I sincerely hope that I did not offend anyone with my perceptions in
answering why this NG might appear to be skewed.

This is, after all, a support group.  Coming in for help and leaving when
you don't need it anymore is perfectly normal and okay.  Lurking for a time
(I lurked before I leapt) is probably universal.  Lurking and never posting
is perfectly okay.  There have even been a couple who came, saw, thought
they conquered and came back when the bastard bit them in the arse again.
All of those are perfectly acceptable activities in a support group.

Furthermore, I think Curtis's interest in self-introduction of lurkers is
like mine.  I am interested... maybe only curious.... as to whom I am
addressing in cyberspace.  No more.  No less.  I like know who they are,
where they are, how they are and what they've been through.

On January 23, Warren wrote, in pertinent part:

I must respectfully disagree; that is *not* "just the way it is" with
regard to osteoprosis.

Loss of bone mass density (BMD) as a result of ADT treatment with LHRH
agonists such as Lupron is a well-known side effect. If Warren's medic
did not take steps to address the issue, well, I have to question his
competence.

My rad oncologist did not mention it, either. But my study of this devil
had led me to knowledge of the hazard. I demanded a BMD test, got it,
and was diagnosed with osteopenia, a precursor of osteoporosis and such
fun things as pathological fractures, especially of the spinal
vertebrae. If I had followed the rad onc's recommendation, I would have
followed it directly into catastrophe.

I have posted on this subject elsewhere on this NG.

The rad onc told me that my suggestion that a med onc be brought aboard
was "premature." But I consulted one anyhow. She immediately prescribed
Actonel 35 mg q weekly. This is a bisphosphonate that will, along with
the calcium 1000 mg qd and vitamin D she prescribed, help to reverse the
bone loss. She also prescribed close following of PSA, and of
testosterone. The rad onc had not thought of that, either. The package
insert for Lupron recommends frequent tests of BMD, testosterone, and
PSA while on ADT.

I recommend that Warren run, not walk, to the nearest medical oncologist
for consultation.

Moreover, Dr. Stephen Strum, medical oncologist and co-author of _A
Primer on Prostate Cancer_ recommends against long-term (eg 4-month)
LHRH agonist injections. I will not go into it here, but suggest that
Warren refer to the website of the Prostate Cancer Research Institute at
http://prostate-cancer.org/index.html

I will say though that many insurers and Medicare will *not* pay the
$1000 per month cost of ADT if the longer-term injections are given at
intervals less than x number of calendar months (eg, 4 calendar months,
$4000). Per my med onc, timing is critical. The Lupron manufacturer's
package insert calls for intervals of x weeks, not months, eg 16 weeks
(112 days) for the "four-month" injection. The insurers save a few
hundred dollars per patient per year, and to hell with proper medical
protocol. It is an outrage. I am currently on the second month of a
four-month Lupron injection, and have instructed my medic to give me the
one-month injection hereafter. At least, the latest the injections can
be will be three days, instead of up to ten days with the four-month
injection.

Apologies for the rant.

Study, learn, take charge!

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