On January 25, Ralph wrote, in pertinent part:

A urologist is trained as a surgeon.

This case is beyond the capability of a surgeon.

I recommend immediate consultation with a cancer specialist, a medical
oncologist. Preferably one who is well-trained in tx of PCa.

Eligard is chemically the same as Lupron; both are leuprolide acetate. I
wonder whether the uro had an economic motive for the change.

The referenced study on pomegranate juice involved only 48 men, all of
whom had been treated for PCa and who were not as far advanced as Ralph.
Other studies (2006) appear to involve mice.

Two more recommendations:

1. The authoritative website of the Prostate Cancer Research Institute
(PCRI) at:

http://prostate-cancer.org/index.html

.....and see the section "Advanced PC."

2. Obtain and read the handbook "Living with Advanced Prostate Cancer."
It is available free from the Institute for Continuing Healthcare
Education at www.iche.edu/advancedpca

Has anyone thought to order a check on bone mineral density (BMD)? I'd
bet not. Loss of BMD (aka osteoporosis) is an inevitable result of
androgen deprivation therapy (ADT), which is what the leuprolide acetate
is. It is treatable/preventable. All too many medics are ignorant about it.

There may be other side effects (SEs) of the ADT. One can learn about
them and their txs on the PCRI site. See: Androgen Deprivation Syndrome.

Study, Learn, Take Charge!

Regards,

Steve J

"Empowerment: taking responsibility for and authority over one's own
outcomes based on education and knowledge of the consequences  and
contingencies involved in one's own decisions. This focus provides the
uplifting energy that can sustain in the face of crisis."
--Donna Pogliano, co-author of _A Primer on Prostate Cancer_, subtitled
"The Empowered Patient's Guide."

Sorry to hear Ralph. My only suggestion is to consider finding a Medical
Oncologist who specializes in Prostate Cancer. Yes a Radiation Oncologost
and a Urologist can treat Advanced Prostate Cancer, but when I asked, all
said that if they were in my shoes that they would seek out a MO
specializing in PCa. They also said that to be sure that the MO specializes
in PCa as he would have a better idea on how to approach the situation.

BTW, I prefer Eligard over Lupron.

Good Luck,

Gourd dancer

Does not hurt to ask.

This is interesting.  My PSA is rising and my docs have been tracking
"Scattered ill-defined nodular densities of sub-centimeter size .. with
absent metabolic activity, as expected for their size."  for the last 6
months.

This was first picked up in a radioactive heart scan, confirmed by two
enhanced CAT-scans and MRI, no metabolic activity/hot spots on a
Prostascint, PET-scan, or 2 bone scans.

So what is it?

Something is going on but what?    Anyone have anything like this?

-kh

Welcome, Ralph, to the newsgroup.

The only comment I would have is, ain't medicine great!  With a G8 and lung
mets, it has not been all that long ago that you would have been near-term
terminal.

I'm reading good things about Pomegranate Juice, but I suspect it was the
Lupron that knocked your PSA back.  And, when that starts to wander up
again, they can add Casodex and knock it back down again. (which is where I
am).  Looks like you have a few years to carouse and cause mayhem.

I know from a personal experience that an FNA diagnosis of metastatic
prostate adenocarcinoma is a very tricky diagnosis and requires an
experienced pathologist. It could possibly require immunostains on the
cell block of your FNA. I would sincerely advise you to obtain a second
opinion on you FNA slides. It changed my own life. I recommend Confirm
Path company. They are dedicated for second opinions. check out their
website. they will charge you for the second opinion service but hey it
did change my life and you can even ask their pathologist physician a
question for free. their website is confirmpath.com. Good Luck