Home | Contact Us | FAQ | Search & Site Map | Link to Us
Sign In | Join | Other 45 Sites in Network
Home
Discussion Groups
General
GeneralCardiologyVisionDentistryPharmacyLaboratoryNutritionAlternative
Diseases and Disorders
AIDSAlzheimer'sArthritisAsthmaCancerBreast CancerDiabetesEpilepsyGlaucomaHepatitisHerpesLupusProstate BPHProstate CancerProstatitisSinusitisTinnitus

Medical Forum / Diseases and Disorders / Prostate Cancer / February 2005

Tip: Looking for answers? Try searching our database.

Trelstar, etc.

Thread view: 
Enable EMail Alerts  Start New Thread
Thread rating: 
Stephen Jordan - 16 Feb 2005 17:06 GMT
On February 15, I had a strategy meeting with my med onc.

The most important decision arising from the consultation is that, due
to the 0.01 PSA as of a month ago (due to ADT), I will not have to start
adjuvant chemotherapy -- yet.

If/when the PSA rises to 0.7, I will start Casodex. If/when it rises to
0.9, I will probably start chemo. She agrees with me that ADT3 is overkill.

If PSA is still low in late summer/fall, I'll consider intermittant ADT.
Twelve months of steadily low PSA is considered to be the criterion for
IADT.

BTW, there was recently some discussion here about what variations in
PSA readings of ~0.01 or so mean in terms of doubling time and velocity.
The med onc agrees that it means little: "we're measuring hairs."

Also, I'll do a Pyrilinks-D urine test in May to see whether the Actonel
is succeeding vs. the Lupron-caused bone loss. His failure to take this
loss into consideration is one of the several reasons I fired my rad onc.

Lastly, because Medicare will not reimburse her the cost of Lupron (I
wonder why my prior onc continues to use it), she uses monthly 3.75 mg
injections of Trelstar, triptorelin pamoate. So far, my reading tells me
that its action is the same as Zoladex and Lupron, as are the SE's. I
had not heard of it until yesterday. I had planned to go from four-month
to one-month injections, anyhow.

Can anyone brief us on his experience with Trelstar?

Thanks!

Regards,

Steve J
__
"Well, I've wrestled with reality for thirty-five years, Doctor, and I'm
happy to state I finally won out over it."
-- James Stewart as Elwood P. Dowd in "Harvey"
I.P. Freely - 16 Feb 2005 18:08 GMT
> Twelve months of steadily low PSA is considered to be the criterion for
> IADT.
[quoted text clipped - 7 lines]
>
> Can anyone brief us on his experience with Trelstar?

I can't help with the Trelstar, but . . .

My uro and med oncs said they would tend to believe hypersensitive PSA DT
and V *IF* the data looked "clean", i.e., clear trends without too much
noise or bounce in the data. Jagged plots and it's back to nothing more than
an early warning system. IOW, if the hairs line up like ducks, they may be
usable ducks. I presume this was an opinion, not a fact, but we're sure
going to keep watching mine with a hypersensitive "microscope" quarterly,
especially considering my attitude towards preemptive (early) ADT.

Last I read, there have been just two IADT periods clinically tested: 9
months and 28 months. 9 did not "work", 28 did. The downside? After 28 month
many people don't recover from some of their nastier SES, and the benefit is
arguably marginal anyway. Tests are under way for IADT periods between 9 and
28 months. Maybe some of those tests are completed, providing your 12-month
criteria?

It's not clear to me how a different LHRH (ADT1) drug would help wsith the
SEs, since the SEs are primarily due to the testosterone deprivation, not
the drugs used to achieve it. LHRH drugs including triptorelin are often
listed and lumped together in discussions of ADT-induced osteoporosis. I
gather the usual bone-preserving/restoring drugs and other measures are not
working for you? That's a serious concern to me, since my sports can get
pretty rough-and-tumble at times (I broke two ribs last July and incurred a
shoulder separation a year ago -- they lit up on my CT). If I had a bone
density problem I'd be a formless bag of bone meal. ;-)

Crap. Now I can't get the song, "Telestar" out of my mind.
That's OK.

I.P.
Stephen Jordan - 16 Feb 2005 18:33 GMT
On February 16, I.P. Freely quoted part of my last:

>>Twelve months of steadily low PSA is considered to be the criterion for
>>IADT.
[quoted text clipped - 7 lines]
>>
>>Can anyone brief us on his experience with Trelstar?

He replied:

> I can't help with the Trelstar, but . . .
>
[quoted text clipped - 3 lines]
> an early warning system. IOW, if the hairs line up like ducks, they may be
> usable ducks.

(ka-snip)
Makes sense. We just should bear in mind that, at such low levels, we
are dealing with hairs in the nanogram per hundredths of a milliliter range.
(ka-snip)

> Tests are under way for IADT periods between 9 and
> 28 months. Maybe some of those tests are completed, providing your 12-month
> criteria?

Dunno either. The twelve-month criterion is that of Scholz and his
former partner, Strum. AIUI, during the "on period" PSA is monitored to
the point where it reaches a predetermined nadir. The patient then
begins his "off period" pending a rise in PSA to a predetermined level.

The idea is to extend the time to PSA failure (when on ADT).

> It's not clear to me how a different LHRH (ADT1) drug would help wsith the
> SEs, since the SEs are primarily due to the testosterone deprivation, not
> the drugs used to achieve it.

Correct. Checking the SE's of Trelstar vs. those of Lupron leads me to
the conclusion that they are essentially the same.

>  I gather the usual bone-preserving/restoring drugs and other measures
are not
> working for you?

Sorry if I gave the wrong impression. I have only been on Actonel +
calcium + Vitamin D for ~five weeks, far too short a time to see any
measurable effect. That's why I'll wait until May before doing the
Pyrilinks-D urine test to see how it's going.

(su-nip)

Regards,

Steve J
Stephen Jordan - 16 Feb 2005 19:11 GMT
Correction:

I wrote:
> (ka-snip)
> .....we are dealing with hairs in the nanogram per hundredths of a
> milliliter range.

Argh. Dunno where my head was -- quiet, IP! -- but I should have written
"nanograms per milliliter."

Regards,

Steve J

:-(
I.P. Freely - 16 Feb 2005 19:38 GMT
I KNOW where my head's been the past few years, and that's BEFORE any PC
treatments. I swear I'm going to have to start injecting Beano and/or
Lactaid into my brain.

I.P.

"Stephen Jordan" <mycroftscj@earthlink.net> wrote >  >
> Argh. Dunno where my head was -- quiet, IP! -- but I should have written
> "nanograms per milliliter."
 
Sign In
Join
My Latest Posts
My Monitored Threads
My Blog
My Photo Gallery
My Profile
My Homepage

Start New Thread
Enable EMail Alerts
Rate this Thread



©2008 Advenet LLC   Privacy Policy - Terms of Use
This website includes both content owned or controlled by Advenet as well as content owned or controlled by third parties.