SHORTER ADT APPEARS TO BE BEST FOR HIGH RISK PROSTRATE CANCER

RADIATION HOPEFUL · February 2013

Hello EVERYONE----HOPE YOU ARE DOING WELL

WAnted to share a report published on www.medscape .com regarding androgen blockade.

Report was written by Nick Mulcahey --dated February 12,2013

Report states > Long term androgen blockade in men with high risk localized prostrate cancer CAN BE SAFELY reduced from the current standard of 36 months to 18 months without compromising survival, according to results from a phase 3 trial.

The lead study author Abdenour Nabid ,MD associate professor at Centre Hospitalier Universitaire de Sherbrooke in Quebec ,Canada spoke at the American Society of Clinical Oncology being held in advance of the 2013 Genitourinary Cancer Symposium , February 14 to 16 in Orlando Florida. ALL of the men in the study treated with radiotherapy. The study involved at least one of the following risk factors, a prostrate specific antigen (PSA) level above 7 (ALL had node-negative disease)

Wanted to share this info with my friends on this site.

Respectfully

Radiation Hopeful

VascodaGama · February 2013

Combi RT + HT treatment

RadHope

Thanks for bringing up this study which clearly evidences the lack of benefits in the adjuvant hormone therapy after RT, during prolonged periods of administration.

http://www.medscape.com/viewarticle/779184

There are studies that evidence the benefits of the hormonal portion in the combi treatment of RT + HT, when given neoadjuvant (previous to RT). They say that such benefit rounds the 35% better in biochemical free rates with a combi treatment than the administration of RT alone. This applies not just to the risky cases (T3 or T4) but to all stages.

My lay opinion is that HT looses after one year of adjuvant treatment.

I hope that with this data you are at easy with yourself. I know how worried you have been in regards to ADT side effects.

And if you permit me, how are you faring? What are the latest results (PSA and Testosterone) ?

What about the osteopenia?

Regards

VGama

RADIATION HOPEFUL · February 2013

VascodaGama said:
Combi RT + HT treatment
RadHope

Thanks for bringing up this study which clearly evidences the lack of benefits in the adjuvant hormone therapy after RT, during prolonged periods of administration.

http://www.medscape.com/viewarticle/779184

There are studies that evidence the benefits of the hormonal portion in the combi treatment of RT + HT, when given neoadjuvant (previous to RT). They say that such benefit rounds the 35% better in biochemical free rates with a combi treatment than the administration of RT alone. This applies not just to the risky cases (T3 or T4) but to all stages.

My lay opinion is that HT looses after one year of adjuvant treatment.

I hope that with this data you are at easy with yourself. I know how worried you have been in regards to ADT side effects.

And if you permit me, how are you faring? What are the latest results (PSA and Testosterone) ?

What about the osteopenia?

Regards

VGama

MEDSCAPE ARTICLE

HELLO VGAMA

THANK YOU FOR WRITING---MY last PSA was 0.30 which I THOUGHT was pretty good. I'm scheduled to get my second PROLIA shot on the 28th of MARCH & I will ask if I CAN be taken off the shots. As you may know from a earlier post I was switched to the 4 month shots of ELIGARD which mean only two more shots if he decides not to take me off them----better than the monthly shots of FIRMAGON. HE Did say if the PSA or anything changes I can always go back on the FIRMAGON. PERHAPS this will be the end of hormone shots when I Show him the medscape article.

THIS MONDAY JAN.18th I HAve A consulation at a center for oral & Maxillofacial surgery regarding extraction of a tooth & implant -----I PRAY their aren't any complications. It would have to be a front tooth.

THANK YOU IN ADVANCE FOR ANY ADVICE __I TRULY APPRECIATE YOUR INPUT

RAD HOPEFUL

VascodaGama · February 2013

RADIATION HOPEFUL said:
MEDSCAPE ARTICLE
HELLO VGAMA

THANK YOU FOR WRITING---MY last PSA was 0.30 which I THOUGHT was pretty good. I'm scheduled to get my second PROLIA shot on the 28th of MARCH & I will ask if I CAN be taken off the shots. As you may know from a earlier post I was switched to the 4 month shots of ELIGARD which mean only two more shots if he decides not to take me off them----better than the monthly shots of FIRMAGON. HE Did say if the PSA or anything changes I can always go back on the FIRMAGON. PERHAPS this will be the end of hormone shots when I Show him the medscape article.

THIS MONDAY JAN.18th I HAve A consulation at a center for oral & Maxillofacial surgery regarding extraction of a tooth & implant -----I PRAY their aren't any complications. It would have to be a front tooth.

