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JohnThomas
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- Traverse City, MI
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Stopping Hormone Therapy
Replied Jun 25
Stopping Hormone Therapy
Replied Jun 25
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My opinion is detailed here: http://tinyurl.com/cped9h
And dealing with side effects here: http://tinyurl.com/5snxzx
And I would recommend educating yourself by going to www.pcri.org then clicking on the index words "PCRI Papers."
And I would reco...
Paul.....
I too had a low..similar to yours, PSA at your age. I elected watchful waiting with the approval of my internist who is my primary Doc. When I was 66 PSA had slowly climbed to 4.2. Doc getting concerned, but advised me that I had a 40% c...
I clearly understand your thinking on that January decision. I also had a "stuck" for 3 months PSA a year ago. I attributed it to the pure Pomegranate juice I was using. When I started the ADT I elected not to continue Pomegranate so I wouldn't be...
John,
As a bit of an update - I decided to quit having the lupron shots in late January. My reasoning was - I thought my body needed a rest and I was soooo tired of the side effects from the lupron that I felt I would have a better quality of life...
Brad..Thanks for the input.
I agreed to the Casodex regimen with Finasteride..which I understand, one needs a blocking androgen when taking an anti androgen such as Casodex. Urologist and Oncologist both knew I was still active and working and so ...
John,
I have been on intermittent hormone therapy since 1998. My usual on cycle has been 9 months. I stay on the off cycle until my PSA nears 5.0. It has only been in the last year that signs of "hormone refactory" are present.
I did not choose to...
Sniff......Sniff.... You smell like a sailer!!!!
Comment Wall (5 comments)
- At 3:57pm on August 28, 2009,
E. Michael D. ("Mike") Scott said…
- John:
Dog breed unknown. Came from the pound ... but HAS to include some Golden Retriever. However, she is WAY more "elegant" and less "square" than what are known as "white Golden Retrievers" so I really have no idea.
Glad the other stuff was helpful.
- At 12:02pm on August 28, 2009,
E. Michael D. ("Mike") Scott said…
- Dear John:
Over the past 20 years there has been ENORMOUS discussion over "the best" way to use hormone therapy. It would take me weeks to summarize it all, and the bottom line is that different men tend to have very different types of response to hormone therapy -- and we really don't know why.
To answer your specific questions:
A: Does not our system build an immunity to this stuff ... what they call refractory, if we take it a lot? YES, it does. In the end, if they live long enough, most men who receive hormone therapy will become hormone refractory, but WHEN that happens can vary enormously.
B: Will we live longer as a healthy working man by extending treatments using PSA marker as a guide? There is absolutely no doubt that hormone therapy DOES allow men to delay the onset of bone pain and other symptoms associated with metastatic prostate cancer. Whether it has the same impact on men with progressive prostate cancer but no gross evidence of metastatic disease (i.e., no lesions that are evident on a bone scan) is a much harder question to answer, and many specialists would say that it doesn't, and that one should delay the use of hormone therapy until there is clear evidence of metastatic disease.
C: How high is a guy's PSA when he dies of PC? It might be anywhere from 50 ng/ml to 10,000 ng/ml. There is no "one number". In the "old days" (i.e., when PSA testing first became common) it was common for men to be diagnosed with metastatic disease and a PSA of several hundred or higher.
D: By driving PSA down does this actually stop/delay the disease from becoming metastatic? On average, NO. But on a patient by patient basis we really don't know. It is quite certainly the case that some men who have gone onto hormone therapy for years and then come off it again have low and highly stable PSA levels. My best guess is that there are men who are highly responsive to hormon therapy, and that their lives are indeed extended by it, and then there are men who are eith unresponsive or only somewhat responsive, and hormone therapy in their cases is only palliative (i.e., it helps them control their sysmpoms but makes no difference to their overall survival).
E: Are we being medicated for prevention/slowing of the coming metastatic condition or are we.......prolonging life span? I think I have answered that in answering the questions above -- it depends on the individual patient.
Last but not least, and worth a discussion with your oncologist ... There have been papers published that suggest that hormone therapy should actually be closely tied to testosterone levels rather than just PSA levels. In other words, since hormone therapy is used primarily to drive down one's testosterone level, it make sense that each shot of homones should be given only when the testosterone level starts to climb as opposed to just on a regular 3- or 4-monthly schedule. HOWEVER, the long-term benefit of this type of hormone treatment has never been tested in a large, randomized clinical trial.
Hope this helps!
Mike
- At 11:35pm on June 26, 2009,
Joseph Morin said…
- John
I had 1 dose of Eligard before surgery in Dec 06.Psa at the time was 63.Dr.Krongrad performed a radical robotic prostatectomy in may 07.All nodes were clean and no sign of spread.My urologist gave me half a dose of Eligard 4 mos after surgery as an insurance.I had all the side effects except the cardiovascular problems.My psa has gone from .04 to 1.2.I refused any further treatments. My attitude is to hell with psa and adt treatment.Unless they come up with something better I will take my chances.Right now I feel great am active and am enjoying what time I may have.Putting up with hot flashes,nite sweats,fatigue,memory loss, shrunk penis, and the rest is not for me.But thats me.I am not advising anyone to do as I do.No radiation for me.I did anesthesia for 40 yrs and I have never been impressed with radiation for prostate cancer.I am 74.Good luck with your choice,and will support your choices.
Joe
- At 7:02am on June 25, 2009,
E. Michael D. ("Mike") Scott said…
- John: If your side effects are that bad from 50 mg Casodex + 5 mg finasteride, but your PSA isn't undetectable, I think you should talk to your doc about coming off them and trying an LHRH agonist (one shot for 3 months). You will still (probably) have the side effects but it has a higher likelihood of driving down the PSA, but at least you won't have to think about taking the tablets every morning, and if you have the right insurance it will cost you less anyway.
I am concerned that 50 mg Casodex per day may not be enough Casodex to drop your PSA into the undetectable range anyway.
- At 7:41pm on June 24, 2009,
E. Michael D. ("Mike") Scott said…
- John: I left you an answer to your question about stopping ther hormone therapy early but ... what dose of Casodex are you on? 50 mg/day or higher?
And ... welcome to the site; sorry you had to come and visit!
Mike
Profile Information
- Have you been diagnosed with prostate cancer?
- Yes
- What brings you to the New Prostate Cancer InfoLink social network?
- Information on Prostate Cancer
- Would you help us grow the network? Would you tell others about it?
- Yes
- About Me:
- 73 year old male..177 lbs, physically active all my life, retired and working at woodworking and gardening.
Radical Prostatectomy 12/13/2004. Currently on Casodex and Finisteride these last 3 months due to rising PSA . No other treatments since RP.
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