Hormone Therapy

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tiredwanderer
New Member


Date Joined Oct 2009
Total Posts : 2
   Posted 10/13/2009 6:34 PM (GMT -6)   
 I've just found out that my psa has doubled into a dangerous zone. I had radical surgery little more than three years ago. The doctor has stated that I won't live five years unless I start hormone therapy treatments. I am, frankly, very scared of the side effects. Does anyone have knowledge of this treatment?

Geebra
Regular Member


Date Joined May 2009
Total Posts : 476
   Posted 10/13/2009 6:38 PM (GMT -6)   
You should find out about salvage radiation, if your PSA is reasonably low.

Father died from poorly differentiated PCa @ 78 - normal PSA and DRE

5 biopsies over 4 years negative while PSA going from 3.8 to 28

Dx Nov 2007, age 46, PSA 29, Gleason 4+4=8

Decided to participate in clinical trial at Duke - 6 rounds of chemo (Taxotere+Avastin)

PSA prior to treatment on 1/8/2008 is 33.90, bounced on 1/31/2008 to 38.20, and down at the end of the treatment (4/24/2008) to 20.60

RRP at Duke (Dr. Moul) on 6/16/2008, Gleason downgraded 4+3=7, T3a N0MX, focal extraprostatic extension, two small positive margins

PSA undetectable for 8 months, then 2/6/2009-0.10, 4/26/2009-0.17, 5/22/2009-0.20, 6/11/2009-0.27

Salvage IMRT + 6 Months ADT: Casodex started 6/12/2009, Lupron 6/22/2009, PSA 6/25/2009-0.1, T=516, 7/23/2009-<0.05, T<10, IMRT to start mid-Aug


zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 10/13/2009 7:15 PM (GMT -6)   
Can tell you more than you want to hear, did ADT3 hormone therapies and other(s), been 7.7 yrs. since I was given the sentence, luckily at this juncture I am still doing well and my original stats were quite bad, had total urinary blockage too in 2002 (bpsa 46.6 gleasons 7,8,9's, 12/12 biopsies all 70-95% range). Send me an email I will give you my phone number if you are that interested. My name thingy herein has info for my email.
 "I wouldn't join a club that would have me as a member" (Groucho Marx)


Hopeful in MD
Regular Member


Date Joined Apr 2009
Total Posts : 66
   Posted 10/13/2009 8:41 PM (GMT -6)   

Hi Tiredwanderer,

I don't have the experience that Zufus has and I have been on Lupron hormone therapy for only 5 months.  Shots I get are designed to last for 4 mos.  First shot Apr. 21, second Aug. 21.  Next due Dec. 21.  So far, so good.  My PSA went down to 0.5 from 3.9 after the first shot.  Felt a lot of fatigue at first, but that is gone.  Now I just get hot flashes, which are little more than a nuisance. 

I am on a bone supplement from Theralogix in Rockville, Md, since Lupron can cause osteoporosis.  I do light weight lifting to stave off muscle loss, another side effect, and to help with bone loss.  So far, I have not noticed any loss, but it is early in my treatment.  I have not had the mood changes that others have experienced with hormone therapy.

I am probably one of the lucky ones - responding well to the hormone therapy with minimal side effects.

Bottom line is that it is keeping my PSA in check and I'm still kicking.  See my signature for a little more info about my journey.

Good luck with whatever decision you make concerning hormone therapy.

Gene in Md


Hopeful in MD
Age 70.
Dx Dec 07. PSA 8.4. DRE confirmed tumor. Three of six biopsies positive. Gleason: 6 (3+3).
Seed implants Iodine 125 Jan 08.
PSA's 3.9, 1.7 after implants. 
Rising PSA's: 2.3, 3.4, 3.9, indicating  seed therapy not working. 
April 09 began hormone injection therapy with Lupron 30 MG ea. 4 mos.  Side effects - hot flashes, about 1 an hour, initial severe fatigue. Gone as of mid-July. Jun 09 - Oncologist DRE negative for nodules - hooray!!! Aug 09 - PSA 0.5!!!  Lupron is working! Aug. 21 - 2nd Lupron shot.  Flu-like symptoms. Aug. 31 - hyperbaric oxygen chamber treatments for rectal bleeding. At least 20, possibly 40 or more.  Sep. 10 - dx radiation proctitis after sigmoid exam. 


tiredwanderer
New Member


Date Joined Oct 2009
Total Posts : 2
   Posted 10/14/2009 12:07 PM (GMT -6)   
Thanks to all who responded. I am still not sure if the hormone therapy is worth doing. The side effects and possiblity that the treatments won't work, or only work for a short time are things that bother me. Of course having the cancer spread to my bones and spine are not things I look forward to.
darn, I hate this disease........