THANK YOU IN ADVANCE FOR ANY ADVICE __I TRULY APPRECIATE YOUR INPUT

RAD HOPEFUL

Follow-up tests

RadHope

Today is Feb.19, so you are one tooth less. Just kidding but I image your smile with a black hole in the middle of the white wall.

I hope the maxillofacial surgery procedure is done and that nothing has happen in particular. You have been worried because of the bisphosphonate you are taking but osteonecrosis of the jaw is an “accident” from prolonged periods on the drug. This is not your case and you shouldn't be so worried.

I think that you are better out with lesser bone loss than with agravated osteoporosis, in particular in guys like us at the risk of metastases.

It is good for you to discuss with the doctor about the length of the period on ADT. I hope he agrees in making it shorter. Please read this survivour story; http://www.yananow.org/display_story.php?id=969

Meanwhile you should get another testosterone test and a bone densitometry scan.

Wishing you continuous good outcomes from the treatment.

VGama

RADIATION HOPEFUL · February 2013

VascodaGama said:
Follow-up tests
RadHope

Today is Feb.19, so you are one tooth less. Just kidding but I image your smile with a black hole in the middle of the white wall.

I hope the maxillofacial surgery procedure is done and that nothing has happen in particular. You have been worried because of the bisphosphonate you are taking but osteonecrosis of the jaw is an “accident” from prolonged periods on the drug. This is not your case and you shouldn't be so worried.

I think that you are better out with lesser bone loss than with agravated osteoporosis, in particular in guys like us at the risk of metastases.

It is good for you to discuss with the doctor about the length of the period on ADT. I hope he agrees in making it shorter. Please read this survivour story; http://www.yananow.org/display_story.php?id=969

Meanwhile you should get another testosterone test and a bone densitometry scan.

Wishing you continuous good outcomes from the treatment.

VGama

ADT

VGama

THANK YOU SO MUH FOR THE REPLY----your replies always make me feel better. My biggest dilema is the upcoming surgery to install a tooth implant. As you stated I haven't been on PROLIA very long > only had one shot & hopefully everything will turn out "OK". I'm scheduled to get my next PROLIA shot on MARCH 28th & the ELIGARD shot which I hope the urologist cancels. TIME will tell --- "THANK YOU again for the reply"

COrdially

Rad Hopeful

RADIATION HOPEFUL · February 2013

RADIATION HOPEFUL said:
ADT
VGama

THANK YOU SO MUH FOR THE REPLY----your replies always make me feel better. My biggest dilema is the upcoming surgery to install a tooth implant. As you stated I haven't been on PROLIA very long > only had one shot & hopefully everything will turn out "OK". I'm scheduled to get my next PROLIA shot on MARCH 28th & the ELIGARD shot which I hope the urologist cancels. TIME will tell --- "THANK YOU again for the reply"

COrdially

Rad Hopeful

DENTAL IMPLANT

Hello VGAMA & ALL

TOday FEbruary 25th I had my tooth implant & it wasn't as bad as I originally thought. SO far no problems ------I ASKED THE DMD At ST. LUKES for his professional opinion & he told me the bone looked good & he will see me in a couple weeks. Just thought I would let you know how the tooth implant went well. DESPITE being on PROLIA I"M also now taking Amoxicillin to prevent infectionn. (SO far so good)

RAD HOPEFUL

RADIATION HOPEFUL · March 2013

RADIATION HOPEFUL said:
DENTAL IMPLANT
Hello VGAMA & ALL

TOday FEbruary 25th I had my tooth implant & it wasn't as bad as I originally thought. SO far no problems ------I ASKED THE DMD At ST. LUKES for his professional opinion & he told me the bone looked good & he will see me in a couple weeks. Just thought I would let you know how the tooth implant went well. DESPITE being on PROLIA I"M also now taking Amoxicillin to prevent infectionn. (SO far so good)

RAD HOPEFUL

PSA UPDATE

Hello ALL My fRIENDS

I GOT MY LAtest PSA Results today & THEY WERE ---0.27------perhaps I REached NADIR. Appears changing from FIRMAGON to ELIGARD didn't have much affect. MY last PSA in NOVEMBER Of 2012 was 0.30. TOOTH IMPLANT went well -----no problems with the bone despite being on PROLIA. Next week I"M going to show the urologist the MEDSCAPE article pertaining to SHORTER ADT APPEARING BEST FOR HIGH RISK PROSTRATE CANCER. PERHAPS he will stop the stomach shots.

