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Medical Forum / Diseases and Disorders / Prostate Cancer / August 2007numbers for Steve K, again
Hi Steve, new numbers for you. I sent this several days ago and not only did the email go off into la-la land, I lost internet after that so did not know what happened. Something weird going on. The new numbers are lower than expected, something weird there too. The current psa as of 8/6/07 is 1.4 giving a doubling time of 6 months. The previous reading on 5/1/07 was 1.1. It won't be much longer and I'll be going back on Lupron, with the addition of Casodex, but the oncologist does not feel it will do any good. He says it's worth the try though. I tried to get on the current Provenge trial, but my psa is still a little low to qualify and the enrollment will likely be closed soon. It's good to see that your own readings are so stable and so low. Keep it up!!! On August 26, Bob C. wrote, in pertinent part: > I tried to get on the current Provenge trial, but my psa is still a > little low to qualify and the enrollment will likely be closed soon. Provenge is far from the only clinical trial. I recommend checking on GVAX. For four trials that are recruiting, see http://clinicaltrials-nccs.nlm.nih.gov/ct/search The manufacturer's site is http://www.cellgenesys.com/clinical-prostate-cancer.shtml Regards, Steve J Bob, I agree with Steve J. that you should learn more about clinical trials. Another site you can look at is: http://www.cancer.gov/clinicaltrials/finding/treatment-trial-guide I'm not a doctor and my advice is strictly non-professional, but for whatever it's worth, here is what it is: I would talk to your oncologist about a long term plan. What hormone therapies will he try? Will he try triple ADT (that's something like Lupron, something like Casodex, and something like Avodart (dutasteride))? Steve K. was starting to have a PSA rise on Lupron alone but when he added Casodex, the numbers came down again. If and when the first line HT stops working, will he try second line therapy, i.e., ketoconazole and/or estradiol? At what point would he try that? When and if would he recommend chemotherapy? When and if would he recommend entering a clinical trial? And when it comes to that, will he help you to find one that matches your need? I don't know your age or general health, but I think that if I were in your shoes I would want to try aggressive treatment. It is my understanding (remember, I'm not an expert and my "understanding" might well be "misunderstanding") that the less cancer you have, the better it responds to treatment. To me, that means that you want to hit it hard with everything you can while it's still relatively contained. I think I'd want to try something like chemotherapy early on rather than wait until I was dying and in pain. It may be that if you tell your oncologist you want to fight this disease hard, you can enlist his aid in doing just that and not just following a non-plan of "let's wait and see what to do next." Best of luck. Alan > Bob, > I would talk to your oncologist about a long term plan. Alan, thanks for the reply and the most informative link you passed on. It should be called "Trials for Dummies, a Primer." Very educational. The oncologist I see is a new guy in the area, actually the only one in the area at this time. I have seen him but once, recently. My urologist, who I have had a lot of faith in these past years, referred me to him due to my progression and need for services beyond the scope of most urologists. He said sure, try the Lupron plus Casodex per the urologists recommendation, it's not likely to do anything for me but it's worth a try and I have time to play around with the numbers. His words. He suggested possibly ketoconazole plus whatever as the next step after the Lupron thing, and taxotere plus whatever somewhere down the road. He would not comment on the current Provenge trial and I did not press him further about trials at that time. This oncologist did not seem to be an overly aggressive person nor did he come forth with anything new I was not already familiar with. But then I did not impress upon him my intent to get back to an aggressive approach. My impression was that he is very busy and booked solid, and maybe inclined to follow a standard step 1-12 treatment plan of some sort that does not entail any real investment in thought and minimal investment in his time. My age is a young 62, my health is not bad, and I am retired and active. I began fighting this thing with a psa of 55 at age 55 and from day one have followed what I considered to be an aggressive approach until this summer "vacation." It is now time to step back into the ring. I can see that I do have to inform this oncologist how I want to fight this thing, and then see what tools he thinks we should employ and get a long term battle plan established. With or without his aid, I am most interested in the immunotherapy trials, but also view conventional chemotherapys at an early stage to be an option. In our first and only face to face meeting, he did not impress me at all, but then I did not give him much to work with. Thanks for your educated input and your personal thoughts on this, it's much appreciated. Bob C Bob, Is there anyway to travel to a Medical Oncologists that specializes in Prostates? Gourd Dancer >> Bob, > [quoted text clipped - 40 lines] > Thanks for your educated input and your personal thoughts on this, it's > much appreciated. Bob C > Bob, > > Is there anyway to travel to a Medical Oncologists that specializes in > Prostates? > > Gourd Dancer That would be a definite possibility. Even if only for a second opinion as to what plan(s) of attack are feasible. From where I live, travel is pretty much required to see anyone!! I do feel that I have to give another shot at my new oncologist and see where that leads. No matter what, seeing one who specializes in prostate cancer would be much preferred but they too did not all graduate at the head of their class and references from someone you trust would be wise. That's not always easy to come by, especially long distance. I do have a couple sources I can go to though, for references. Thanks for the suggestion. Bob C On August 27, Bob C. replied to "MAS": >> Is there anyway to travel to a Medical Oncologists that specializes in >> Prostates? Bob wrote: > That would be a definite possibility. Even if only for a second opinion > as to what plan(s) of attack are feasible. From where I live, travel is > pretty much required to see anyone!! From the comfort of one's computer, one can post a PCa Digest and questions on P2P (Physician to Patient) at: http://www.prostatepointers.org/p2p/ Very shortly, one should receive a response from at least one PCa specialist. Free, because they care. All that a patient is required to do is to post a coherent Digest. > I do feel that I have to give > another shot at my new oncologist and see where that leads. It might lead to prison! ;-) > No matter > what, seeing one who specializes in prostate cancer would be much > preferred but they too did not all graduate at the head of their class > and references from someone you trust would be wise. That's not always > easy to come by, especially long distance. See http://prostate-cancer.org/resource/find-a-physician.html Regards, Steve J Both look to be good sites. Once upon a time I frequently went to p2p and monitored what was going on there but never posted or did the digest. I will have to revisit that site again. The other site looks to be useful also, thanks for the links. Bob C > > I recommend checking on GVAX. For four trials that are recruiting, see > http://clinicaltrials-nccs.nlm.nih.gov/ct/search > Regards, > Steve J Steve, many thanks for the input and the link. For checking out current trials, it's the best I have seen so far. Not only has this summer been a vacation from drugs, it has been a vacation from the constant checking into one thing or another regarding this cancer thing. My wife and I have been elsewhere as much as possible, like at our cottage, or fishing the river at home, or doing any of the many other things there does not seem to be enough time for!!! I am just now getting back to the reality of looking for a plan of attack, with the intent to continue with an aggressive battle. Or so go the plans. Provenge looked to be the most promising weapon possibly available to me and with a trial center only 200 miles away, that was my first attempt at enrollment in any trial. GVAX is also of interest for sure, and I will check into it as well. Thanks again. Bob C > Hi Steve, new numbers for you. I sent this several days ago and not only > did the email go off into la-la land, I lost internet after that so did > not know what happened. Something weird going on. Got it, Bob. Your Internet must have gone down after you sent it and before you got my reply. I sure hope he's wrong about the re-addition of ADT2.  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 PSAD 0.19 years EBRT 05-07/2002 @ 47 PSA .34 .22 .15 .21 .32 PSAD .056 years Lupron 07/03 (1 mo) 8/03 and every 4 months there after PSA .07 .05 .06 .09 .08 .132 .145 PSAD 1.4 years Casodex added daily 07/06 PSA <0.04, <0.05, <0.04 (06/12/2007) Non Illegitimi Carborundum |
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