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 10/14/2009 12:26 PM (GMT -6)   
tired,

how old are you anyway? don't see it posted. you should never give up hope, there is research going on all the time for advance prostate cancer, new trials being developed..

If your doctor feels that HT is your only hope, having ruled out other treatment possibilities, why wouldn't you want to give it a chance?

If my PC takes me out, it won't be because I quit fighting and trying. That is why I am fighting my way through salvage radiation right now, pissed that surgery failed its main objective. And if the radiation fails later, I guess I will off to the HT path myself. Won't like that either, but not going to die from this thing without trying every possoble source of hope and cure.

Perhaps you could post your stats, make it easier for the rest of us to partially understand your journey and unique situation

Keep the faith and the f ight, brother

David in SC


Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Latest: 7/09 met 2 rad. oncl, 7/09 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 - out  38 days, 9/14/9 - met 3rd rad. oncl.agree to start radiation, mapping on 9/21/9, 9/24 - mtg with uro/surg, 9/29- pre-op, 10/1 - 3rd corr. surgery - suprapubic cath/hard dialation, 10/5 - began IMRT SRT - 39 sessions/72 gys.


don826
Veteran Member


Date Joined May 2008
Total Posts : 1010
   Posted 10/17/2009 12:01 AM (GMT -6)   
Hi TW,
 
I have been on the Lupron since May of 2008. So far the side effects have been tolerable. Seems that the hot flashes are less frequent these days but just as intense. I hve some mild nausea usually a week or two after the shot but it does not last more than a day or so. I work out regulary and the last bone density was higher than average for a man my age and I have not had any issue with what I dread most... man boobs. No libido and loss of body hair on legs, chest and arms. (although there has been some regrowth on my legs) I am coming up on two years on HT and my uro has suggested a third. I am taking a wait and see approach. In short one can adjust to the HT. However, I am curious why you would not look at salvage radiation. Is there some other issue? Either way best of luck to you.
 
Don
Diagnosed 04/10/08 Age 58 at the time
Gleason 4 + 3
DRE palpable tumor on left side
100% of 12 cores positive for PCa range 35% to 85%
Bone scan clear and chest x ray clear
CT scan shows potential lymph node involvement in pelvic region
Started Casodex on May 2 and stopped on June 1, 2008
Lupron injection on May 15 and every four months for next two years
Started IMRT/IGRT on July 10, 2008. 45 treatments scheduled
First 25 to be full pelvic for a total dose of 45 Gray to lymph nodes.
Last 20 to prostate only. Total dose to prostate 81 Gray.
Completed IMRT/IGRT 09/11/08.
PSA 02/08 21.5 at diagnosis
PSA 07/08 .82 after 8 wks of hormones
PSA 10/08 .642 one month after completion of IMRT, 6 months hormone
PSA 03/09 .38 six months post radiation and nine months into hormones 
PSA 06/09 .36 or .30 depending on who did the test
PSA 09/09 .33 one year after IMRT and 16 months into hormone
 
 
 


Mbshine
Regular Member


Date Joined Aug 2008
Total Posts : 67
   Posted 10/17/2009 8:42 AM (GMT -6)   
I joke about side effects but much less than anticipated....some hot flashes or sweatsin middle of night50 mg of Casodex daily and quarterly shots of Zolodex for past 13 months.....no ill effects of shots....some enlargement of breasts but no tenderness....a bit more emotional...not depression but sort of overly sensitive to sad movies, tv shows etc.....

good energey levels, no interference with weight loss program and PSAs virtual zero for past year....davinci surgery scheduled at sloan kettering in two days..


some literature says average effectivness of hormones is 2 years....my home townurologist has patients who are dormant or perhaps arrested for 8 to 10 years...other doctors dont put much stock in the whole hormone therapy and consider it a form of watchful waiting.....some literature on benefits of intermittant hormones but then again some concerns that as with other drugs the deprivation then creates a more aggressive tumor growth.....bottom line is learn all you can and talk to knowledgeable doctors particularly urologists rather than listening to us amateurs on the blog....having said that this is a wonderful site for support an guidance on where to go for information....one thing I have done is ask physicians I know point blank what they would do if they had my kind of prostate cancer...the answers are revealing and so is their choice of institutions...
good luck

mbshines


AGE 62
DX 7/08
psa HAD GONE FROM 1.7 TO 4.3 IN THREE YEARS...DIGITAL AND ULTRA SOUND EXAM SHOWED NO ENLARGEMENT.
BIOPSY SHOWED 2 OF 12 CORES POSITIVE.
TWO TUMORS SHOWED GLEASON 4+3 AND 3+4
NO INDICATION OF ESCAPE FROM CAPSULE OR METASTASIS
STARTED CONSULTATIONS AT SLOAN KETTERING 8/09
DR GUILLONNEAU SAID NO SURGERY UNLESS MASSIVE WEIGHT LOSS.
AT DX 333 LBS, SLEEP APNEA, AND HIGH BP
BARIATRIC SURGERY RECOMMENDED.
LAP BAND SURGERY IN EL PASO, TX 1/23/09
10/1/09 276 LBS, TRIGLYC AND CHOL NORMAL, NO SIGNS OF SLEEP APNEA, ONE BP RX REMOVED AND OTHERS CUT DOSAGE IN HALF;

