ADT3 for localized PC; any experience?

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John T
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Date Joined Nov 2008
Total Posts : 4251
   Posted 1/23/2009 10:45 PM (GMT -6)   
I was browzing Dr Leibowitz's web site today and read about 10 of his published papers. He talked about treating localized PC with Lupron, Casodex and Proscar for 13 months then maintenance with Proscar. His results seeemed impressive with only a small % of patients needing a 2nd treatment. These results are better than either RP surgery or radiation with the benefit of no side affects after the 13 months and still leaving all other treatment options still available.
I know a lot of you are on this protocol after failed surgery or radiation or for mets,; I also know that this protocol is commonly used for 3-6 mos before radiation. Has anyone done this protocol alone without surgery or radiation? Are his results real? Any comments would be appreciated.
JohnT
 

Diagnosed 10-08 at 63 with PSA of 33

PSA was 4.4 in 1999 and has risen steadily.
Had 13 biopsies and an endorectal MRI, all negative until 10-08. Two cores out of 25 with a gleason 6
2nd opinion with an oncologist said cancer found was insignificant, but suspected larger tumor somewhere.
Doppler ultrasound with target biopsy indicate a large tumor in the transition zone, gleason 7.
Bone and CT scans negative.
PSA3= 43; (high normal is 35)
Scheduled for Combidex MRI in Feb. (Lymph node imaging MRI done in Holland).
location of tumor makes positive surgical margin unlikely.
Looking at IMRT with hormone therapy as soon as staging is complete with Combidex MRI.
Changed diet, eliminated all meat and dairy. Taking the normal supplements recommended for PC.
 
JohnT
 
Post Edited by TC-LasVegas
   Extra spaces deleted in Signature area
   JohnT contacted to help fix signature
 
 

Post Edited By Moderator (TC-LasVegas) : 1/24/2009 10:20:06 AM (GMT-7)


livinadream
Veteran Member


Date Joined Apr 2008
Total Posts : 1382
   Posted 1/23/2009 11:24 PM (GMT -6)   
Not familiar with that John. I am on ADT3 but like you mine is after failed surgery. I am going to watch this post and read some of the responses. Thanks for posting the question.

peace to you
Dale
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
Casodex
Currently on Lupron
I go to The Cancer Treatment Center of America
Married with two kids
latest PSA 5-27-08 0.11
PSA July 24th, 2008 is 0.04
PSA Dec 16th, 2008 is .06
Testosterone keeps rising, the current number is 156, up from 57 in May
cancer in 4 of 6 cores
92%
80%
37%
28%
 


zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 1/24/2009 6:27 AM (GMT -6)   
John T (et al)- I posted once before on a person I know that has done this, kind of like a pioneer for us to look at these days. He took his chances on this 12-14 yrs. ago (1996 actually). Here is the awesome story from another Michigan guy, that I met at my support group and have called by phone a couple years ago to see how he was still doing. (I care about our choices big time)

Rick K. is his name he was in his early 50's when diagnosed, I am looking at my notes right now that I know about his case. His bPsa 10.8 4 cores found with Pca, was given Gleason 5 (2+3) and this was never reviewed by an expert (local pathology guy)....it is rare to see anybody with less than a 6 gleason (but is possible), he believed he was T2b stage, not sure on the DRE (my guess is it was positive).
He did Dr. Leibowitz program herein Michigan under a different doc (most likely was an onco-doc, I believe he got the information from PAACT.org group). Using the ADT3 combo (Lupron+Casodex+Proscar) for 13 months and quit, except you stay on Proscar for maintenance. (Proscar for me had no noticeable effects when I took it alone, as to side effects)
Well within months Rick says he is completely normal as a man (manhood restored, no issues).
Years going by and his psa in normal range levels now, Rick still decides to get re-biopsies....is the PCa to be found or not????? First re-biopsy nothing found no PCa on pathology. He did this again after some time went by, Rick is nobodys fool and needs to know how effective is this....2nd rebiopsy and nothing found.
It has been like 13 yrs. now and Rick is totally normal as a man, he monitors psa always, but still looking good....."cured".......myself I say maybe at best....and more likely would say "no" he is not cured. Is he stupid for avoiding life altering invasive or more 'heavy duty' modalities upon his person as a patient?????
He can still do all treatments available, however surgery would be more difficult because of shrinkage of the gland using these drugs, makes it harder for the doc to do this, but could still be done.

I KEEP SAYING PCA IS LIKE THE TWILIGHT ZONE- it is crazy world of choices and outcomes.

Now this does not mean that every man whom tries this will achieve identical results....this is the Twilight Zone....there are no guarantees in PCa....if so "show me the money", been looking at everything for many years. However, is Dr. Leibowitz giving the straight up truth, could be, we need more examples and studies or abstract of hundreds of patients, besides his own to be more objective.

Now ask yourself was Rick K. stupid?????????????????? (Rick's psa a few years ago stabil at 1.6 which he still has an intact prostate gland, 2 re-biopsies an nothing found!!!

Oh the maintenance on Proscar or using Avodart.....zufus-s.w.a.g. (scientific wild ass guess as to why???) It shuts down DHT (your body takes normal testosterone and coverts it into this type, which is 5 times more potent than the normal "T" levels....PCa is fueled by "T" and prefers "DHT", that is my swag guess....but I am layperson....and it is the Twilight Zone~~~do~do~do~do~do~do~do (background music)


 

Post Edited (zufus) : 1/24/2009 4:56:34 AM (GMT-7)


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 1/24/2009 12:00 PM (GMT -6)   
no stupidity here, Bob,
But I will mention that having been through a gambit of treatment modalities, it was HT that was the harshest. Rick faired well and I am glad to see it, but not all handle even 13 months well on HT. Rick's cancer could have been indolent right out of the gate with that G5.


