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dkob131
Regular Member


Date Joined Apr 2008
Total Posts : 364
   Posted 11/13/2009 10:05 AM (GMT -6)   
A little late for some of us but hope of better outcomes down the road.
 
David

Aspirin May Prevent Prostate Cancer Recurrence

Anti-clotting Medications Lower Odds of Recurrence

by Charlene Laino | WebMD.com | 11.06.2009

The use of anti-clotting drugs, including aspirin, appears to lower the odds that cancer will recur in men undergoing radiation treatment for prostate cancer, researchers report.

"We found that taking an anticoagulant lowers the risk [of recurrence] by almost half," says Kevin S. Choe, MD, PhD, a radiation oncologist at the University of Chicago.

The anti-clotting medications, or anticoagulants, studied were Coumadin, Plavix, and aspirin.

"Prostate cancer is very common among older men, the same people who have cardiovascular risk factors and often require anticoagulants to prevent a heart attack," Choe tells WebMD. "So we wanted to see if there was an interaction between the two."

Research in animals and in the lab suggests that anti-clotting medications can interfere with tumor growth and cancer spread, Choe says.

Also, research suggests that the drugs may cause molecular changes that make cancer cells more sensitive to radiation, says the University of Miami's Alan Pollack, MD, PhD, who was not involved with the work.

The findings were presented at the annual meeting of the American Society for Radiation Oncology.

Anti-clotting Medications Cut Risk of Prostate Cancer Recurrence

The study involved 662 men with prostate cancer undergoing radiation treatment at the University of Chicago from 1988 to 2005.

Of the total, 196 were taking aspirin, 58 were taking Coumadin, and 24 were on Plavix. The other men weren't taking any anti-clotting medication.

about four years after they were treated, cancer recurred in only 9% of men taking an anti-clotting medication, compared with 22% of those who weren't taking the drugs.

After taking into account other risk factors for recurrence, taking an anti-clotting medication was associated with a 46% lower risk of recurrence, Choe says.

The benefit was most pronounced in men with high-risk aggressive cancers that had not yet spread (metastasized) at the time of radiation treatment. In this group, cancer recurred in 18% of men on anticoagulants vs. 42% of men not taking the drugs.

Cancer recurrence was defined as a rise in levels of prostate-specific antigen, or PSA. After radiation therapy, PSA levels usually drop to a stable and low level. Rising PSA levels are usually a sign of recurrence, Choe says.

The anticoagulant drugs benefited men regardless of whether they received traditional external beam radiation therapy or radioactive seeds. The study did not include men who received newer forms of radiation therapy, such as proton therapy.

The researchers did not analyze the three drugs separately.

Choe cautions that men with prostate cancer should not start taking blood-thinning drugs for purposes of cancer control.

The drugs have risks of their own, including internal bleeding, he notes. Choe's previous research showed that Coumadin and Plavix increase the risk of rectal bleeding in men undergoing radiation treatment.

"We need more data from a larger study before we can say with confidence that the benefits outweigh the risk of toxicity," he says.

But if your doctor has prescribed the drugs for reasons of heart health, "this may be an added benefit," Choe says.


 54 y.o.
 Diagnosed 4/10/08
 DRE Normal
 PSA-5.5
 Biopsy- 12 cores, 4 positive highest 4+4=8
 Bone scan, CT scan and Chest X-ray clear 4/16/08
 Urologist suggested surgery 4/16/08
 MRI on 4/24/08 clear no suggestion of lymph node   involvement.
 4/24/08 -Started on Lupron and Casodex preparing for HDRT and IMRT in late July.  This treatment will not preclude me from surgery if I change my mind.
Decide to have DaVinci surgery after another consult with surgeon.
6/19/08- DaVinci surgery at University of Washington.
6/25/08- Path report, clear margins, no noted extension
9/12/08- PSA <0.02 
12/05/08-PSA <0.02 Six months after surgery 
3/02/09-PSA <0.02 Nine months after surgery
5/02/09-PSA .10
8/17/09-PSA .21 Begin HT and set up for SRT to begin in 2 months.
 


