PCa choice by Rick K (Michigan guy)~outside the box~not known by alot of newbies

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zufus
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Date Joined Dec 2008
Total Posts : 3149
   Posted 10/23/2009 6:52 PM (GMT -6)   
Not saying this is anybodies particular choice to make or take, but  alot of newbies (especially) don't even know this is an  option, just as w.w.-surveilance can be too. Rick K. diagnosed back around  1997 and found with gleason 5 (total 2+3) seems rare but he did not have it reviewed either (so lets assume it is a 6 total), has 2 cores of 12 that showed PCa and a psa of 10.3 or very near that number. Decided no surgery or radiation and back then it was quite a leap of faith to even consider...did hormone therapy similar to Dr. Leibowitz protocol:  ADT3:  lupron (or zoladex)+ casodex (or equals)+ proscar and take them for 13 months, then quit and take only proscar as a maintenance thing.
 
So, Rick says a few months after this protocol his manhood returned to normal and he was totally normal. Had rebiopsies done even later, two different times, nothing found on biopsies when taken. Well 11-12 yrs. go by and Rick has lead a perfectly normal life, no urinary issues, no e.d. etc.,  his psa did change about 1 yr or so again, so he went back on the ADT3 for 13 months, which is not unheard of in this protocol. He plans on quitting that in 13 months and stay on proscar. Now he can also still get any treatment on his PCa at any time, yes surgery would be more difficult with a gland that shrinks via those drugs (but can be done) along with any other protocols (radiations, hifu, brachy, etc.). Maybe somebody out there likes the idea of being normalish for a decade or more and then decide what roads to take, whom knows what 10yrs out we will have for treatments, then. Look at what has happened in last 10-20 yrs. of PCa history.
 
So can Rick die of PCa, sure and so can anyone even with treatments at any given level of PCa, low stats have the best scenarios for cures and longevity.  Did Rick enjoy being totally normal all these years???(what do you think!!) I have his phone number...I am not spreading b.s. on this. Not many docs mention this as a treatment plan, it is not identical to hormone therapy that is mono or dual therapies, although those could render maybe comparable results (at best). Not as profittable for the treating physician either, but still is proffitable...not saying these drug companies are saints either. It is just another possible choice in the PCa world..there are others too. A patient could go on emcyt or estradiol patches or DES that work against PCa, and even some other drugs.  Dr. Fred Lee uses or used emcyt on his own case of it, no surgery, no radiations etc. He has been dealing with it for well  over a decade and it living large and doing his doppler color ultrasounds (a master at such, too).  So I guess he is stupid for not having surgery or radiation?
 
Interesting that there are so many ways to go about dealing with PCa, for some people and depending upon their age and other variables, quality of life may be a priority first, perhaps.
Make your decision(s) on your own PCa case...only you have to walk the walk and atleast at this juncture we still have choices....that may change in 1-2 yrs. time, which would add a new parameter to all of us in treatments, food for thought too.
 
 

John T
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Date Joined Nov 2008
Total Posts : 4227
   Posted 10/23/2009 7:45 PM (GMT -6)   
I don't think it is a coinsidence that all treatment options and all treatment centers have the same cure rates for low grade PC. It may just be the properties of the cancer and not the treatment. You start getting real differences in results from treatments and doctors when you get into high grade PC where skill of the doctor and choice of treatment make a large difference. No evidence to support this line of thinking; it's just a theory of mine after reading a lot about PC. Using HT on low grade PC makes as much sense as all the other options. I belive with low grade PC the side affects are much more important than the cure, as they all have the same cure rate.
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


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 10/23/2009 9:45 PM (GMT -6)   
zufas,

with your friend rick, and i am sincerely glad its working for him, do you think his approach just happens to work for him in particular, say due to the uniqueness of his body, cancer, and situation, or do you think it would work just as well for others that attempted to follow his course of action?

david

if something works, it works, i am not going to argue with sucess
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: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out  38 days, 9/9 - met 3rd rad. oncl., mapped  9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - began IMRT SRT - 39 sessions/72 gys.


