(snip)

(snip)

So Art is depending upon a surgeon, which is what a urologist is, to
treat him for a condition that is not treatable via surgery.

That won't work. Urologists are usually not qualified to treat any
illness of the genito-urinary system (nor any other system) that is not
amenable to treatment by surgery.

I most earnestly recommend that Art seek the advice of a genuine cancer
specialist, a medical oncologist. Preferably one who is well-qualified
in treatment (tx) of prostate cancer (PCa).

Some of those specialists are listed through this page of the
authoritative website of the Prostate Cancer Research Insititute (PCRI):
http://prostate-cancer.org/resource/find-a-physician.html

Regards,

Steve J

"We must tailor the treatment to the nature of the disease. We must
listen to the biology."
-- Stephen B. Strum, MD
Medical Oncologist

Art,

I see a medical oncologist that specializes in PCa. I asked him about
stopping Eligard. His response was simple yet firm. "Do you want your PSA to
go up?"

I wish you success in your fight.

Gourd Dancer

I have been on Eligard since May 2004.

Art,

I'll begin with the standard disclaimer.  I'm not a doctor and
can't credibly play one on the Internet.

I'll follow that with nods to the other three posters:

1. Steve J. suggests a visit to a medical oncologist specializing
in prostate cancer.  That's good advice, much better than any I
can give you.

2. Gourd Dancer says that he was told that PSA will go up when
you stop HT.  I'm sure that's true.

3. I.P. says PSA is a number.  It is not a direct measure either
of quality of life or of longevity.  That's also very true.

And now for Alan Meyer's two cents - or maybe it's only worth one
cent:

There have been a number of studies of intermittent hormone
therapy vs. continuous HT.  You need to check these out for
yourself because my recollection may be faulty, but I seem to
recall that intermittent therapy works for patients who achieve a
low PSA on HT.  Their longevity is not reduced and may be a
little increased, and their quality of life is improved.

Now for another penny's worth:

There are different ways to do intermittent therapy.  You can set
a target PSA and go back on when you reach it.  I would think
you'd need a regular schedule of PSA tests to find out when you
hit the target.  Different doctors probably recommend different
target PSAs.

You could take other drugs during the off period.  Some docs use
finasteride or dutasteride - which provide some anti-cancer
capability with fewer side effects.

IIRC Strum gives triple ADT (an LHRH agonist like Lupron, an
anti-androgen like Casodex, and a 5-alpha-reductase inhibitor
like dutasteride.)  Then, if the patient reaches 0.05 PSA for
some period of time, they stay on dutasteride alone until the PSA
goes back up.

To sum up, I think that what your urologist is offering you is
probably good, but you could maybe do it better, or more
precisely, if you were able to consult with a real expert in this
stuff - which was Steve's original recommendation.

Best of luck.

   Alan