RADIATION HOPEFUL

VascodaGama · March 2013

RADIATION HOPEFUL said:
PSA UPDATE
Hello ALL My fRIENDS

I GOT MY LAtest PSA Results today & THEY WERE ---0.27------perhaps I REached NADIR. Appears changing from FIRMAGON to ELIGARD didn't have much affect. MY last PSA in NOVEMBER Of 2012 was 0.30. TOOTH IMPLANT went well -----no problems with the bone despite being on PROLIA. Next week I"M going to show the urologist the MEDSCAPE article pertaining to SHORTER ADT APPEARING BEST FOR HIGH RISK PROSTRATE CANCER. PERHAPS he will stop the stomach shots.

RADIATION HOPEFUL

Nadir

RadHope

Congratulations for another low result. I am glad to know that you are "fine" with the leuproline acetate.

I wonder what nadir may mean on combi therapies. Surely the "lowest" result is a nadir and in terms of PCa it indicates control and submission of the bandit, but in cases like yours the treatment outcome should not be judged with a "masked" PSA. The success can be confirmed once you stop the HT portions and you get a stable level of PSA.

One should recall that you got a prostate in place producing serum PSA which level can be higher than the 0.27 ng/ml you report here, and still be judged as excellent.

I hope you continue to report the successes to us.

Best

VG

RADIATION HOPEFUL · March 2013

VascodaGama said:
Nadir
RadHope

Congratulations for another low result. I am glad to know that you are "fine" with the leuproline acetate.

I wonder what nadir may mean on combi therapies. Surely the "lowest" result is a nadir and in terms of PCa it indicates control and submission of the bandit, but in cases like yours the treatment outcome should not be judged with a "masked" PSA. The success can be confirmed once you stop the HT portions and you get a stable level of PSA.

One should recall that you got a prostate in place producing serum PSA which level can be higher than the 0.27 ng/ml you report here, and still be judged as excellent.

I hope you continue to report the successes to us.

Best

VG

THANK YOU VGAMA

VGAMA

THANK You for the reply, very encouraging ---- I will update & report what the urologist tells me on THURSDAY of next week regarding the hormone shots.

I FEEL GREAT-- taking a tree down tomorrow.

Cordially

RADIATION HOPEFUL

tarhoosier · March 2013

Prostate-ONE R, not 2

Prostate, not prostrate

I only wish my prostate cancer were prostrate " completely overcome and lacking vitality, will, or power to rise"

Samsungtech1 · March 2013

Ht

Not sure how it works, but seems to me that you keep going until your PSA rises or they find cancer has spread. Then they change it up. It just depends on your chemistry. I think once you start down this trail you ride it u til the end. Seems fairly straight forward. We all have the option of saying "no mas" whenever we want.

RADIATION HOPEFUL · April 2013

LATEST PSA UPDATE

Friends

LATEST PSA TEST Was 0.20 & the white blood cell reading was 5.2 which is in the normal range---just passing the latest update to my many friends on this site

Apparently the PROLIA nor the switch from FIRMAGON to 4 month shot of ELIGARD didn't affect anything---LAST month PSA was 0.27

I'm HAPPY with the white blood cell reading which I thought would be low due to the cancer-- (HAD A CBC blood test)

VascodaGama · April 2013

Any other detail?

RadHope

It is great to hear about the yet still lower levels.

Share with us more of your experiences. Can you update us about the side effects?

What has been the difference between the times on Firmagon and now Eligard?

Have you checked your bone density for osteoporosis?

Enjoy life.

VG

RADIATION HOPEFUL · April 2013

VascodaGama said:
Any other detail?
RadHope

It is great to hear about the yet still lower levels.

Share with us more of your experiences. Can you update us about the side effects?

What has been the difference between the times on Firmagon and now Eligard?

Have you checked your bone density for osteoporosis?

Enjoy life.

VG

OTHER DETAILS

VG

THANKS FOR THE REPLY----NO PROBLEMS ---APPEARS ALL IS WELL. I'm feeling good & hope things stay this way. NO problems or side affects from the drugs. I see the urologist on MONDAY the 29th-- see if he has me take another ELIGARD shot, I'll let you know. AS you know I Had a bone density check which is why I had to take PROLIA.

BLESS EVERYONE

RAD HOPEFUL

jwoodie · April 2013

HT After RT

Great info! I am wondering about the benefit of HT at all after RT if PSA drops to near zero. I am newly diagnosed G4+3 and got a 4 mo. Lupron injection prior to upcoming EBRT. Why would I need continuing (2 yr) HT if PSA drops to near zero, and wouldn't this mask the PSA results of the RT?

RADIATION HOPEFUL · April 2013

VISIT TO UROLOGIST

LATest UPDATE AS PROMISED

UROLOGIST-PA> gave me a prolia & another ELIGARD shot in the stomach. CLAIMS the PSA should be at ZERO--not 0.20 ---- Another ELIGARD shot is scheduled for AUGUST & another PROLIA shot in OCTOBER of this year. PA told me something is going on or the PSA wouldn't keep going lower.

