Prostate Cancer Treatment Options Are Improving-----Not Sure I Agree.

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Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8122
   Posted 1/25/2008 10:40 AM (GMT -7)   
This may spark some contraversy here.  But I'm a bit ticked that my options have not improved.
 
I went back and looked at the improvements in treating prostate cancer over the last ten years.  Guess what I found.  Aside from some radiation techniques, and ways of treating local cancer, I would have had the same treatment options ten years ago.  And I doubt anyone here would have had different options either.  I have seen recent treatment options like HIFU, Cyberknife, daVinci, IGRT, Tomotherapy, Cryotherapy, and such.  But there is no scientific study supporting that these techniques are any better than regular open surgery.  Proton is more precise than it was ten years ago, but again all that is different is a slight improvement in side effects, not halting cancer progression. 
 
Ten years ago, I would have had the same options I have today.  Surgery, ADT (using the same drugs), and Radiation.  This is not the case in virtually every common cancer type listed in the AMA journals.  I am a positive thinker. And I understand that the way things are being delivered is slightly different.  But in Ten Years, c'mon.  We need to stop advanced prostate cancer in it's tracks.  We need better results.  When you look at nomagrams on cancer occurance by type, prostate cancer is a positive number and all others are negative numbers.  Meaning that the rate of prostate cancer occurance is increasing, while the others are declining.  What's up with that? 
 
Rant over!
 
It's nervous time again at our home. 
 
Tuesday CT, PSA, Blood work, possibly results. 
Wednesday, Oncologist, Lupron, continue Casodex, 
Friday, Radiation oncologist, tell him I'm fine, talk about his Porshe
 
Tony
Age 45 (44 when Dx)
Pre-op PSA was 19.8
Surgery on Feb 16, 2007
Post-Op Pathology was poor: Gleason 4+3=7, 4 positive margins, Stage pT3b (Stage III)
HT began in May, '07 with Lupron and Casodex 50mg
IMRT radiation for 38 Treatments ending August 3, '07
 
My PSA did drop out after surgery to undetectable.  It has not returned and I will continue HT until January '08.
 
My Life is supported very well by family and friends like you all.
 
Visit my journey at:
 
STAY POSITIVE!


biker90
Veteran Member


Date Joined Nov 2006
Total Posts : 1463
   Posted 1/25/2008 10:50 AM (GMT -7)   

Well Tony, I've often wondered why there have been no cures for major diseases since Jonas Salk discovered a cure for polio in the early 50s.  There have been lots of advances in the TREATMENT of disease.  And there's lots more money in treating disease than in curing it.  Look at what happened to the iron-lung manufacturers.

Talk about controversy - I'll probably get double slam dunked for this...

Jim


Paul1959
Veteran Member


Date Joined Nov 2007
Total Posts : 598
   Posted 1/25/2008 11:21 AM (GMT -7)   
tony,
To my mind, you've earned the right to rant. With all this stuff facing you right now, I think it's perfectly acceptable.

The vice pres of urology at NYC-Pres lamented to me that we can now diagnose PCa earlier than ever, but we still don't really know how to treat it. Without a control group who is willing to do nothing to treat their cancer, they have been unable to prove any technique at all and its efficacy.

yet, the media would have us believe that PCa is nothing to worry about anymore - and that is exactly what several people told me - "oh, that? they have so many treatments now, you don't have to worry about it at all!"

My son looked at me the other day and said "Dad, grandpa died of this, you've got it, that means I'm gonna get it, right?" He's only 14. I assured him that by the time he reaches my age, they'll have new treatments so that he will have nothing to worry about. I hope I'm right!
Paul
47 at Diagnosis.
Father died of Pca 4/07 at 86.
1/06 PSA 3.15
1/07 PSA 4.6      (Biopsy 3/07 just suspicious)
10/07 PSA 5.06   (Biopsy 11/07  1 of 12 with 8% involvment) (1mm)
Da Vinci surgery Jan 5, '08 at Mt. Sinai Hosp. NYC  www.roboticoncology.com
Saved both nerve bundles.
Path Report:  Stage 2cNxMx
-Gleason (3+3)6
-totally contained to prostate,
-10% involvement in L & R Mid lobes
 
 


JCL
Regular Member


Date Joined Jul 2007
Total Posts : 242
   Posted 1/25/2008 12:29 PM (GMT -7)   

Oh man, you hit a nerve, Paul.

When I advised an acquaintance I had been diagnosed with prostate cancer and had had surgery to remove my prostate, he replied, "Oh, that’s pretty common stuff from what I hear, not much to worry about there," I almost went ballistic.