Sephie
Veteran Member


Date Joined Jun 2008
Total Posts : 1804
   Posted 11/13/2009 10:09 AM (GMT -6)   
If I understand this article correctly, the benefits noted apply to men who had RT has a primary treatment. However, I don't frankly see what the difference is between radiation as a primary treatment or as salvage.

Thanks for the info...interesting.
Husband diagnosed in 2/2008 at age 57 with stage T1c. Robotic surgery performed 3/2008. Stage upgraded to T3a (single small EPE in posterior left). Perineural tumor infiltration present. Apex margin, bladder neck and SV negative. Final Gleason 3+4 SA. PSA: 0.0 til July 2009. August 2009 PSA was 0.1, in September it was 0.3 Met with radiation oncologist, CT scan and bone scan clean. Third PSA on October 16 - PSA BACK TO UNDETECTABLE! Next PSA scheduled for early December. No radiation treatment at this time!


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 11/13/2009 10:11 AM (GMT -6)   
Sounds like another contridictary report to me, more confusion in the world of PC. No, not shooting the messenger, thanks for posting.

I have had to quit taking Advil for pain going through my current SRT, cant take aspirin or any thing resembling a blood thinner. The advil has been causing excessive bleeding, aggervated by the radiation treatment. In my case, its easy to see because I am being treated while wearing a SP catheter. Soon as I stop taking the advil, the bleeding ends. My dr. said its off limits for the duration. Its a shame, because advil helps bring down the swelling that associated with radiation treatments. tylenol does nothing for the pain or the swelling, kind of a catch 22.

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: 7/9 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 sess/72 gys cath #8 33 days, 11/2- SP Cath #9 in place


dkob131
Regular Member


Date Joined Apr 2008
Total Posts : 364
   Posted 11/13/2009 10:24 AM (GMT -6)   

Sehie:  Good point I didn't catch that originally but I would think that what is good for the goose is good for the gander.

David: 10 more, just two weeks and you're in the clear.  You're a true soldier, to be honest with you each time I start having issues with the endorectal balloon I think of your situation and say"Yes drill sergeant may I have another."

David


 54 y.o.
 Diagnosed 4/10/08
 DRE Normal
 PSA-5.5
 Biopsy- 12 cores, 4 positive highest 4+4=8
 Bone scan, CT scan and Chest X-ray clear 4/16/08
 Urologist suggested surgery 4/16/08
 MRI on 4/24/08 clear no suggestion of lymph node   involvement.
 4/24/08 -Started on Lupron and Casodex preparing for HDRT and IMRT in late July.  This treatment will not preclude me from surgery if I change my mind.
Decide to have DaVinci surgery after another consult with surgeon.
6/19/08- DaVinci surgery at University of Washington.
6/25/08- Path report, clear margins, no noted extension
9/12/08- PSA <0.02 
12/05/08-PSA <0.02 Six months after surgery 
3/02/09-PSA <0.02 Nine months after surgery
5/02/09-PSA .10
8/17/09-PSA .21 Begin HT and set up for SRT to begin in 2 months.
 


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 11/13/2009 11:16 AM (GMT -6)   
Sephie, the mechancis of RT and SRT can very well be close to being the same. But in SRT, they are treating an area already damaged and healing from complex surgery. In my own SRT, my dr. tried to 3-D recreate where and how my prostate was formerly located, and based on surgical notes, where the one positive margin was located. Using the IMRT, she created a shooting zone for the radiation to replicate the size, shape, location of my former prostate gland, and the immediate surrounding area. They showed me on the screen how the seven zaps make for a perfect looking "ghost" prostate gland visually, each and every time I am zapped. When you are talking RT, it redefines all the borders and edges inside the prostate bed, which is why it makes it difficult, at best, to do surgery after RT. Between the open surgery and now the SRT, I can only imagine what a mess my prostate bed looks like.

David, I am sure you own story has its share of pains and frustration, I never think any one has an easy path here, some paths are just more difficult than others. Good luck in your own journey

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: 7/9 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 sess/72 gys cath #8 33 days, 11/2- SP Cath #9 in place

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