RRP & Hormone Therapy

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Michael Kiely - 29 Jun 2005 02:00 GMT

I have also heard that having hormone therapy for three months before RP can
increase the likelihood of non-recurrence of cancer. It would seem to me
reasonable to wait to see whether the surgeon and pathologist think the
cancer is entirely contained within the prostate before doing hormone
therapy, but is there good reason to start it before surgery? Or do it at
all?

Michael K
Gleason score 6, pattern 3
One core 5% to 10% of "moderately differentiated invasive adenocarcinoma of
intermediate nuclear grade having architectural features of Gleason's
pattern 3."
"No perineural invasion is identified."
PSA: 3.23
High grade PIN in 2 cores
Age: 60 in otherwise excellent health

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John Loomis - 29 Jun 2005 03:32 GMT

Hello Michael,

I am not sure why hormone therapy prior to Rp works.
I had hormone therapy, (Lupron) 3 month shot.
I was ready for radiation, and opted for Rp.
the Dr. had no problems with me having hormone shots.
So, I had an RP, a suffered through hot flashes, small balls, and little or
no sex. After Rp. I regained my body back!
I was dx'd 1999, I was 49. I am now 55. hum.
Thank God for Dr.s, and Thank God I never got radiation.
I do not pee myself, and can have a natural erection.
I do take viagra, once in a bit. It helps...
John Loomis

>I have also heard that having hormone therapy for three months before RP
>can increase the likelihood of non-recurrence of cancer. It would seem to
[quoted text clipped - 14 lines]
> High grade PIN in 2 cores
> Age: 60 in otherwise excellent health

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ron - 29 Jun 2005 13:32 GMT

Michael Kiely wrote...snip...

> I have also heard that having hormone therapy for three months before RP can
> increase the likelihood of non-recurrence of cancer.

Hi Michael...There has been a study by Klotz (J Urol. 2003
Sep;170(3):791-4; Long-term followup of a randomized trial of 0 versus
3 months of neoadjuvant androgen ablation before radical prostatectomy;
Klotz LH, Goldenberg SL, Jewett MA, Fradet Y, Nam R, Barkin J, Chin J,
Chatterjee S; Canadian Uro-Oncology Group) that addresses your
question. After 6 years of follow-up, they find no advantage from 3
months of neoadjuvant HT (cyproterone acetate) prior to RP, except in
the high-risk group (PSA>20).

Further, HT supposedly affects how prostatic tissue adheres to the
nerves and other surrounding tissue. The "feel" of how prostatic
tissue can be pulled away provides information to the surgeon regarding
whether the tissue in the area is cancerous or not. When HT is
practiced prior to RP, this "haptic" information is generally
lost...Best wishes and good health, Ron

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