First, let me express my sorrow for your continuous bad news.  It must seem
that from March to July, your world has just gone topsy-turvy.

I have not been through these treatments yet, but....

I do not recall you before mentioning mets on your pelvis.  Were you trying
to say "no lymph invovlement...."?  Otherwise, your state would be a T4 and
then some, but then you say the Dexascan was excellent.  Which is why I
think you mistyped.

Of course, this may all be moot.  You may be (and have been) a T4 all along,
based on your barely interrupted rise in PSA.

Please let us know how things are going as you proceed.  I, for one, fully
expect to be in your position too soon.

Hi Duke...Did your docs measure your T level during your 4 month ADT
treatment?  Sometimes the ADT dosage or specific ADT drugs need to be
adjusted/switched to effectively reduce T to castrate levels.  If your
T level was not tracked, then it is an assumption that ADT did not work
(that you are hormone resistant) and that you need to move on to chemo.
In fact, typically hormone resistant men will show a PSA decrease when
casodex is removed, you did not...Best wishes and good health, rion

IMO, Duke, any doc who put me on all those chemicals, including chemical
castration, without giving me a complete course in ADT SE likelihoods,
prevention, and cures would see little more than a cloud of dust where I
used to sit in his office. The SE list is long, their likelihoods vary
significantly among sources, their incidence and severity and impact and
preferences vary dramatically among individuals, some SE preventatives
must be initiated BEFORE treatment or at its beginning, and maybe most
important . . . no one man's experience is worth squat to you for many
reasons.

A few basic "facts" about ADT SEs include:
1. They include almost certain fatigue, osteoporosis, hot flashes, and
emotional changes, all of which can be reduced -- not necessarily
prevented, REDUCED -- by other meds which have their OWN SEs *IF* one
can tolerate those meds (a large percentage of middle age men can't take
osteoporosis meds, for example).
2. ADT will not cure PC. It may delay its progress by months on average,
with a range from negligible to years.
3. Most SEs will decline within months when a pt quits the ADT.
Exceptions include bone loss, breast growth, and older men who don't
recover their testosterone production (the primary SE cause is T
deprivation, not the drugs per se).
4. Strum's ADT Syndrome treatise lays out many detailed pages of ADT SE
discussion. It looks extremely scientific and useful, but many
researchers doubt his credibility because Strum can't back it up to
their satisfaction. Base decisions on it at your own peril.
5. One of the reasons anecdotal ADT experience is all but useless to
individuals is that reactions to ADT range from a) such devastation that
even some oncologists have stopped it at their own grave risk to z) pts
who claim not to notice it a whole lot as long as they follow their
anti-SE regimens. A poll of this forum yielded about 20 responses over
that range, with a vast majority in the severe range.

There was extensive HT (aka ADT) discussion here over the winter of
'04-'05, beginning roughly in about Nov-Dec '04, and it has sporadically
returned. Do you know how to Google it up?

I.P.

Duke, this is my first post, but can relate to your story. I'm a
patient and do my reading via books and the internet and have no
medical training. I am currently on Taxotere, which is semi-synthetic
type of taxane and probably the one you are about to undertake. I am in
early metastasis as my PSA was 4.8 at DX with lymph involvement found
during surgery - not before. PSA after surgery was <0.1, on hormone for
22 months, then PSA rose to 1.7, then Taxotere. Bone scan negative. The
SEs have been tolerable, but frustrating - some diarrhea, some fatigue,
some hair loss, and other minor stuff. I would caution you though -
everyone is different on SEs from talking to my chair mates after 15
treatments. My biggest problem has been the mental stress which pecks
away slowly at your resolve. Currently my PSA is 0.3 with 4 more
treatments scheduled, then wait and watch. I wish you well - my
advice to me is to stay as active as possible and keep the hope -
that's what drives me. Recommend the same. (by the way, I recently
joined this group)