On March 25, tarhoosier replied to Carl, in pertinent part:

(sic: Taxotere is docetaxel. Taxol is paclitaxel)

Those men were true heroes. They knew that they had little hope, yet
proceeded to volunteer in order to help others, such as Carl. And me
when the time comes.

I have looked into the continual drumbeat of "only a few months" and
learned just what Tar wrote. As my med onc put it, "they were on their
last legs."

This is from the archives of the Prostate Cancer Research Institute
(PCRI): "Taxotere®-Based Regimens Improve Survival in Advanced Prostate
Cancer"

"One clinical trial presented at ASCO (2004 meeting) was a direct
comparison of Taxotere®/prednisone to the historical standard treatment
consisting of the chemotherapy agent mitoxantrone (Novantrone®) plus
prednisone. This trial included 1,006 patients who had
hormone-refractory prostate cancer. Approximately half of the patients
were treated with Taxotere®/prednisone, and the other half were treated
with mitoxantrone/prednisone. Patients treated with Taxotere® received
therapy either once per week, or once every 3 weeks at different doses.
Patients treated on the Taxotere® regimen that was once every 3 weeks
had superior outcomes to those treated with Taxotere® once per week. The
average survival for patients following treatment with chemotherapy was
nearly 19 months for those treated with Taxotere®/prednisone (every 3
weeks), compared to 16.5 months for those treated with
mitoxantrone/prednisone. Pain was reduced in approximately 35% of
patients treated with Taxotere®/prednisone every 3 weeks, compared to
22% of patients treated with mitoxantrone/prednisone. The most common
severe side effect, low white blood cell levels, occurred more often in
patients treated with Taxotere®/prednisone than those treated with
mitoxantrone/prednisone."

Regards,

Steve J

--------------

Kindest thanks for this input - Carl

PSA 19 07/2004 @ 55
12 needle Biopsy 07/2004 G7  T2c
RRP 09/2004 @ Johns Hopkins by Dr. Pat Walsh  positive margins
G8 in 3 of 6 left and 4 of 8 right sampled
Post Op PSA 19
30 mg Lupron began 12/2004 and every 4 mo after
PSA  .069 -.079- 1.15-1.35- 2.23-4-7.18-13.70
50 mg Casodex added daily 12/07
PSA 02/07   13.70 @age 58
Casodex discontinued 2/07
PSA 18.08  3/08

On Mar 25, 10:58 am, tarhoos...@carolina.rr.com wrote:

Carl,

I looked at the web page recommended by tarhoosier.  It's
excellent, very worth reading.

I'm not a doctor or an expert of any kind.  What follows are just
the speculations of a layman.  So please do not think of them as
in any way authoritative.

But, forging on ...

It is my impression that the course of the disease, and the
response to any particular therapy, can vary a great deal from
one person to the next.

Docetaxel may do no good at all, zero.  On the other hand
however, it may add many months or even years to your life.  It's
a crap shoot.  There's no way to know how sensitive a particular
cancer is until you try it.

In general, chemotherapy works by killing rapidly dividing cells.
That is why it is less effective in prostate cancer than in some
other cancers.  Because PCa is relatively slow growing, there are
fewer cells dividing and multiplying at any given time than with
fast growing cancers.

Now if that's true, men like you Carl may actually derive more
benefit from chemo than the average patient.  The very high PSA
doubling rate you are experiencing may indicate that you have an
exceptionally large number of tumor cells dividing at any one
time and hence susceptible to chemo.  This is something to ask
your doctor about.

The treatments Dr. Carducci recommended comprise what is often
called "second line hormone therapy".  Surprisingly, they quite
often work after "primary" hormone therapy has stopped working.
As with everything else, whether they work or not is an
individual thing.  Some men get great benefit from them, some get
none, and a few have unacceptable side effects.  I think they are
worth trying.

A friend of mine with advanced, metastatic PCa (PSA 500 before
treatment started) went hormone refractory over a year ago.  He
has been treated by Dr. Charles "Snuffy" Myers, a medical
oncologist in Virginia.  Dr. Myers has been trying almost
everything.  He hasn't done any chemo yet.  That's still in
reserve.  But he has tried second line HT, very large doses of
pomegranate extract and some vitamins, and now Revlimid, a
thalidomide analog.  Each time the PSA goes up, Dr. Myers tries
something new.  Some of the things haven't seem to have done
anything, but a number of them have.

One year later, my friend, who is 71 years old, is still walking
around and still living a relatively normal life.  He still has
no symptoms.  His PSA has not yet gotten above 18 (IIRC) before
being checked or brought down again.

So I think if it were me, I'd do what my friend did.  I'd try
lots of treatments.  I'd find an aggressive doctor who would work
with me to keep trying new things.

So far, there still don't seem to be any magic bullets.  But it
may be that by battling the disease with one treatment after
another, you can get an extra year or two.

Finally, although you're facing death at an earlier age than most
of us, I think it's important to remember that you aren't dead
yet.  I don't think it does any good to be so depressed over
dying that you wish you were dead.  If that was the right
attitude, we'd all do well to do ourselves in as soon as we
learned that all men are mortal.

You may have one year of life left.  You may have more.  Whatever
you have, try to make the best of it.  Make financial
preparations, gather up diaries or photos or keepsakes, etc., and
prepare to pass them on.  Maybe write some letters or make a
sound or video recording for your children and grandchildren, if
you have them.  There is a recent posting by I.P. with more good
suggestions.

Do what you can for your family now, while you can do it.  Make
things as easy for them as you can.

And beyond all that, don't forget to watch those favorite movies
you've always loved, or listen to your favorite music, or read
your favorite books, or eat at your favorite restaurant, or visit
your favorite friends, or take that vacation to the place you've
always wanted to see but never made time for.  And of course,
spend some time with your loved ones.  They'll still be here
after you're gone, remembering you and carrying on for you.

Life ain't over till it's over.  Let's live while we can.

Best of luck.

   Alan

Actually, they do, so take heart. My odds of making 10 are much better
after three years with virtually no PSA then than they were fresh out of
the OR. Heck, if I can make 9 w/o PSA, my odds of making 10 will be
pretty close to 1.0. Every little bit helps.

I.P.

Actually, it was 2015, which is just outside my window of opportunity (I
think).

However, more recently, I was told that they no longer feel that way.  While
the genome project was far ahead of schedule and the identification of the
offending DNA strands came much sooner than expected, the cure is lagging.
Last I heard (about three months ago, I think) is that they hope to reduce
it to a chronic disease by then rather than a fatal one.  :-(