WATCHFUL WAITING

This is for all of you "watchful waiting" guys. Sorry for my typical long-windedness, but this may be some handy, outlook-boosting poop you're anxious to hear.

Although I've already been through cryoablation, I consider myself in a second period of "watchful waiting" in that the disease is temporarily "suspended" with a drug that targets and blinds hormone receptors of prostate cancer cells to the presence of the testosterone needed for prostate cancer cell replication. Testosterone production is unaffected. In other words, the gearshift has been shoved up into "neutral," though the motor is still running until it runs out of gas...watchful waiting.

The only gold-standard "cure" for prostate cancer at this time is a radical prostatectomy at the earliest detectable stage of the disease while it's totally confined to the prostate capsule. Of course, a low Gleason score (measure of aggressiveness) is darn sure helpful. Even then, there is a 30% rate of recurrence, but that also means a 70% cure rate...again, only if caught at the earliest detectable stage.

Unfortunately, many men won't or don't act soon enough for an early diagnosis, much less get excited about having the earliest possible radical prostatectomy and the associated quality-of-life altering side effects. On the other side of the coin, if the disease is caught in its earliest stages, there is a far better chance a patient may be a candidate for a nerve-sparing procedure or nerve-grafting. If the prostate cancer is too far advanced, a nerve-sparing or nerve-grafting procedure may be out of the question because the remaining, spared nerve tissue or nerve-grafted tissue could provide a propagation path for further spread to metastatic sites beyond the prostate. Of course, very few have the capability to perform nerve sparing and nerve grafting integral to a radical prostatectomy surgical procedure. Even then, these are extremely delicate procedures performed that don't come with a guarantee, but are having higher success rates than ever.

Speaking of quality-of-life altering side-effects, there are all kinds of counseling available on solving problems with erectile dysfunction. However, for reasons I'll never figure out, most of these self-annointed counselors are estrogenated women having no clue how the testosterone-driven mind works at onset. I mean no offense, but until someone stiches up their vagina and gives them a massive dose of an aphrodesiac, they never will truly relate. The psychological and neurologically-driven orientations between genders are night and day different. In my opinion, all of the erectile dysfunction solutions more popularly offered suck...totally suck, and are far from a spontaneous norm. As far as I'm concerned, the only real-world solution is one of the new, saline-inflatable penile implants. Do a web-search, you'll find them...then go to the page featuring what I call a "Gorilla version or high-performance, sports version" that expands in both length and girth. I'll put it this way: you'll be swapping your old jockeys for 34DD underwear with underwire support...I guess what Victoria's Secret would call "Miracle Shorts." Currently, they are experiencing a 14-year reliability before having to replace a failed part, which usually winds up being the concealed pump...no major biggie. Anyway, until you make a bold decision on that subject, hang in there...pun intended.

There are other reasons to boost your thinking on prostate cancer. In cancer circles, you hear the word "hope" a lot. I hate that friggin word. It sounds too "iffy." I need something more definitive and concrete. In that pursuit, I can say that a more active stance to prostate cancer-focused research has been going on for only the last 10 short years. I conjecture that other forms of highly lethal cancer affecting much younger age groups resulted in putting middle-age to older males on the back burner. That is now no longer true and prostate cancer microbiological research is at an unprecedented high. Development of a "magic bullet" might come in the form of (1) being able to simply manage the disease to the point patients are provided an acceptable quality of long life, winding up dying with it, rather than dying from it or (2) a true-blue cure by developing drugs having the ability to target prostate cancer cells to induce apoptosis (normal cell life-cycles involving triggered, self-destruction). Research is now so active that someone being diagnosed with early-stage prostate cancer today, could very likely have their entire treatment protocol hit a new fork in the road due to development of new treatments since their original diagnosis. Of course, I'm in reference to research-based treatment protocols as opposed to treatment by cancer clinics using follow-the-leader methods or samo, samo, yesteryear treatments. As cancer is a profitable enterprise, it seems like cancer clinics have sprung up like gasoline service stations...one on every corner. Other enterprises are making their bucks by hawking magic pills and weird herbs from some remote corner of the planet.

I'll never be one that's into herbal or snake oil solutions. Obviously, if any of that stuff worked, it'd be in the forefront of treatment in pill or injectionable form...of course, with a pharmaceutically modified price tag. The big pharmaceuticals will go after anything for which there's a market, presuming it provingly works. Think about that. As to something more scientific and research-based, there are currently large-scale trials going on in major cancer research clinics involving nutritional supplements found in ordinary everyday foods that appear to be of preventative value. Do a search on ACS's site. You'll find it. However, once you have this stuff, you're probably spinning your wheels by gobbling supplements like M&Ms. If you are, inform your doc immediately.

As to lab, research-based, potential solutions, here's one on the horizon that will knock your socks off...yet, it's an existing drug used for an entirely different purpose:

http://www.cancer.org/docroot/NWS/content/NWS_1_1x_Bone_Density_Drug_May_Fight_Prostate_Cancer.asp

Pretty shocking, huh? Yeah...and that comes from the most respected and reliable source of cancer info there is: ACS. Like many other studies in the past, I also downloaded the detailed lab studies and reports on Raloxifene from the NCI (National Cancer Institute). Of course, one has to understand that cancer has already been "cured" a zillion times in lab dishes and sometimes in animals, only to find it doesn't do squat in a human model. This may be one such case, but animal studies are now underway, and until human trials are performed, no one knows.

The only prob I found with the study above is that 1000X the dosage found in a Raloxifene tablet was required to induce targeted apoptosis (cell death) in prostate cancer cells. For all I know, peanut butter would do the same at that level of concentration. The study's last paragraphs contained a caveat candidly posing the question on how to obtain a level in human blood serum equal to 1000x the dosage of Raloxifene...which they had no answer at the time. I suggested to my onco, I could take a several 100 tablets orally, another 100 or so as a mega-suppository, grind some up and smoke it, while sticking the rest up my nose.

The bottom line is, this "watchful waiting" could be a dynamic period because it is also a time when new diagnostic research, microbiology research in labs, and treatment technologies are being improved, all on the move faster than ever.

The key thing is, instead of "hoping" for tomorrow, make today a good one! I had advanced prostate cancer long before my diagnosis in late 2000 amd before being biopsied in early 2001...and am doing great!

Good Luck!

"Perry"