On Jan 16, 9:47 am, khildebra...@casselsbrock.com wrote:

Dear Karen:

Thank you for your honest post. There is a distinction between the
posts on this site by men and those by women, generally. Yours is an
example of the open and emotional impact cancer has on the lives of
partners and family members. I believe there is a message of hope
within your husband's case. With a doubling time of more than a year,
by the two dates and psa numbers you give, your husband may have years
to go before he must initiate hormone therapy. And when that time
comes, the most common response time is years again, ten years or more
is common. This suggests that he, and you, have much more time than
you calculate. Certainly no one can promise tomorrow, but the numbers
in his case offer opportunity for him to benefit from treatments
coming in the research world which may extend life, with quality, yet
again.
I know how reluctant doctors are to discuss life expectancy, and when
they do, how poorly and pessimistically they perform. Trust the
research and experience of many men on this. If your medical team has
provided the 4-5 years that you mention, they are wrong. As one who is
farther down the line than your husband I submit life is for living.

My comment at the bottom.

You have chosen a great group for support, help, and encouragement.  Your
husband's condition and concern is probably mirrored by many people here,
and they're a wonderful group, believe me.

My PSA was much higher than your husbands and was detected and treated about
six years ago.  My urologist recommended surgery, and I trusted him.  After
that, I had a couple of hormone injections to reduce the PSA again, but only
marginally effective.  But then, I am maybe 20 years older than he is and
worrying at his age (I assume at about your age) is absolutely
counterproductive.

All the best to both of you,

Ken Bland

Karen,

I'm going to recommend something that is probably stupid, but I'm
not sure there's anything to lose.

What I suggest is that your husband begin a regimen of diet and
supplements that are thought to be useful against cancer.  I'm
suggesting that for two reasons.

One is that a friend of mine with very aggressive cancer was put
on such a regimen by Charles "Snuffy" Myers, a leading prostate
cancer oncologist.  I don't know if it did any good.  Myers is
also treating him with very complicated hormone therapy, so it's
impossible to separate the effects of the prescription drugs from
the supplements.  However, the fact that Dr. Myers thinks these
things are worth doing says something to me.  He is a nationally
recognized expert.

The other reason is that your husband's PSA is rising relatively
slowly.  I think that means that the rate of tumor cell growth is
only a little higher than the rate of tumor cell death.  If
that's true, and if the supplements promote cancer cell death
("apoptosis" is the technical term), then maybe they can tip the
balance a little the other way.  Just slowing down the process a
little may have a much more significant effect in a slow growing
cancer than slowing it down a little in a fast growing cancer.

Now the next question is what to take.  Unfortunately, I don't
know the answer.  Dr. Myers had my friend (whose PSA reached 700
by the way) on 5 pomegranate extract capsules each day from:

  http://www.lef.org/newshop/items/item00956.html

I don't know if these are better than cheaper ones from other
sources, but you can look at what they contain and compare them
to others.

He's also taking megadoses of vitamin C, but I don't know the
specific dosage.

Other things that people have suggested include: lycopene, EGCG
(green tea), vitamin D, and maybe other things.  A low fat diet,
with lots of fruits and vegetables is also often recommended.  If
you search the archives of the newsgroup you'll see
recommendations from others who know more than I do about this.

I don't see how this can hurt.

Finally, I'll make a few remarks about hormone therapy.

The "two years" that the oncologist predicted may stretch
considerably longer than that.  Steve Kramer, a stalwart
contributor to this group, began hormone therapy in July, 2003.
Four and a half years later, his PSA is still undetectable.

Steve started HT early, while his PSA was still below 1.0.  But
it's working well for him.  Since your husband's PSA growth seems
reasonably slow, HT may work very well for him too.

Hormone therapy does eventually fail, but that's not quite yet
the end of the line.  There is "second line" hormone therapy
(ketoconazole and/or estrogen patches) that works well for some
men.  Then there is chemotherapy.  There are also a number of new
therapies in clinical trials that may add more months or years
and may be available by the time other therapies stop working for
your husband.

