coca Cola, its all rot-gut. I don't have butter/margerine or sugar in the house I do use olive oil sparingly, and I always carve off the fat from any meat and send that out with the rubbish. My docs are much pleased by my lifestyle habits and they never feel I am just another lazy fat smoking SOB who isn't worth helping because he isn't helping himself. As I type to you now, my resting heart rate is 48BPM. Its been 65 when I could not exercise.
I cannot recall any time during the last 2 years when someone aged over 60 has overtaken me during my rides of up to 120km. I enjoy being fit, despite the aches and pains it generates. In 2005, docs told me I needed 2 new knee joints, I had bad pains then, but since then I've done maybe 60,000km and I can live with my damn knees. I inherited some of the worst characteristics of my mother's knees - she was anything but athletic. So I loathe walking far, and never run. But I can ride, and I love the speed, the motion, the zing-along, the land, lakes, rivers, sky, birds, grass, trees, and when I'm out on the bike, the damn world can go to hell.

Welcome to the board.
Wishing you a continuing positive look in your journey.

**I like to think I'm able to consider whatever may happen. It could be a nice long old age, or a short one. I reckon I'll die alone, because I've never got around to having a family and stuff, and although I like this town, most friends I've had have left it. I think I'll give my body to science. I'll at least get one final moment of glory, when they wheel me outa the fridge and sharpen up the scalpels. I reckon docs and students will say "WOW, get an eyeful of this old ****, what a very fine corpse he is!"....

**When all is said and done, life is mere therapy, and its final side effect is death. I like to think that if I am fully alive, I will realise I could be dead. We see things best in terms of contrast.

Between now and death I plan to do what I can until I cannot. I'd even like to marry again. Been 34 years since last time. But at 65, I realise I am Mr Invisible, or Mr Untouchable, Mr Short Term and Diseased, and what woman would take me? None took me properly ever, even though I was kind, fair, and energetic. Nobody gets all they want from life. And most theories from do-gooders and advisors often sound so hollow, so in fact we are alone, even when thousands live nearby, mostly suffering dreadful Affluenza and Consumeritis.
**I also need to try to do some Yoga. Its so hard to find a group session with the right sort of ppl and leader not hell bent of forcing me along.
Pardon me, but I am a reluctant member of that species called "Homo Wrectus."

**Patrick Turner.

VGama