Rant away, Tony. I’m wondering how much money is annually spent on prostate cancer research, and how it compares to money designated for other cancer research? I may be wrong, but ever since I've been diagnosed I've gotten the impression that PC takes a back seat to other diseases, and I'm not sure why.

Most of the articles I’ve seen recently pertain to genes liked to prostate cancer and how researchers can better understand how prostate cancer develops - studies that are expected to provide answers about the genetic changes that lead to prostate cancer, which could make it possible to design medicines that reverse those changes.


Diagnosed: March 25, 2007. Age 49
Biopsy: Gleason 6. Five of twelve samples positive with <5% each. No perineural invasion seen.
Surgery: May 21, 2007
Post-op Pathology: Upgraded to Gleason 7 (3+4), negative margins, negative capsular penetration, negative seminal vesicles, lymph nodes left intact, multifocal perinural invasion, 15% of prosate involving cancer in both lobes. T2c
Continence: Out of pads at five weeks. Seven months post-op I'm fully continent.
Erections: Yes! With the assistance of Cialis.
Post Surgery PSA: Three tests, all <0.1
Family history: Great-great grandfather died from PC. My Father had his prostate removed at age 67 in 1997 and has had an undetectable PSA ever since. I was diagnosed at a much earlier age and had a more agressive cancer than my father. Go figure.


pcdave
Regular Member


Date Joined Oct 2006
Total Posts : 444
   Posted 1/26/2008 12:59 PM (GMT -7)   
Dear Tony
 
I always love to read your messages--they are always inspiring and/or thought provoking!  It is hard to disagree with your general premise, but prostate cancer is not the only disease in which we haven't made enough progress in combating. For example, we haven't cured AIDS, but we have slowed down the death rate with new drugs (albeit taking those drugs to keep living can be unpleasant and does not guarantee how long you are going to live because such drugs may eventually become resistant to the disease in one's body).  We really haven't accomplished miracles in breast cancer either.  I befriended a women with breast cancer who I met while being treated for prostate cancer.  Compared to my treatment, she has gone through hell in her treatment (i.e., chemo, removal of one breast, reconstruction of that breast with an artificial implant and x-ray radiation for several weeks).  She is a very strong woman, but she still has unpleasant side effects and has difficulty in returning to her work which requires a lot of physical strength.  This woman has no assurance that her breast cancer will not return.
 
I guess the bottom line is that there are no quick cures for most types of cancer and other horrible diseases, notwithstanding the research that is being done and the greater dollars sometimes available for research.  In some respects, instead of fighting a war which is costing us mega zillions of dollars, having some of those dollars available for more intensive research for cancer would be gratifying. It is presently a very slow and painful process to readily find cures for cancer.  I can't begin to tell you how emotional I get when I hear the stories on this forum of men who are dealing with advanced stages of prostate cancer.  While I seem to be doing ok so far after my treatment, there is no guarantee that I will not have to deal with advanced PCa in the future. I get very tense every time I know that I am due for another PSA test.  No matter which treatment we choose, the prospect of having to deal with advanced prostate cancer looms over all of us even if we reach the desired PSA nadir.  Getting to the nadir gives us some comfort, but the question is always whether or not we will maintain the nadir for the rest of our lives.
 
As you probably know, Michael Milken (who established the Prostate Cancer Foundation) has worked tirelessly to step up research for PCa after he was stricken with it at a younger age.  I don't believe that we would have been as far along in combating prostate cancer if it were not for some of his efforts.  Luckily, he is a wealthy man and has been able to fund contributions and make contacts with people in high places to spur on more research than had been done in the past.  Obviously it was also self-serving for him, because he didn't want to be a victim of PCa. Bravo to Michael!
 
While it does not appear that enough major advances have been made in combating advanced prostate cancer in the past ten years, we all have to admit that the rate of death from PCa have declined because the word has gotten out to men to be periodically tested for PCa (PSA and DRE), preferably starting at age 40 unless there is a family history of PCa which may dictate earlier testing.  I very foolishly ignored my doctors advice to get a biopsy over three years sooner than I did.  I waited until my PSA got to an alarming level which forced me to have the biopsy. 

As you know, there continues to be new clinical drug trials for those with advanced prostate cancer.  We can only hope that one of these drugs will offer more hope and promise in the future.  We will continue to pray that some miracle cure will eventually be there (especially for those whose only hope right now is to embrace hormone treatment, which can have unpleasant side effects).  While the hormones won't cure the cancer, it can starve it off for many years.  When one of the members here recently posted a thread telling of the passing of her husband in his 50's from prostate cancer, I felt as if I had lost a member of my own family.  It was very emotionally draining on me. 

