Hi Jamie, Alan & Dale,

First of all THANKS for your feedback, comments and support...

Without a doubt Royal Surrey is well up there in the UK but I saw Dr
Damien Greene who works out of Newcastle and Sunderland Hospitals {in
the NE of England}. He has significant expertise in Cryo in the UK and
I believe he has treated more patients than anyone in the UK, to add
to that he's a real nice bloke to chat to, and spends much of his time
teaching this Cryo treatment to other Dr's across the UK, so I'm
confident of the mans skills and ability.

My main concern is that some 3 weeks ago he told me that it was likely
that I would be treated early in September, now that's been rolled
back to October, add to that the fact that I was DX'ed around 10 weeks
ago, and that Plan A {HIFU} didn't pan out for me {due to the
calcification thing}, I'm getting really anxious about the ticking
that this little time bomb is doing inside
of me.

I was a bit surprised when his office simply advised me of the later
date, and didn't mention anything that I should be/could be doing in
the meantime.

Maybe Dr Greene {with his expertise} doesn't see or feel the anxiety
or need for the urgency that I feel, and if that's based on his
knowledge then I would feel fine banking {my life} on that {almost}.

Being concerned {to put it lightly} I contacted his office and asked
"what options might help" in the couple of months I have now to wait,
and they came back with the suggestion of 150mg of Casodex a day.

Maybe {and hopefully} this option was given to me simply to calm my
jangling nerves ? maybe the time frame isn't of great urgency ? maybe
I'm OK without the Casodex ? but it's a hell of a bet to get wrong,
so...

What's with this Casodex stuff ? what's the pros and cons of it ? I
don't want to turn into Dolly Parton overnight {sigh} but right now
being Dolly Parton beats being Elvis Presley to me, at least as far as
body temperature is concerned...

Looks like Casodex isn't a problem for the Cryo treatment, so no
worries there,
and I don't think that Casodex gives a rush to testosterone that I've
heard Lupron does.

Other than all this, Alan I appreciate your comments, but I can't
speed things up, Dr Greene is doing his best and is serving patients
both privately and some done through the NHS system, so I'm stuck like
the rest of the poor sods, sweating it out waiting to have me vitals
frozen off...

Dale... much appreciate your support, maybe the worries I have are
{slightly} out of proportion to my condition, maybe the
knowledge/experience of Dr Greene
gives a better insight to where I'm at {statistically}, but it sure as
hell don't stop me sweating this one out.

Should I start gulping down the Casodex or not ? THAT is the question
!

Canada Bob,
aka Wigin Bob, depending on which side of the pond I find myself on.

CBob--

Following is the meat of something I posted a few weeks ago, with the usual
caveat that I'm no doctor . . .

Casodex 150 has been shown in a study not effective--and perhaps slightly
counterproductive--for the treatment of localized PCa either as an initial
therapy prior to radiation or surgery, or as an adjunct to watchful
waiting.  See this link:
http://www.info.doh.gov.uk/doh/embroadcast.nsf/vwDiscussionAll/.  Click on
the 28/10/03 topic re Casodex.

A study apparently suggested that use of Casodex 150 slightly increased
death rates. Key excerpt from an October 2003 official-looking UK medical
advisory from the chairman of the committee on the safety of medicines:

"CASODEX 150 MG (BICALUTAMIDE): NO LONGER INDICATED FOR TREATMENT OF
LOCALISED PROSTATE CANCER

"I am writing to inform you that following review of new clinical trial
data, Casodex 150mg (bicalutamide) is no longer licensed for the treatment
of localised prostate cancer. "Localised" is considered to be a relatively
small tumour, with no tumour spread outside the prostate gland.

"New Data
"Recent results from a study of Casodex (bicalutamide) in early prostate
cancer have shown that in patients with localised prostate cancer who would
otherwise have been managed only by watchful waiting, there is a trend for
an increase in the number of deaths in patients receiving Casodex 150mg
when compared with patients who received placebo [196 (25.2%) deaths versus
174 (20.5%) deaths, hazard ratio (HR) =1.23, 95% confidence interval 1.00 -
1.50]. This analysis is at median follow-up of over 5 years. (Watchful
waiting is where the patient is monitored and treatment is only started
when there are signs that the disease is getting worse.)

"Committee on Safety of Medicines (CSM) advice
CSM has advised that the balance of risk to benefit in patients with
localised prostate cancer is unfavourable. Consequently, Casodex 150mg
should not be used for the treatment of these patients.

"Casodex 150mg is also used in patients with locally advanced prostate
cancer, as immediate therapy either alone or as adjuvant to treatment by
radical prostatectomy or radiotherapy (locally advanced is considered to be
a larger tumour or tumours with spread to lymph nodes, but not involving
spread to other organs). CSM advised that the overall risk benefit remained
positive in this group, however they concluded that for some patients at
lower risk of disease progression in this group who are also receiving
surgery or radiotherapy, Casodex therapy might not be suitable as an
initial therapy."

If a doctor suggested Casodex 150mg as a pre-cryotherapy treatment it would
make sense to show him this UK medical advisory.

Good luck!

Paul