I though I was doing GOOD

RADIATION HOPEFUL

VascodaGama · May 2013

Visit to Urologist: "I though I was doing GOOD".......

RadHope

We have exchanged many opinions since your diagnosis and I see you as an experienced PCa survivor, well versed in your treatment. We trust our doctors but they cannot prove or assure that their ways in treating PCa are the best. They follow principles and the norms of their associations. However, in this “PCa treatment affair” there is lots of guessing. What one doctors says is not exactly what another doctor thinks. They differ because they also are not sure on what is good.
Accordingly, either we trust and strictly follow what our doctor tells us or simply get second opinions from other specialists. At the end we have to “separate the wheat from the chaff" and do our own judgement.

Your Urologist PA is simply following a protocol which he thinks to be proper to your case. However, I think that he has done nothing to find the cause of the value of 0.20. He expects your PSA to get still lower on the assumption that another Eligard shot will get you there, whatever time it takes. It could be forever until he fells satisfied.
Did he comment about his PSA threshold that corresponds to Zero in your case?

I believe that shorter period of adjuvant HT is better in cases like yours. You will never know if RT was in fact successful if you are not taken out of castration. That can be checked only with the results of both tests; a total testosterone and a total PSA.
The “functionality” of Prolia can only be checked with bone densitometry tests. The PSA has nothing to do with the success of that drug. I hope your doctor has not decided to give you Prolia for life.

Sorry for my “negative” opinion in regards to the comments of your urologist.

Best wishes for continuing low levels of PSA and symptomless status.

VGama

RADIATION HOPEFUL · May 2013

VascodaGama said:
Visit to Urologist: "I though I was doing GOOD".......
RadHope

We have exchanged many opinions since your diagnosis and I see you as an experienced PCa survivor, well versed in your treatment. We trust our doctors but they cannot prove or assure that their ways in treating PCa are the best. They follow principles and the norms of their associations. However, in this “PCa treatment affair” there is lots of guessing. What one doctors says is not exactly what another doctor thinks. They differ because they also are not sure on what is good.
Accordingly, either we trust and strictly follow what our doctor tells us or simply get second opinions from other specialists. At the end we have to “separate the wheat from the chaff" and do our own judgement.

Your Urologist PA is simply following a protocol which he thinks to be proper to your case. However, I think that he has done nothing to find the cause of the value of 0.20. He expects your PSA to get still lower on the assumption that another Eligard shot will get you there, whatever time it takes. It could be forever until he fells satisfied.
Did he comment about his PSA threshold that corresponds to Zero in your case?

I believe that shorter period of adjuvant HT is better in cases like yours. You will never know if RT was in fact successful if you are not taken out of castration. That can be checked only with the results of both tests; a total testosterone and a total PSA.
The “functionality” of Prolia can only be checked with bone densitometry tests. The PSA has nothing to do with the success of that drug. I hope your doctor has not decided to give you Prolia for life.

Sorry for my “negative” opinion in regards to the comments of your urologist.

Best wishes for continuing low levels of PSA and symptomless status.

VGama

Visit to Urologist: "I though I was doing GOOD".......

VG

THANK YOU FOR THE REPLY---you have some very valid points. I asked if I should have another DEXA SCAN & he told me NO. I guess it's up to me to refuse the shots. The regular full doctor (urologist) is scheduled to give me the PROLIA shot in OCTOBER. (I will question him then). AS far as the ELIGARD shots go, I know it's controversial about how long one should be taking the hormone shots ----which is why I allowed another shot to be given. YOUR OPINION is VERY VALID & I appreciate it VERY MUCH. I can only HOPE theses guys aren't in it for the money. SAD I HAVE TO EVEN CONSIDER THIS. WHEN the scheduled time is up for the hormone shots, I'm going to stop them ---period. THE doctor (PA) never discussed PSA THRESHOLD that corresponds to zero in my case.
ONE HAs to put their faith & HOPE in what the professional doctors are telling them, but one has to also consider why isn't anything being done to find out why the PSA isn't going to zero. I will keep posting updates as they occur & HOPE FOR THE BEST. I ONLY SEE THE REAL DOCTOR ONCE A YEAR, it's always the PA taking care of everything.THE REAL DOCTOR is lways in the HOSPITAL performing prostrate OPERATIONS. (MAYBE it's time to switch)

CORDIALLY

RAD HOPEFUL

SHORTER ADT APPEARS TO BE BEST FOR HIGH RISK PROSTRATE CANCER

Comments

Discussion Boards