I have heard that taking Casodex will shrink both the prostate and the tumor moving the smaller prostate away from some of the major organs and enabling better margins. It also may kill small amounts of PC cells that may have escaped into the blood stream. It definately will slow down any androgen dependent PC cells. I know that most surgeons don't agree with this and as pointed out the surgery becomes more difficult. I don't know if there is a difference in taking Casodex or Lupron in it's effects on the surgery.
Again, this is another area in which there is a lot of disagreement among professionals when it comes to treating this disease.
There is also disagreement as to whether adjuvent HT helps in radiation. It seems logical that anything that can make the prostate smaller would be a huge benefit because you are giveing the same dose to a much smaller prostate and tumor, so the targeted area is getting 100% more radiation if it is 50% smaller. It also is logical that HT would make the PC cells weaker and easier to kill.
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.