Tony
Age 46 (44 when Dx)
Pre-op PSA was 19.8 : Surgery at The City of Hope on February 15, 2007
Geason 4+3=7, Stage pT3b, N0, Mx
Positive Margins (PM), Extra Prostatic Extension (EPE) : Bilateral Seminal vesicle invasion (SVI)
HT began in May, '07 with Lupron and Casodex 50mg (2 Year ADT)
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (January 13, 2009): <0.1
 
My Journal is at Tony's Blog  
 
STAY POSITIVE!


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25382
   Posted 1/24/2009 12:14 PM (GMT -6)   
was Rick K. stupid? no, can't imagine anyone saying or thinking that. rick had or has is options, he made his choice, and sounds like he is sticking to it for now with that kind of long term sucess. Would that work for everyone else in the exact same scenerio, probably not. one thing i have been learning, every human body is different, and it reacts different to almost everything you can think of, and when you factor in some of many variable in PCa, it makes it even more difficult to decide. in the end you have to do what is best for yourself. perhaps one day in the distant future, there will be a better way to make the dx earlier and better understood, and who know what treatments will be thought of years from now.
Age 56, 56 at DX, PSA 7/7 5.8, 7/8 12.3, 9/8 14.9, 10/8 16.4
3rd Biopsy 9-2008 Positive 7 of 7 cores positive, 40 - 90%, G 4+3 & 3+4
Open RP surgery 11/14/8, Non-nerve sparing, 4 days hospital, staples out 11/24/8, Catheter out on 12/15/8. Stopped flowing, new catheter put in 12/16/08, Catheter out 12/29/08. Emergency room put in Catheter # day 45, 1/5/9 - Cath #3 out, dr. did cycloscope, saw potential blockage, put in Catheter #4, 1/13/9 - removed blockage, put in Cath #5, 1/19/9 -out
Post-surgery Pathlogy Report:Gleason 3+4=7, pT2c, 42 grams, tumor 20%, Contained in capsular, clear margins, clear lymph nodes 
First PSA Post Surgery  Scheduled now for 2/9/9
 
 


gpg
Regular Member


Date Joined Jan 2009
Total Posts : 180
   Posted 1/24/2009 2:44 PM (GMT -6)   
Hi John T, yes it is a very tough descision.

Not to discount the story on Rick and I wish him continued success.

If these treatments worked on anything like a reasonable percentage of PC patients almost everyone would be on them. It is well documented that in nearly all prostate cancers there is a population of hormone insensitive or refractive cells. Even though the ADT stifles and may even cause to expire over time the cells reliant on the hormones the refractive cells unfortunately continue to double until they represent a majority of cells present and PSA begins to move up again as this tumor mass grows. For me also the worst aspect of my treatment was the range of changes that the Lupron visited on me for the four months I was on it. While Rick's story is interesting it is also unique.

I think you need to be seeing an genitourinary oncologist if you are not, and I think you will be hard pressed to find one which will prescribe a treatment of ADT alone in the presence of what is reasonably considered contained cancer.

Best wishes. Scott


Diagnosed @ 48yo 04/07
focal, low volume tumor gleason 6
RRP 07/30/07
Persistance of PSA
IMRT 11/07-01/08
Emerg, cysto obstructed bladder 01/08
Persistance of PSA
08/08 learned Dr. left significant amount of prostate
12/08 saturation biopsy 36 cores 24 having normal prostate tissue
12/08 referred whole to med malprac attorney


zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 1/24/2009 2:48 PM (GMT -6)   
Hey no disagreement with any of you, David I go along with what you mentioned that early and reliable assessment is the most important variable that needs defining as to when or what to do. I do not believe that this Rick K. is a freak of nature, it is possible that other men could have decent and/or similar results if they were diagnosed with something close to his. What we need to know is further examples of patients in further staging levels and see how they fared as to durations of PCa free or reknewal of drug combo.

You can imagine when Rick K. chose this 12+ yrs. ago, it was a leap of faith that he kind of threw the dice on, it was not well known so much back then. It just shows how bizarre PCa can be as a whole.
 


divo
Veteran Member


Date Joined Jul 2008
Total Posts : 637
   Posted 1/24/2009 9:01 PM (GMT -6)   
...With two sons in their thirties, I want to learn all we can about this disease...Maybe John T has a good option...?? who knows..Di
Husband Pete
dx Jan 2001 gleason 4 + 3 PSA 16.5
Seed implant and conformal radiation and Lupron from Jan 2001 to Jan2002
2005 Dec PSA began to rise from .5 to 8 within 6 months
Salvage surgery at MSK 9/06 Dr. Eastham
Fistula operation 2/07 MSK Dr. Wong
Many cystoscopies and ER visits with strictures
Catheter for one year....Catheter taken out Sept 07..
Total Incontinence since then....
PSA .52 3/08
AUS Operation at MSK Sept 8 2008 Dr. Sandhu
Activated Oct 28th Dr. Sandhu..MSK
Some difficulty with AUS arising Nov 10 2008
Meeting with Dr. Sandhu to discuss AUS problems and new PSA test Dec 11, 2008
PSA .6 12/08
AUS improving..only 2 pads a day and one at night
Complete hip replacement surgery Dr. Waters Gainesville, FL 1/9/09
Forging ahead to health!

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