I, like many other PCa patients, get very upset when others will say that prostate cancer is no big deal when they hear of someone who has it.  To those people, I would give them a life sentence of reading the postings in this forum.  Yes, it may well be one of the cancers that is slower growing, can be treated and hopefully cured, but the side effects of such treatment can be nasty for some of us.  It robs many of us of some of our joys of manhood that we had before PCa.  It is no fun.  We rise up, accept the challenge and do the best that we can do.  Keeping a positive attitude is our only salvation at times.

Tony, I pray that a miracle will happen which will help you and others in your situation to be rid of this nasty disease. I have the greatest admiration and respect for you as a human being.  Your positive and spiritual outlook on life, despite the challenges you have faced, are a wonderful inspiration to all of us.  God Bless You!

Dave


-69 years young!
-29 core biopsy 9/27/06 at age 68
-PSA 7.1, Stage T1c, Gleason 7 (3+4) [less than 20% in one area], Gleason 6 [less than 5% in two other areas], Negative DRE, bone scan and Endorectal MRI. 
-Completed 39 Proton radiation treatments 2/22/07-4/18/07.   
-PSA History: 7.1 pre-treatment; post treatment: 2.1 (3 mo.), 2.4 (6 mo.), 1.7 (9 mo). Radiation oncologist said the 3-mo. drop of 70% exceeded expectations and the slight 6-mo. movement upwards was not a cause for concern now.
-The following is a link to My Journey With Prostate Cancer -- Proton RadiationTherapy.  
 
 

Post Edited (pcdave) : 1/26/2008 1:04:15 PM (GMT-7)


wd40
Regular Member


Date Joined Jan 2008
Total Posts : 218
   Posted 1/26/2008 1:47 PM (GMT -7)   
I ran across a paper that clearly defined the majority of reductions in the out come of prostate cancer was improved and early detection.

I too have run into a couple of people who say "Oh ya, prostate cancer grows slow and is no problem." I think next time I will be asking if they are willing to be a prostate doner. By the way, can they do that?
12/06/07 DaVinci and LRP


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8122
   Posted 1/26/2008 2:47 PM (GMT -7)   
Well spoken (typed) Dave,
And thank you once again for your kind words. I know all the diseases need attention. My rant is about the fact that PCa is on the rise, while most others are on the decline. But I do understand that this rant is stated by me only because I have this disease. My son enlightened me the other day by bringing home a glow in the dark wrist band with "Glow for Kids" enscribed on it. That's perspective indeed. I guess I would forfiet funds for our disease to increase funds for children's diseases. In addition, my mother is now a cancer patient and it amazes me how little tools there are for these doctors.

I had to learn how to take a comment downplaying prostate cancer. But it's an opportunity, and I jump on it. That is a person that needs an explaination and a little enlightenment. I remind them that there is no such thing as a good cancer.

Tony
Age 45 (44 when Dx)
Pre-op PSA was 19.8
Surgery on Feb 16, 2007
Post-Op Pathology was poor: Gleason 4+3=7, 4 positive margins, Stage pT3b (Stage III)
HT began in May, '07 with Lupron and Casodex 50mg
IMRT radiation for 38 Treatments ending August 3, '07
 
My PSA did drop out after surgery to undetectable.  It has not returned and I will continue HT until January '08.
 
My Life is supported very well by family and friends like you all.
 
Visit my journey at:
 
STAY POSITIVE!


pcdave
Regular Member


Date Joined Oct 2006
Total Posts : 444
   Posted 1/26/2008 3:16 PM (GMT -7)   
Hi Tony
 
Nice to get your reply.  As we all know, this is like a family here.  It gives us a chance to pour out our souls and also solicit the views of other members which often give us comfort and maybe a different perspective from our own. When I was being treated with Proton Radiation, I saw all of these very young children who were there for Proton Radiation treatment (safer form of radiation especially for young kids) for cancerous tumors in their brain or elsewhere.  It really opened my eyes to the world around me that is not always visible and made me feel quite humble and less concerned about myself.  I also got a close view of the struggle that women face with breast cancer.  No matter what kind of cancer it is, it presents one of most challenging times of our life.  It is human nature to fight for survival no matter the difficulty. Those that have been faced with ovarian, pancreatic and lymphoma cancers have not been as fortunate as those with prostate cancer.  Their chances of survivial are far less than those with prostate cancer. That's why I try to accept my fate and realize that I have been more blessed than others.  Nevertheless, dealing with any kind of advanced stage cancer is not easy. We often wonder in this weathy world today, why the advances in technology and medical science have not been able to achieve more in curing cancer and other diseases.  Medical research is all trial and error until they strike gold.  I am very sorry to hear about your Mother.  I will pray for her recovery. Peace!
 