Sleepless09
Veteran Member


Date Joined Jul 2009
Total Posts : 1267
   Posted 10/23/2009 10:05 PM (GMT -6)   
John T said:

"I don't think it is a coinsidence that all treatment options and all treatment centers have the same cure rates for low grade PC. It may just be the properties of the cancer and not the treatment."

Reminds me of when I was thought to have Gleason 6 and a doctor friend said to me that different treatment doctors would be fighting to get their hands on me --- I'd make their statistices look good.

Sheldon AKA Sleepless
Age 67 in Apil '09 at news of 4 of 12 cores positive T2B and Gleason 3 + 3 and 5% to 25% PSA 1.5
Re-read of slides in June said Gleason 3 + 4 same four cores 5% to 15%
June 29 daVinci prostatectomy, Dr. Eric Estey, at Royal Alexandra Hospital Edmonton one night stay
Flew home to Winnipeg on July 3 after 5 nights in Ramada Inn  ---  perfect recovery spot!
Catheter out July 9, so far, so good
Final pathology is 3 + 4 Gleason 7, clear margins, clear nodes, T2C, sugeron says report is "excellent"
First post op PSA Sept 09  0.02
Oct 1st 09 -- dry at night, during day some stress issues, but better every week.    


zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 10/24/2009 6:19 AM (GMT -6)   
Brother Purgatory (zufus not zufas...as that implies the donkey version-LOL), even if it applies that way-LOL. To answer you back and for others:

Why not go to Dr.Leibowitz website (and similar) and read for yourself, the answer is in general yes it works that way, however as you have heard, there are over 12 variants of PCa often not found properly detected which one a patient really has, there are a few variants if you read about them, that do not respond to hormone therapies either at all or very limited duration....so those low percentage of men don't have alot of hope, most likely in any modality. Ones like 'Small Cell PCa' ,usually very aggressive and just plain awful...have seen posts by wives whos husband were diagnosed with such and had short life. The most disturbing post was a wife whom wrote her husband just got diagnosed with small cell, and gone (died) within two weeks.

So, yeah we have it rough being PCa patients.....count your blessing if you have atleast a treatable version of it or may die 10-15 yrs. later...that compariably is a win-win. (hows that for full glass from zufUs)? Happy even when confronted with real death scenario...in this jungle I know I am a so-journer given my original omnious stats, do I enjoy the here and now...I am rockin in paradise, smelling roses and livin la vida loca. In case we forget we all are sojourners, nobody escapes an ending in this world, just a matter of how long. In the span of what is called 'time' we comparitively lived 3 seconds vs. age of the solar system or such..it is said..yada..yada..yada. You think PCa is difficult to understand, try explaining: infinity of the universe, black holes, worm holes, time as we know it and how time travel exists. Makes our genius'es look lame even by todays standards. All we can do is try and we do fairly decent with our limited sticks and stones (per se).

Might want to read up as much as you can on estradiol patches, DES, emcyt, ketoconazole and some other drugs, chemo if you wish to (seems like chemo is good for 4-6 mos. on patients with serious PCa..other than that is palliative therapy with heavy duty side effects, from what I have seen), these are worthy of anybodies time whom is facing recurrence and psa increases after treatments and salvage therapies. We have many choices on how you wish to fight this or how long or even not to do so. Your life, should be your decision, your call...only you walk the walk and will forget the talked and talked.
 "I wouldn't join a club that would have me as a member" (Groucho Marx)


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 10/24/2009 6:58 AM (GMT -6)   
Sorry zufus, not zufas, result of a long day and tired eyes. Good answer to the question I asked. And wow, if you ever want to discuss the subject of cosmology, its one i have studied for years. My older brother is an astrophysicist.
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: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out  38 days, 9/9 - met 3rd rad. oncl., mapped  9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - began IMRT SRT - 39 sessions/72 gys.

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