I know that, psychologically, all of this is very, very
difficult.  It's necessary to be realistic and not live on false
hopes.  But I think it's also important not to give up on life.
There are at least a few very good years ahead, and a few years
with problems.  Even the years with problems can be good years.

I was on a cruise to Alaska once and sat at dinner with a lady in
a wheel chair and her husband.  It turned out that she was dying
of cancer and had only a short time to live, but she had always
wanted to see Alaska.  I was impressed by the lady's good
spirits, by how much interest she took in the conversations at
dinner, by how fine a relationship she enjoyed with her husband,
and by how much she seemed to enjoy the scenery in Alaska.  I
learned something about how to live from her.

Best of luck to you both.

   Alan

I am so sorry, Karen.  Your husband (you've never told us his name) and I
were both diagnosed in 2000, both young (he 41 and me 46), both T3, and both
with PSAs in the mid-teens (he 13 and me 16).  We both went with RRP and
both ended up doing radiation.  For a long time, he did much better than me.
I chose ADT in 2003 after my PSA registered 0.32.  His didn't get that high
until February 2007.

Personally, I thought ADT should have started then.  It has done me good so
far.  But, I have no mets.

My prayers go out to you.

On Jan 16, 9:47 am, khildebra...@casselsbrock.com wrote:

My opinion is that opinion might be wrong.   I straight out asked my
docs and was told that no one knows.

Their words, "we've tried to predict what will happen but have not
been able to do that in individual cases."

Find the most expert medical oncologists you can, work with them, live
your life to the fullest.

-kh you know what to do.

Karen, I am not a Doctor, just a Patient. You might read the following as I
started this trial in July 2004 two months after my first Lupron (PSA was at
32.0 and start of chemo 3.0; plus I had two mets to the spine):

Trial of Chemotherapy plus Hormonal Therapy as Initial Treatment for
Unresectable / Metastatic Adenocarcinoma of the Prostate
H. Henary, R.J. Amato; The Methodist Hospital/The Methodist Hospital
Research Institute/Genitourinary Program, Houston, TX

Background: Chemotherapy is a setting of hormone refractory prostate cancer
has shown palliative benefit especially with substantial PSA decline
strongly suggesting that disease modifying potential exists. Recently,
chemotherapy is beginning to show a survival advantage. The stage is set for
chemotherapy given earlier in a disease course. As a working hypothesis, we
suspect that the transformation from an androgen-dependent to an
androgen-independent phenotype is mediated by the expansion of an
androgen-independent clone already present at the time of androgen
deprivation. If this model is correct, then it would be desirable to bring
treatment to bear on the androgen-independent component when the
corresponding tumor burden is minimal. Thus, we view the
androgen-independent component as analogous to "microscopic residual" or
"micro-metastatic" disease for which adjuvant chemotherapy has shown to be
effective in other contexts.

Methods: Each course of chemotherapy lasts for 8 weeks. Patients were
treated in weeks 1, 3, and 5 with doxorubicin 20 mg/m2 as a 24-hour
intravenous infusion on the first day of every week in combination with
ketoconazole 400 mg orally 3 times a day daily for 7 days. In weeks 2, 4,
and 6, treatment consisted of paclitaxel 100 mg/m2 intravenously on the
first day of every week in combination with estramustine 280 mg orally 3
times a day for 7 days. After completion of 3 courses of chemotherapy,
hormone management [medical castration plus casodex (at the completion of
chemotherapy)] is initiated at the start of chemotherapy and for a total of
24 months.

Results: Nineteen men have been enrolled with a median age of 63 (48-76).
Fifty percent of the men had no prior local therapy, while the other 50%
either failed surgery, radiation therapy, or surgery plus radiation therapy.
Fifty-nine percent of the men had Gleason 7, 12%/8, 24%/9, and 5%/10.
Thirty-five patients presented with bone metastasis and 50% presented with
nodal involvement. The median PSA reduction to date has been 95.6%.

Conclusion: Enrollment is ongoing. Further information regarding PSA
response, associated radiographic response, and toxicity will be presented.

Karen, note that I am still undetectible and the two mets are gone.

Gourd Dancer