Bill,

Your numbers and history are very close to mine.  You seem to have a good
outlook and it is warranted.  I've lived 3 years so far past where you are
now.  And my PSA is virtually undetectable.

At your age, I would go for radiation and a potential cure. Hormone
therapy is palliative at best. The question comes down to, "Where will
you be in 15 years?"
At age 66 I had a very successful RRP with negative margins and
undetectable PSA after 3 months.

Jim Hammond
W4MQY

On December 14, Ed Friedman responded to K9GCO:

ADT3 (androgen deprivation therapy/triple hormone blockade), like any
ADT, can and will become ineffective at some point as the PCa cells
adapt and become hormone-refractory. It may be a reasonable choice for a
man who has a chance of dying from some cause other than PCa during the
time that ADT3 is effective in staving off the PCa.

As a non-medic, that's as far as I can go. It's based upon extensive and
ongoing study.

Regarding study, I'd appreciate a citation to a peer-reviewed article
that supports the zero deaths in 6.2-years figure. I do note that it's
intermittent treatment, which has its proponents (among them, me, FWIW).

Two books that are helpful:

_A Primer on Prostate Cancer_, subtitled "The Empowered Patient's
Guide," by Stephen B. Strum, an oncologist,
and
Patrick Walsh's book, _Guide to Surviving Prostate Cancer_.

Two useful websites:

Prostate Cancer Research Institute: http://prostate-cancer.org/index.html
and
the support group Us Too!: http://ustoo.com/

Regards,

Steve J
__
Study, learn, take charge!

Hi Ed...When I looked at Dr. Bob's 2004 update
(http://www.prostatepointers.org/leibowitz/THB-update.html), he claims
99.5% disease specific survival at 5 years median follow-up.  I wonder
what the disease specific survival is for low-risk men (80% of Dr.
Bob's patients were low-risk) at 5-years post-surgery or RT.  It's got
to be high, not many people die from PCa early on.  I wonder if it
would be any different fom Dr. Bob's number?..Best wishes and good
health, Ron

Ed,

This is particularly useful advice for a man who has already had
two heart attacks.

However one question that comes to my mind is, which therapy
is easier on the body - radiation or HT?  HT seems easier in that
you just get an injection from time to time.  But I'm not sure it's
really easier over a period of a year or two.

External beam radiation is painless.  If it's done well, it can have
relatively manageable side effects.  Brachytherapy is, in some ways,
even easier to take because it's just a one time procedure (though
in other ways it's harder because it does involve anaesthesia and a
hospital stay).  It too has manageable side effects.  In my own case
the side effects that I got from EBRT and HDR brachytherapy all
seemed to pretty much go away within a few months.  However the
HT I got had side effects that got continued and even got worse while I
was on it.

Assuming you don't need a cure because you won't live long enough
to develop symptoms when taking HT, it's still not totally obvious
to me that HT is easier than radiation.

And of course if you do live long enough to develop symptoms - then
you'll wish you had gone for a cure.

   Alan

Hi Ed...When I looked at Dr. Bob's 2004 update
(http://www.prostatepointers.org/leibowitz/THB-update.html), he claims
99.5% disease specific survival at 5 years median follow-up.  I wonder
what the disease specific survival is for low-risk men (80% of Dr.
Bob's patients were low-risk) at 5-years post-surgery or RT.  It's got
to be high, not many people die from PCa early on.  I wonder if it
would be any different fom Dr. Bob's number?..Best wishes and good
health, Ron

Hi Ed...When I looked at Dr. Bob's 2004 update
(http://www.prostatepointers.org/leibowitz/THB-update.html), he claims
99.5% disease specific survival at 5 years median follow-up.  I wonder
what the disease specific survival is for low-risk men (80% of Dr.
Bob's patients were low-risk) at 5-years post-surgery or RT.  It's got
to be high, not many people die from PCa early on.  I wonder if it
would be any different fom Dr. Bob's number?..Best wishes and good
health, Ron

It should be pointed out that this is not the consensus opinion among
most people who treat prostate cancer, at least for a Gleason 6, PSA 7
case.  It might be appropriate for some men who have a high risk of
their cancer having spread.   Also, remember that as a nonexpert, it is
going to be very difficult for you to evaluate claims about success in
treating prostate cancer.   There are a lot of pitfalls in comparing
different approaches.   Perhaps Leibowitz is right and other well known
experts are wrong, but you have no way to judge that.  You are much
better off following your doctor's recommendations than paying attention
to random information you glean from the internet.

...

Ed,

I re-read this web page.  I admit, it is intriguing.  It seems to
me that the techniques they are applying are worth investigating.
However it also raises a lot of questions.  For example:

Are they recommending this treatment to everyone, regardless
of age, general health, PSA, or Gleason?  Would they, for example
treat a 50 year old man this way, knowing that his normal life
expectancy might be another 30 years?

Which patients are getting chemotherapy, and why?  Are they
patients with rising PSA, or are they patients who had certain
initial risk factors?  Is chemotherapy being used because the
ADT appears to have failed with these men, or is it a preventative?

There are some rather surprising statements in the report,
including:
 "All patients refused any form of radical local therapy."
and,
 "No study has ever proven that any form of radical
local therapy is both necessary and effective."

Finally, what sort of financial organization are they working for?
It appears that they are in private practice and are advertising
for new patients.  Could this be biasing their methods and/or
their reports?  I would have been more comfortable with this
report if it had come out of a University research center.

I'm not saying these guys are quacks or charlatans, or that
their claims are wrong, or that they aren't advancing the state
of the treatment art.  They may well be pioneers showing the
way for everyone else.  But strong claims require strong
evidence.  More investigation is needed before we take any
of their claims as established.

If I had to choose between conventional surgery or radiation,
and their techniques, and I weren't yet very old, I would still
opt for the established therapies.

On the other hand, if my standard therapy fails, I'll think
long and hard about trying triple ADT with finasteride.

   Alan

Dwight,

What is your PSA now, and how long after the end of radiation
did it take to reach that level?

I'm guessing that the HT you had prior to radiation lowered
your PSA to an undetectable level.  Then you had radiation,
then, at some point, the HT wore off.  Did your PSA come up
after that, or stay at undetectable (assuming it was once
undectable.)

Thanks.

   Alan

Hi, Mike  I tend to agree with cutis, I had a bad heart attack, and
while it was a concern, after a full physical all of the physicians
gave me the okay for rp if that was what I wanted to do. Glad I had the
surgery as my cancer retuned in Nov and I am now in rt, an opition that
would not be available now, if I would have had radiation to begin
with.  The main thing is to talk to all of your Dr's get informed as
best you can and make the decision that is best for you. I am have way
thru the rt and no problems so far. I never had any problems after rp
either was out of hospital in 2 days and was totally dry in 2 months I
wish you the very best, and may God bless. (note I am not a dr)

Bev might want to update her info.

As reported elsewhere on the NG, the Phoenix 5 website is gone. Netscape
says that it cannot be found. A pity.

The Cooleyville website is personal to Don Cooley. Interesting, but PCa
info can be found at Don's other website, http://prostate-help.org/

Another excellent site for PCa help is that of the Prostate Cancer
Research Institute, http://prostate-cancer.org/index.html

There are others, as well; this is a good start.

Oh, and there's the support group, Us Too! at http://ustoo.com/
They may have a local chapter near Mike H.

Regards,

Steve J
__
"Never give in--never, never, never, never, in nothing great or small,
large or petty, never give in except to convictions of honour and good
sense. Never yield to force; never yield to the apparently overwhelming
might of the enemy.''
--Sir Winston L. S. Churchill