Three different opinions on how long to take hormones

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Regular Member

Date Joined Mar 2008
Total Posts : 66
   Posted 4/26/2008 8:18 AM (GMT -6)   
Ok, My Uncle decided to get his fourth and final opinon at Fox Chase Cancer Center. This is how we stand
Urologist: Short term use of hormones and no radiation
Local Radiologist and U penn Oncologist: Life time hormones nad 8 weeks radiation.
Fox Chase: Intermittent hormones and 8 weeks radiation
She said that they have done studies and have found that
giving hormones intermittently has better effect.  She is contacting the radiologist that my Uncle has chosen to speak with him about their findings.  She said sometimes other doctors will work with them and sometimes they won't.
Any opinions? 
Still moving forward...had first of many Eligard shots. We are now going to "Hot Flash" together tongue
Father diagnosed 13 years ago @ age 63
Watchful waiting until PSA jumped from 6 to 10
Cancer found in 1 core
Gleason score 6
Seeds implanted
PSA has been low since (don't know exact numbers)
Uncle (mother's brother) age 68
PSA jump from 2 to 8 in 18 months (2/08)
DRE was normal (2/08)
Biopsy (3/08) Cancer found
Bone scan (clear) 
CAT scan showed 1 enlarged lymph node
Fine Needle Lymph Biopsy (Positive)
Gleason Score (7) 4 + 3
9 of 12 cores positive

Doting Daughter
Veteran Member

Date Joined Aug 2007
Total Posts : 1064
   Posted 4/26/2008 9:42 AM (GMT -6)   
Your situation is so similar to ours. The more opinions you get, the more opinions you get :-) This is such a personal decision and I feel that your uncle truly has to be onboard with whatever treatment in order to win this. When we first met with the RO and Oncologist, my father didn't want to hear about RT and HT. We (my mom, husband and I) were really worried, because from the studies we read, we felt that RT and HT were his only chance (if any) of a cure, which some will say that once it has spread to the lymph nodes that there is no cure, but I have read cases where with local lymph node involvement following radiation and HT, men have done well for YEARS. My father's urologist, who diagnosed the cancer, recommended not doing RT and waiting to start HT, similar to what your urologist said. However, studies have shown that with lymph node involvement, men have done better starting HT immediately. We also based our decision on another study that showed the 5 year recurrence was much less for men who did RT and HT. This is a new study, your urologist might not be familiar with. This was our only chance to do RT, because if the cancer spreads, RT is no longer an option. Therefore, my father agreed to do 8 weeks of RT and 2 years of HT. He just finished his 8th week on Tuesday and will have his first PSA in three months. The RT was very tolerable and we are praying that it nuked any cancer remaining. There are obviously no guarantees. Best case scenario, we are hoping for a cure. Worst case scenario, we hope that it has bought my father more time, until they find a cure. Best wishes in your treatment decision. Gather all the info you can, and don't look back. Second guessing doesn't do any good.

Father's Information
DX July 15, 2007
Age 62 (now 63)
PSA 5.5
Original Gleason 3+4=7
Post Surgery Gleason- 4+3=7
DaVinci Surgery Aug 31, 2007
Focally Positive Right Margin
One positive node
Bone Scan/CT Negative (Sept. 10, 2007)
T3a N1 M0
Oct. 17 PSA 0.07
Nov. 13 PSA 0.05
Casodex adm. Nov 07
Lupron beg. Dec 03, 2007 2 yr
Radiation started March 03-April 22, 2008- 8 weeks 5x a week
8 weeks of radiation down!!!
Praying for a cured dad. First PSA 3 months!


Post edited to single space signture...

Post Edited By Moderator (bluebird) : 4/26/2008 9:42:06 PM (GMT-6)

Veteran Member

Date Joined Apr 2008
Total Posts : 1382
   Posted 4/26/2008 6:01 PM (GMT -6)   
I remember when I got my second opinion, my hope and prayer was that it would match the first opinion so I would not have to seek a third one. Cancer and cancer treatments are very difficult to grasp, because many doctors use certain techniques that they have found to be best. I agree with dotingdaughter the best treatment is the one you are comfortable with. I personally went thru the radiation and I will be on hormone therapy for two years. My research indicated that it was the right course of treatment for me. One thing I would like to ad is this, I truly believe that attitude, and faith are better than half the battle. Please try to remain positive and find the blessing amidst this dreaded disease. Please keep us posted as to how the course of treatments go, and if you would like to email me we could chat more about this.

peace and love
My PSA at diagnosis was 16.3
age 46 (current)
My gleason score from prostate was 4+5=9 and from the lymph nodes was 4+4=8
I had 44 IMRT's
Currently on Lupron
I go to The Cancer Treatment Center of America
Married with two kids

Veteran Member

Date Joined Feb 2007
Total Posts : 1219
   Posted 4/26/2008 7:57 PM (GMT -6)   
My husband is on HT and will be until it no longer works. We had a number of docs who all agreed as his cancer had spread to distant lymph nodes.