Dave


-69 years young!
-29 core biopsy 9/27/06 at age 68
-PSA 7.1, Stage T1c, Gleason 7 (3+4) [less than 20% in one area], Gleason 6 [less than 5% in two other areas], Negative DRE, bone scan and Endorectal MRI. 
-Completed 39 Proton radiation treatments 2/22/07-4/18/07.   
-PSA History: 7.1 pre-treatment; post treatment: 2.1 (3 mo.), 2.4 (6 mo.), 1.7 (9 mo). Radiation oncologist said the 3-mo. drop of 70% exceeded expectations and the slight 6-mo. movement upwards was not a cause for concern now.
-The following is a link to My Journey With Prostate Cancer -- Proton RadiationTherapy.  
 
 


War-eagle
Regular Member


Date Joined Sep 2007
Total Posts : 219
   Posted 1/26/2008 5:11 PM (GMT -7)   

Tony,

You are so right. When you here people say, "oh, you've got the good cancer". When they get cancer (praying that no one does) I want to hear any of them say that they have a good cancer. They just don't have a clue. They need to walk a mile in our shoes.

Jim states it very well. We don't cure things nowadays. We treat them. We treat a cold. We treat the flu. We treat cancer. When will we get some bang for the bucks and start curing things. Is the health care industry motivated to cure anything anymore? What impact would it have on the world if we found a cure for prostate cancer? Think about this, if 100,000 men get one shot of lupron every 4 months, at $1,000.00 (sell price by drug company), that's $300,000,000.00 per year. I suspect the numbers are even higher. I am not saying that there is a vast conspiracy or any conspiracy at all. I just question motivation.

Tony, you and I have talked at great length about this and we agree that the way to beat this thing is with earlier testing. Catch the monster when he is still a baby. As someone said the other day 50 is the new 40. No, as for testing 40 is the new 50.

My rant is over. Thanks for starting this Tony, I feel better. Wear the blue.

Be blessed and War Eagle.

Walt 


Age: 54
PSA 43 7/2005
Biopsy 12/14 Gleason 7 & 9
Divinci 9/2005 - spread to bladder
HT - 10/2005 (Eligard every 6 months)
RT - 10/2005 (38 treatments)
PSA 0.12 to 1.9 2/2007
Bone Scan and CT 4/2007 Bone mets
Casodex 4/2007
Zometa infusions 4/2007
PSA 4.8 8/2007
PSA 6.34 12/2007
Radiation (15 treatments) started on bone mets 12/2007
PSA 6.72 1/2008
 
 
"I will persist without exception - I will find a way where there is no way"


Cedar Chopper
Regular Member


Date Joined Mar 2007
Total Posts : 432
   Posted 1/27/2008 4:21 AM (GMT -7)   
Selmer said...
BTW, while I've changed my diet over the past decade, I've had near zero influence on anyone around me. ....  I only mention other ways of eating if it comes up in normal conservation, but I don't think even being a proponent would influence others to change.
Selmer

Selmer,

You are not just "preaching to the choir!"
Even this vege peddler has not missed the influence of your dietary diatribe!
I can't spell "cruciferous" without thinking about a Selmer post!

     "If you like to talk to potatoes,
      If a squash can make you smile
      If you like to waltz with tomatoes,
      Up and down the produce aisle,
        Selmer has a diet for you!"

CCedar
ICTHUS!


2 Years of PSA between 4 and 5.5  + Biopsy 23DEC06 
Only 5 percent cancer in one of 8 samples.  +  Gleeson 3+3=6
Radical Prostatectomy 16FEB07 at age 54.
1+" tumor - touching inside edge of gland.  + Confined:)
Pad Free @ 14 weeks.  Six Month PSA <.003  :)   Nine month PSA <.008
:)
At 9 months, ED treated with Pump Exercises & 100mg Viagra Daily
Texas Hill Country FRESH Produce Department Manager
Have you had your 5 colors today?
"Zen and the Art of Orchestral Erectile Function"

"Zen and the Art of Symphonic Continence"

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