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Medical Forum / Diseases and Disorders / Prostate Cancer / August 2006Start HT
2 PSA in a row over 0,2 exactly 0,267 and a month later 0,369. Uro says it's time for HT: Casodex 10 days than lupron evry 3 months. RP 1/19/06 age 61 gleason 4+3. Do you agree? Thanks Colophony What and when was your previous therapy ????? none, as of radical prostatectomy, I monitored only PSA. Colophony > What and when was your previous therapy ????? Colophony, there is no way anyone here can give you any intelligent advice [and I assume that's the kind you want] w/o much more diagnostic information. For example, evidently you have something in your history (other than the G.S. 4) that leads your doctor to think you do not have a local-only recurrence. Salvage RT would be the next step for local disease and HT for systemic. We need your pre-op PSA history, staging, seminal vesicle or nodal involvement, etc. Bill Denton RP 2/12/02 PSA .93 Memphis > Colophony, there is no way anyone here can give you any intelligent > advice [and I assume that's the kind you want] w/o much more diagnostic [quoted text clipped - 3 lines] > disease and HT for systemic. We need your pre-op PSA history, staging, > seminal vesicle or nodal involvement, etc. And lifestyle preferences and objectives. I.P. > 2 PSA in a row over 0,2 exactly 0,267 and a month later 0,369. > Uro says it's time for HT: Casodex 10 days than lupron evry 3 months. [quoted text clipped - 3 lines] > Do you agree? > I'm not a medic; nor is anyone else here, as far as I know. So I'm not going to try to give medical advice. That's for professionals. Which brings me to this: why Colophony is still consulting the uro who failed to "get it all" is a mystery. He has done his job. A radiation oncologist would think in terms of radiation therapy. But where to apply the dosage? The next step is to consult a cancer specialist, a medical oncologist. Regards, Steve J "We must tailor the treatment to the nature of the disease. We must listen to the biology." -- Stephen B. Strum, MD > 2 PSA in a row over 0,2 exactly 0,267 and a month later 0,369. > Uro says it's time for HT: Casodex 10 days than lupron evry 3 months. [quoted text clipped - 3 lines] > Do you agree? > Thanks Colophony It is not for us to agree or disagree. First we don't know how your cancer was treated and what the results were. Second, we are not in a position to give advice about when to start HT. There is some difference of opinion among specialists about the matter, and moreover a lot can depend on the details of the case. I think all of us would recommend finding an oncologist who specializes in treating prostate cancer with first rate qualifications and getting an opinion. >> 2 PSA in a row over 0,2 exactly 0,267 and a month later 0,369. >> Uro says it's time for HT: Casodex 10 days than lupron evry 3 months. [quoted text clipped - 12 lines] > treating prostate cancer with first rate qualifications and getting an > opinion. Bill, Steve J., and Leonard, Based on Age 61, Gleason 7, RRP in January 2006, with PSAs of 0.07, 0.152, 0.267 and 0.369 between February and July 2006, wouldn't you agree that immediate treatment is indicated? I realize that we cannot recommend radiation or HT, but something has to be done and soon. Personally, I think HT is a good idea until he decides on a treatment. >>>2 PSA in a row over 0,2 exactly 0,267 and a month later 0,369. >>>Uro says it's time for HT: Casodex 10 days than lupron evry 3 months. [quoted text clipped - 19 lines] > 0.267 and 0.369 between February and July 2006, wouldn't you agree that > immediate treatment is indicated? My point is that what I think is not relevant. First, I don't know all the details. What was his status with respect to pre RP PSA, and what was the margin status after RP? More to the point, I'm not an oncologist. Unfortunately, there is some disagreement among oncologists about when to begin HT, but even given that, one is better off finding a good oncologist, and asking him/her probing questions than trying to figure it out oneself. > I realize that we cannot recommend radiation or HT, but something has to be > done and soon. Personally, I think HT is a good idea until he decides on a > treatment. > My point is that what I think is not relevant. I think you sell yourself short. "Bill, Steve J., and Leonard, Based on Age 61, Gleason 7, RRP in January 