Hope??

Sadie marie said:

I am very confused trying to

I am very confused trying to study all the info out there. I've read the SWOG 9346 report on continuous hormone therapy in people with low volume metastatic median survival was 7 years. But other info says hormone therapy only lasts 18-24 months. Am I missing something or misreading report.

Sadie Marie,

You are comparing apples (when does hormone therapy fail?) to oranges (how long until death?). As we tried to explain earlier, once the first kind of hormone therapy (like Lupron) fails, there are other therapies that should be tried (like Xtandi etc). Hence, life can be prolonged by many years after failure of the first hormone therapy drug.

Keep the faith!

PS: did your husband enroll in the clinical trial that you wrote about?
 It's almost a month since the first Lupron shot. When will he get his PSA measured?

From your posts I believe that you want to know for how long your man is going to live if he takes Lupron. However, as you may understand nobody can provide you with such answer. It could be 7 years (SOWG) as 15 years or more. The end of the treatment is when your man becomes refractory to all drugs.
The above discussion refers to the drugs' efficacy in the overall treatment. To understand the matter you need to investigate more regarding the "mechanics" behind HT administration and what has been in discussion by the fellas at SOWG.

I have posted in this forum extensively several references regarding the SWOG trials on HT. Unfortunately CSN administrators never tried to improve its search engine so that I cannot provide you the links.  In any case my opinion is that the effectiveness of Lupron in the treatment is not endless. It can continuously avoid the manufacture of testosterone by the testis, depriving cancerous cells from its "food", the androgens, but the bandit manage to mutate its androgen receptors (its mouth) to live of tiny portions of the substance or even start producing testosterone by itself (as a means of survival understood via Darwin principles).
When the above occurs, the patient experiences a period of refractory to the treatment, meaning that the drug is not effective in the treatment (but it can still be working properly in maintaining our body at castration levels). Accordingly, your comment of:  lupron only last 18-24 months means efficacy in the treatment before cancer mutates and looks for means of survival (refractory). Long periods in castration may accelerate this process, so that one should exchange drugs the soonest before it occurs.

The SOWG trial's 7.1 year, refers to the length of life of a patient in continuous HT treatment. You may find this comments confusing but the trial was never clear enough and it has been controversial since its beginnings. The fact is that HT has distinct applications dependent on the patient status and type of cancerous cells.

The trial 9346 were done to compare intermittent against continuous modality involving a cohort of patients with metastatic cancer, not discriminating its extent. Where these mets located in bone alone, or in bone and tissues, or tissues alone, or........
The results were presented indicating that the modality intermittent was "inferior", however, another previous trial prove the contrary (intermittent "superior") but it was designed to patients of failed radical therapies (which is considered by these oncologists as "localized metastases", wherever they exist).

Regarding the effectiveness of Lupron in maintaining castrate levels of testosterone, the length of its period depends on the type of shot. Lupron injection/shot is available for 1 month, 3 months, 4 months and 6 months. To the above length one should add the drugs' half-life plus approximately 2 month which is the period our body (the pituitary) takes to recover and starts producing testosterone.

The SOWG Trials;

http://www.cancernetwork.com/review-article/prostate-cancer-clinical-trials-southwest-oncology-group-0

http://www.ascopost.com/issues/july-1-2012/swog-9346-conclusions-debated-in-special-post-plenary-discussion/

Best wishes,

VG

Sadie,

I think we understand your fear and confusion.  You're driving  by wanting a schedule so you know what to look forward to and what each stage means and when it will occur.

Unfortunately, cancer doesn't stick to time lines.  You seek hope and you're getting the best advice from many people who have lived this life.  Maybe try the AA slogan of one day at a time.  I don't mean litteraly one day as much as getting yourself settled to accept there are no firm answers.

There are lots of potential  out there, I'm glad you're looking around.  You don't have to be in a giant rush.  It took years to get into him, a few days more probably won't matter while you search.  You also have mentioned several types of MDs ordering different test and offering different ideas.  Do you have one person MD or experienced RN who, once you assemble the diagnosis, readings and prognosis gathered, you can sit and create some sort of chart or study guide so you can look at all options side by side and then compare, kind of like you can do when online buying things.

You've got to find  way to slow down your mind full of worries as it can't help to go from post to post with no sense of direction.

I don't know if this makes any sense to you but it's the best I can seem to come up with.  You have a lot of info, you need to sift it.

Good luck, keep us posted.jj

Sadie marie said:

So you are saying lurpron

So you are saying lurpron only last 18-24 months. The study said continuous hormone therapy was advantageous to those with low volume metastatic hormone sensitive cancer than intermittent. Intermittent was better for those with high volume. Didn't say anything about refractory. Median survival for low was 7.1 years. Just trying to grasp the effectiveness of lurpron as we go forward. We are still looking at trial with xtandi while we wait to get appointment at Washington University in St. Louis for second opinion.

Hi Sadie,

I have been reading your posts and the comments. We also live in Illinois and my husband was just diagnosed yesterday and I am really, really scared. We have Gleason scores of 9 & 10 and a bone scan and CT scan scheduled two weeks from today. His pathology report also shows perineural invasion as identified.  

I am curious what part of the state you live in? We are in east central area and are also considering a second opinion after we get all the results. In reading other posts, I have come across John Hopkins University (JHU) remote second opinion program. JHU seeminly has the number one urology program in the nation. Wash U is certainly wonderful and we may head there as well, or Chicago. One interesting thing about the JHU second opinion is they give you an opinion on the pathology, course of treatment, and suggestions for physicians/surgeons in your area to help. Please see below for the link if you want to review.

http://www.hopkinsmedicine.org/second_opinion/

My thoughts and prayers are with you!

Sadie,

Amen & Amen to what Swami Rakendra said above. Especially "Thy will be done".  It's one day at a time in this deal.  On Dec 10, I'll be a three years survivor since my surgery. I started with a PSA of 69, and the PSA has remained at undetectable levels (<0.010 --0.035) since my Surgery, Lupron and Radiation treatments.   I see every new day as a gift, and Thank the Good Lord every day for the new day, and for all the doctors, medical and therapy people who have helped and are helping me.

Love, Peace and God Bless

Will

Sadie marie said:

You are absolutely correst

You are absolutely correst time to quit moping and enjoy life. He has enrolled in the trial study of xtandi with Lupron. He is joining the YMCA and is very positive. A little down about the loss of libido but we will get through that. Thank you for the wake up.

Glad to read your update and the fact that your husband was accepted into the trial. I am pretty sure that his health will be closely watched.