STARTED QUARTERLY ZOLODEX BY TAOS,NM UROLOGIST, WHO TRAINED AT MSKCC, INJECTIONS AND CASODEX 50MG DAILY 9/08

livinadream
Veteran Member


Date Joined Apr 2008
Total Posts : 1382
   Posted 10/17/2009 9:30 AM (GMT -6)   
I was on ADT3 for two years and I to would say the side effects were tolerable. At first I thought impotence would be hard to handle but once the libido is gone it doesn't really matter. Fatigue was my worst enemy until I forced myself to exercise more than I did. I was able to overcome all the side effects. To me if you are going to be on HT it is vital that you stay active because if you don't depression can set in. I say go for it, fire every bullet you can at this enemy. The battle can be won. Keep us posted and if you don't mind share more of your history in regards to the disease.

peace and love
Dale
My PSA at diagnosis was 16.3
age 47 (current)

http://www.caringbridge.org/visit/dalechildress

My gleason score from prostate was 4+5=9 and from the lymph nodes (3 positive) 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 .016
PSA Mar 30th, 2009 is .02
PSA July 28th 2009 is .01
PSA OCt 15th 2009 is .11

Testosterone keeps rising, the current number is 156, up from 57 in May

T level dropped to 37 Mar 30th, 2009
cancer in 4 of 6 cores
92%
80%
37%
28%


John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4268
   Posted 10/17/2009 10:20 AM (GMT -6)   
My neighbor has been on Lupron for 12 years and my cousin on it for 10 years. Both are very active and there seems to be no affect on what they want to do. Everyone reacts differently so there is little downside in trying it for a few months and a lot of upside.
The effectiveness depends on the volume of hormone dependent PC cells to hormone independent cells. If most of your cells are hormone dependent you can live a long time on HT.
JT

64 years old.

PSA rising for 10 years to 40, free psa 10-15. Had 5 urologists, 12 biopsies and MRIS all neg. Doctors DXed BPH and continue to get biopsies yearly. 13th biopsy positive in 10-08, 2 cores of 25, G6 less than 5%. Scheduled for surgery as recommended by Urological Oncologist.

2nd Opinion from Dr Sholtz, a Prostate Oncologist, said DX wrong, pathology shows indolant cancer, but psa history indicates large cancer or metastasis. Futher tests and Color Doppler confirmed large transition zone tumor that 13 biopsies and MRIS missed. G7, 4+3, approx 16mmX18mm.

Combidex MRI in Holland eliminated lymphnode mets. Casodex and Proscar reduced psa to 0.6 and prostate from 60mm to 32mm. Changed diet, no meat and dairy. All staging tests indicate that tumor is local and non agressive. (PAP, PCA3, MRIS, Color Doppler, Combidex, tumor reaction to diet and Casodex, and tumor location in transition zone). Surgery a poor option because tumor is located next to the urethea and positive margin is very likely; permanent incontenance is also high probability with surgery.

Seed implants on 5-19-09, 3 hours door to door, no pain, minor side affects are frequency and urgency; very controlable with Flowmax and lasted 4 weeks. Daily activities resumed day after implants with no restrictions. Gold markers implanted with seeds to guide IMRT.

25 treatments of IMRT 6 weeks after seed implants. No side affects at all.

PSA at end of treatment 0.02 mostly the result of Casodex. When I stop Casodex next week expect PSA to rise. Next PSA in November. Treatments and side affects have greatly exceeded my expectations. Glad to have this 11 year journey finally conclude.

JohnT


zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 10/18/2009 7:16 PM (GMT -6)   
  Dump the uro-doc if you are seeing them any time you are a failed (recurrent PCa patient), you are outside his limited 'expertedness'.  You should be under the guidance of an Oncologist and better still a PCa-Onco-doc would be in your better interests. It is amazing what some Uro-docs don't know(some of us would be amazed at what they say...as even some of us know the correct answer on some PCa things that are basic), as Dr. Strum has pointed out in his books about this very thing, and if you have seen a number of them then you would also know fact from fiction in the real world. You might have a great uro-doc, to what do you have to compare or as your referencing methodology i.e. how do you actually know? (you also might not) . I hope you do have the best and a righteous doc, but don't be shy about finding out what the score actually is, it could make a difference in your life in many ways. I will stop there.
 
 
 
 
 
 
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