2006, with PSAs of 0.07, 0.152, 0.267 and 0.369 between February and July 2006, wouldn't you agree that immediate treatment is indicated?" Well, Steve, as you know, my last post-RP PSA was .93 [should be getting latest results today] and I have not had any salvage Tx so, no, I don't automatically think he needs immediate Tx. What I was getting at is why his doctor is recommendinhg SHT and not SRT. There must be something significant in his Hx that we don't know. So we can't answer his question w/o more info. "I realize that we cannot recommend radiation or HT, but something has to be done and soon." Even though I am the lawyer here and should be sensitive about such matters, I skip the disclaimers because this is not a P2P site and surely everone knows that we are just guys sharing our experiences and whatever knowledge we have picked up along the way. We are competent to answer the "if it was you, what would you do" questions because we've been there. That's why people come here. I will state my opinions based on what I know and believe, and they will involve medical terms, but it is not medical advice because I am not a doctor - it is lay opinion about medcial matters. What he needs done soon is be to be informed by his doctor why he is not a candidate for SRT. Bill Denton RP 2/12/02 PSA .93 Memphis >2 PSA in a row over 0,2 exactly 0,267 and a month later 0,369. > Uro says it's time for HT: Casodex 10 days than lupron evry 3 months. [quoted text clipped - 3 lines] > Do you agree? > Thanks Colophony Additional treatment is certainly indicated. Some might say late. It's an interesting approach there in Italy -- start with a course of Casodex and then hit it with Lupron. In any case, I'd look into radiating the prostate bed before accepting indefinite Lupron.  SignaturePSA 16 10/17/2000 @ 46 Biopsy 11/01/2000 G7 (3+4), T2c RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins PSA .1 .1 .1 .27 .37 .75 EBRT 05-07/2002 @ 47 PSA .34 .22 .15 .21 .32 Lupron 07/03 (1 mo) 8/03 (4 mo), 12/03, 4/04, 09/04, 01/05, 5/05, 10/05, 2/06, 6/06 PSA .07 .05 .06 .09 .08 .132 .145 Casodex added daily 07/06 Non Illegitimi Carborundum > 2 PSA in a row over 0,2 exactly 0,267 and a month later 0,369. > Uro says it's time for HT: Casodex 10 days than lupron evry 3 months. > RP 1/19/06, age 61, gleason 4+3. > Do you agree? > Thanks Colophony -------------------------- Colophony, When you begin Lupron, it's prudent to receive a 1-month shot instead of a 3-month shot because of the infrequent possibility that you would experience terrible side effects. Then you would suffer for 3 months instead of 1 month. I agree with the recommendation that you consult a medical oncologist, preferably one who has treated many PCa patients. (I'm not mentioning a medical oncologist who specializes in PCa because, according to my knowledge, there are only about 40 or 50 in the United States.) Lawrence J. Bookbinder (have PCa & BPH) http://www.ljblgb.com (my BPH story) Colophony, where are you located? Every Doctor that I talked to including two Radiation Oncologists, although they would treat me if I wanted, suggested that they would seek out a Medical Oncologist that specializes in PCa if they were in my shoes. I found one in Houston who has now researched PCa for 27 years. Gourd Dancer >> 2 PSA in a row over 0,2 exactly 0,267 and a month later 0,369. >> Uro says it's time for HT: Casodex 10 days than lupron evry 3 months. [quoted text clipped - 15 lines] > Lawrence J. Bookbinder (have PCa & BPH) > http://www.ljblgb.com (my BPH story) > Colophony, where are you located? > [quoted text clipped - 4 lines] > > Gourd Dancer Gourd, Go south on Main Street, east on I-10 about 20,000 miles. He's in Rome. SignaturePSA 16 10/17/2000 @ 46 Biopsy 11/01/2000 G7 (3+4), T2c RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins PSA .1 .1 .1 .27 .37 .75 EBRT 05-07/2002 @ 47 PSA .34 .22 .15 .21 .32 Lupron 07/03 (1 mo) 8/03 (4 mo), 12/03, 4/04, 09/04, 01/05, 5/05, 10/05, 2/06, 6/06 PSA .07 .05 .06 .09 .08 .132 .145 Casodex added daily 07/06 Non Illegitimi Carborundum Oh heck Steve, I guess that would be a heck of a long commute And I was thinking Italy, Texas which is a half hour south of Dallas...... :) . >> Colophony, where are you located? >> [quoted text clipped - 8 lines] > > Go south on Main Street, east on I-10 about 20,000 miles. He's in Rome. |
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