Doctors give their opinion based on studies, experience and what a patient presents to them, so it's a tough decision on your part to determine what avenue is best.
Everything has to be weighed - what do these doctors expect the results to be, how will your uncle tolerate the side effects, does he have other health concerns that factor get the picture. His decision, once made, will be a relief and he can move on from there. My husband's PSA is undetectable and we hope it stays that way for a long time. We wish the same for you.
Please keep us up on how things are going - we do care.

Husband Diagnosed 11/17/05 Age: 63 PSA: 7.96 No Symptoms
2/09/06: LRP - Post Pathology - Gleason 4+3 Stage T2b NO MX
3 mo. PSA: 11.8 Stage T3a
6 mo. PSA: 18.8 Stage IV Systemic w/ distant lymph node involvement
Start HT - Lupron 3 mo. shots
12/06/06: PSA 0.8
03/07/07: PSA 0.3
PSA - Undetectable since 6/07/07

Link to journey:

Tony Crispino
Veteran Member

Date Joined Dec 2006
Total Posts : 8128
   Posted 4/27/2008 9:16 AM (GMT -6)   
Hi Cheryl,
All of the doctors are reflecting the contraversy that surrounds your uncles stage. So none are wrong and none can say they are right 100%. I know that sounds like nothing you want to hear but it is what it is. Here comes Tony's opinion again so if you can grin and bear it:

The Urologist: I believe that a urologist should stick to things like plumbing and infections. Since that is 90% of what they do, it is their specialty. Saying that no local treatment will work is blindly saying that is 100% fact. Well it isn't. And even if is a small chance that local treatment along with HT will help, small is big.

The radiologist and the Penn Oncologist: They are giving you uncle a shot at that small chance. The only thing that would have me hesitant is the declaration that HT will be a lifetime treatment is again premature. There is still a chance that the radiation alone can cure this thing. but adding HT now is prudent given your uncles stage.

The Fox oncologist: IHT or intermittent HT is what you should strive for. If he can't get there so be it, but any doctor suggesting a lifetime of HT should try it themselves. I am 100% certain that once they start it, they will be looking forward to the day they stop it.

Feels like "Let's Make a Deal" doesn't it? The door behind Carol Merrill, and a shot at the Big Deal. Well my two cents worth: I agree most with the Fox oncologist.

Age 45 (44 when Dx)
Pre-op PSA was 19.8
Surgery on Feb 16, 2007 @ The City of Hope
Post-Op Pathology: Gleason 4+3=7, 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
Current PSA (1/08): <0.1
I will continue HT until May '09. 
Years in Remission (3/23/07): 1
Visit my Journey at:
Prostate Cancer Forum Moderator

Post Edited (TC-LasVegas) : 4/27/2008 8:46:26 AM (GMT-6)

Regular Member

Date Joined Apr 2007
Total Posts : 101
   Posted 4/27/2008 9:39 AM (GMT -6)   
Lots of schools of thought on Hormone Treatment, see my signature and statistics. My Doctors immediately put me on Lupron after I apparently had a failed surgery due to my psa still being present in quantities of more than .2, to wit .62 and then a recheck a couple of weeks later of .59. I was told that I would be on HT for two years then a very close monitoring of my psa after that, if any appreciable rise then back on HT, probably forever. I still have another one+ year to go, fortunately I have very few side effects mostly just hot flashes. I'm hoping that the two years of HT plus the 35 IMRT treatments will have taken care of anything residual left in the prostate bed and I'll be rid of this dreaded disease. Good luck all....jwb.
age: 62
PSA 4.57 - Positive DRE
Biopsy 3-19-07 - Gleason 4+4=8
Negative bone scan 3-20-07
DaVinci 4-24-07
Catheter out 5-01-07
post op pathology:
positive margin left side of prostate
left seminal vesicle involved (both removed)
No lymph node involvement
New gleason score 9
T3B....radiation consult on 5-9-07.
June 5, 2007 1st psa post surgery 0.62
June 27, 2007 second psa post surgery 0.59
June 27, 2007 started Lupron injection (24 mos)
September 6, 2007 scheduled to be marked and prepped for radiation therapy.
Start IMRT therapy on September 13, 2007.
September 26,2007 psa test .08
Finished IMRT therapy October 31!!!
January 17, 2008 psa test .<.05!!!!
April 8, 2008 psa test .<.05!!!!

Regular Member

Date Joined Mar 2008
Total Posts : 66
   Posted 4/27/2008 6:07 PM (GMT -6)   
Thank You everyone for your heartfelt replies. I do believe we are ready to land in a place we are all comfortable. We are now finding out that there might have been a warning sign a year ago. I am going to post about it to help others as soon as I get the information.
Thanks again
Father diagnosed 13 years ago @ age 63
Watchful waiting until PSA jumped from 6 to 10
Cancer found in 1 core
Gleason score 6
Seeds implanted
PSA has been low since (don't know exact numbers)
Uncle (mother's brother) age 68
PSA jump from 2 to 8 in 18 months (2/08)
DRE was normal (2/08)
Biopsy (3/08) Cancer found
Bone scan (clear) 
Fine Needle Lymph Biopsy (Positive)
Gleason Score
(2) 4 + 3
(1) 3 + 3
(4) 4 + 3
7 of 12 cores positive
Waiting for MRI and another CAT Scan before radiation
Started Casodex and Eligard

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