Revisiting Rick K.~ADT3 as primary treatment for PCa~Dx-1996~updated he ok'd my posting

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zufus
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Date Joined Dec 2008
Total Posts : 3149
   Posted 2/16/2009 4:41 PM (GMT -7)   
I got more of his story and newer information, just called him and talked to him about his PCa journey and it is something in the PCa world. He is also in Michigan and I met him at my PCa support group back in 2002 era when I was a newbie and wondering what jungle I just landed in.
 
Rick K. (age 50's)- Dx-1996 with bPsa: 10.8  biopsies showed two positive, given Gleason 5 (2+3) 4 or 5 cores taken (back then), he thought he was stage T2b.  Well he was looking at all the treatments as we all do and he did not like what he saw. He got a consultation with Dr. Fred Lee (I did not know this from last post on this) and back in that era he mentioned doing ADT2  (zoldex + casodex) and monitor your results...no time frame....well about this same time Dr. Leibowitz (onco-doc)had come up with his brand new concept of ADT3 as a treatment protocol  (lupron or zoladex+ casodex + proscar) a method to shut down all testostorone and conversions of DHT for men, which would stop the fuel that PCa thrives on.
Well Rick went to a meeting in Grand Rapids back then, just so happens that was the Paact group  (Patient Adocates for Advance Cancer Treatments). At the meeting he heard more about the Dr. Leibowitz new protocol, so he linked up with a local onco-doc and did this as his primary treatment.
 
ADT3 combo drugs for 13 months, then quit and take only proscar as a maintenance drug. Also, noted that his manhood and functions all returned to normal like within 1 year. His psa stayed low and looked excellent, so after a couple years got biopsies and nothing found, did them another time 1-2 yrs. more went by and nothing was found. He goes 5 yrs. with low psa levels was 1.7 when I saw him in 2002. Now the updated story:  his psa finally started moving upwards and in 2006 got up to 5.0 range, so he decided to revisit the ADT3 protocol (2nd time now), finished this in Dec. 2007 and his current results:   psa .70 currently and testostorone is extemely low at 50 as of this date (much lower than when done in the past after 1 yr.+).
 
So he got 13 yrs. since diagnosis with no other treatment, psa level is still excellent, he could still get most or all PCa treatments if and when it were needed or via his decisions. He could probably have the luxury of revisiting the ADT3 protocol again and/or switch to ketoconazole, nizoral, estrogenics and/or other drugs. Could even try HD-casodex (150 mg), perhaps, etc.
 
*note his pathology was never reviewed by any of the leading experts, it is rarer to see a Gleason 5 in anyone, but is possible. He may have also really been a Gleason 6, and note he had a higher level of psa than the average presentation of patients (10.8).
 
Not saying that 'you' should consider this protocol, but it will work for somebody. Does show how bizarre PCa can be.


 

Post Edited (zufus) : 2/16/2009 4:45:31 PM (GMT-7)


John T
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Date Joined Nov 2008
Total Posts : 4168
   Posted 2/17/2009 5:39 PM (GMT -7)   
I read some of Liebowitz's papers and he he states that he treated around 250 patients with a gleason ranging from 6 to 8 and PSA averaging around 10. (The numbers may not be accurrate but they are close) go to his papers to see the actual numbers. I think he has had only 8 reoccurrances in 7 years. If these are true and I have no reason to believe they are not, they are better than any of the other treatment options currently being offered. This is without any of the long term side affects of the other standard treatments and still leaves all other options open with the exception of nerve sparing RP since the drugs scar the nerves and they are difficult to spare in surgery. The other benefit is that the protocol can be done anywhere. This is definately worth looking into as an option for a local treatment. The protocal is 150 mg of Casadex daily, Lupron every 28 days and proscar for 13 months, then proscar maintenance. All side affects usually go away within a couple of months.
JohnT

I had a psa of 4.4 in 1999 and steadily increasing psa every 3-6 months before reaching 40 in 5-08.Free psa ranged from 16 to 10%

I had biopsies every year, 13 total in all. I saw 5 different doctors, all urologists or urological oncologists at Long Beach, UCLA, UCSF and UCI and had an MRIS at UCSF in 2007. All tests were negative and I was told that because of all the biopsies I most likely didn't have PC, but to keep getting biopsies every year.

in Oct 08 my 13th biopsy of 25 cores indicated 2 positive cores, gleason 3+3 less that 5% in 2 cores. Doc recommended surgery.

2nd opinion from a prostate oncologist, referred by my wife's oncologists said cancer found wis indolant and statistacally insignificant, but PSA histor was a major concern and ordered a few more tests.

Color Doppler ultrasound with targeted biopsy found a transition zone tumor 18mmX16mm, gleason 3+4 and 4+3. CT and bone scans clear, but Doc thinks that there may be lymph node involvement (30% chance) because of my high PSA, and referred me for a Combidex MRI in Holland, currently scheduled for Feb 14.

Changed diet and takiing supplements while I wait. The location of the tumor plus the high psa make surgery an unlikely option. I'm still evaluatiing all treatment options and will make a decision once I get the results of the Combidex scan.

JohnT


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 2/17/2009 6:06 PM (GMT -7)   
Ralph Valle (innagual Pinchot award winner) typed this story on the InfoLink before. And while it worked for 13 years, Rick is dealing with his prostate cancer once again. Living true to form, hormonal therapy is definately not a cure. One has to wonder that if Rick and his G5 had his prostate removed, could he have survived without relapse? Most legitimate studies say yes. And likely even at 13 years.

I have no doubt that ADT3 will stop almost any non-metastatic cancer in it's tracks for a while. But it will likely never stop it forever. And the younger the patient, the more likely of a relapse. It's a shame to be on ADT3 11 years after initial treatment for a gleason 5 disease in my book. Clearly to me the worst of my gauntlet of treatments has been ADT. But I had no choice but to do it. And good numbers by Lebowitz in 7 years does not persuade me one bit. How the heck am I supposed decipher how that will pan out in 35 years ~ my life expectancy after my diagnosis. That's not a healthy run of any form of hormonal therapy intemittent or otherwise. I am certain Lebowitz cannot dispute that.

My oncologist is not a surgeon. But he is a well known prostate oncologist, and wrote the "Textbook of Genitourinary Oncology" with four other well known and highly respected oncologists. He said if it were him, he would have started right where I did.

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!

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