Here is the Johns Hopkins article on HT Side Effects

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Sonny3
Veteran Member


Date Joined Aug 2009
Total Posts : 2448
   Posted 4/22/2010 10:36 PM (GMT -6)   
I know we don't like cut and paste, but since it is a fairly short article, I hope the modes won't mind. I can't seem to make the link work for others.

Here is the news brief that was emailed to me:

Male sex hormones (androgens) -- testosterone in particular -- are required to maintain the size and function of the prostate. As a result, a number of prostate cancer treatments are aimed at interfering with the effects of androgens. Blocking testosterone can temporarily cause the cancer to regress, or at least to grow more slowly.

Now research reported in BJU International (volume 102, page 44) finds that men who undergo androgen-deprivation therapy (ADT) for prostate cancer lose bone and muscle mass and accumulate more body fat.

Researchers documented these changes in body composition over 36 weeks among 72 men (median age, 73) with prostate cancer who were receiving intermittent ADT. At the start and end of the study, the men with prostate cancer underwent dual-energy x-ray absorptiometry scanning to determine whole-body and regional lean mass, fat mass, and bone mineral content and density. The researchers also measured PSA, testosterone, and hemoglobin levels and evaluated the men's physical activity levels and fatigue at both time points.

Bone mineral density decreased by about 1.5% at the hip, 4% at the spine, 2% for whole body, and 1% in the upper limbs. Lean body mass decreased in the upper limbs by about 6%, in the lower limbs by 4%, the trunk by 1%, and whole body by 2%. During the same period, fat mass at these sites increased by 21%, 19%, 12%, and 14%, respectively. The men also experienced greater levels of fatigue and became less active during the treatment period.

Bottom line: If you're on ADT for your prostate cancer, be aware that over time, these changes can increase the risk of cardiovascular disease, bone fractures, and falls. Taking steps to reduce your risk of these conditions, including lifestyle changes and medication, is an important component of your care.

Sonny
60 years old when diagnosed
PSA 11/07 3.0
PSA 5/09 6.4
Diagnosis confirmed July 9, 2009
12 Needle Biopsy = 9 clear , 3 postive
Gleason Score (3+4) 7 in all positive cores
da Vinci 9/17/09
Post Surgery Pathology: GS 4+3=7
Stage: T3a
Tumor Volume 12.5%
positive margin, extra-prostatic extension
30 day PSA 0.4, 50 day psa 0.53, 64 day psa 0.6
IMRT completed 1/15/10 35 treatments- 70Gy

2/24/10 FIRST POST RAD PSA 1.0---CARRRP --waiting for the next test.
3/22/10 Second Post RAD PSA 1.5 Dammmmnnn stubborn son of a gun
4/19/10 YAHOO PSA dropped to 1.2 Moving in the right direction.


JoeyG
Regular Member


Date Joined Jul 2009
Total Posts : 162
   Posted 4/23/2010 10:44 AM (GMT -6)   
My Mother use to say "drugs may help one problem but they create other problems." Interestingly, it was a drug taking care of one problem that ultimately took her life.
 
More research has to be done on the utilization of estrogen as a first line hormonal treatment. Many of the side-effects of Lupron/Zoladex,etc are not apparant with estrogen. All of them have cardio-vascular impacts but it has been shown that estrogen/DES in low but still effective, doses has limited cardio-vascular events.
 
I truly fear going on Lupron.  
Age -57; Diagnosed 10/05 PSA 13.4 GS 7 (4+3) Organ confined (T2B)
Cryoablation 4/06 Allegheny Hosp-Dr Ralph Miller (Cohen/Miller)
Post Cryo Nadir 8/06 0.2
Rising steadily to 0.7 4/09 :-(
Steady at 0.7 (7/09)
Doubled to 1.5 (2/10) YUCH!
Hoping to qualify for salvage cryo or radiation


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 4/23/2010 10:51 AM (GMT -6)   
Sonny, thanks for getting the info out. Did it change your own opinion about HT for yourself as a possibility?

Although I know that it has helped many of our brothers here, and some have very good results with it, I am still of the mindset
that I personally don't want to deal with HT. Now that my PC finally is showing sign of being in remission, I hope it stays that way so that I don't ever have to make the HT choice.

Hope you have great fun at the beach being "slave boy"

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
Incontinence:  1 Month     ED:  Non issue at any point post surgery, no problem post SRT
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, next one:  July
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 - 11/27 IMRT SRT 39 sess/72 gys ,cath #8 33 days, Cath #9 35 days, 12/7 - Cath #10 43 days, 1/19 - Corr Surgery #4,  Caths #11 and #12  same time, 2/8-Cath #11 out - 21 days, 3/2- Cath #12 out - 41 days, 3/2- Corr Surgery #5, 3/6 Cath #13 out - 4 days, Cath #14- 27 days, Cath #15 - 26 days, Cath #16 - 4/23 put in


zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 4/24/2010 7:10 AM (GMT -6)   
Joey G. let me note: the drug companies have no patents to get on DES (compounded drug man made) and very little is made off of estradiol patches and emcyt I don't have a reference on cost. There is plenty made on Lupron, Zoladex and all the LHRH drugs and alot on casodex and its equals, even avodart and proscar are money makers. Drug companies will not even bother with non-profitable looking drugs, they are in it for the money. Plus they over charge Americans and market to us (note pricing in other countries), I love them for that. Call this objective observation by a 'cable guy'.

Do you think a drug company would endorse you eating apples or anything they could not control, as a benefit for your health concerns??? Obviously, they believe we need a pill for every ailment there can be...just look at television ads and the last decade(s) of new drugs for this or that. We are over sold, over prescribed and all because???? I didn't say don't take these possible choices, but realize there are many choices. Who has your back in this world?

The more I learn about our medical systems, the more I believe the Amish are wiser than I would have first believed. Maybe I should read there home remedies type book if they have such.


Youth is wasted on the Young-(W.C. Fields)


Carlos
Regular Member


Date Joined Nov 2009
Total Posts : 486
   Posted 4/24/2010 1:58 PM (GMT -6)   
Zufus,  I looked up some actual drug costs paid by a typical Medicare Part D insurer.  The listed costs are monthly:
 
Lupron Depot, 11.25 mg. - $1931.51
Casodex 50 mg. - $43.59
Estradiol 1 mg. - $6.35
 
Should I have a recurrence I'll let you know how difficult it is to get Estradiol.  With my insurance it would cost me $4 for a 90 day supply.
 
Carlos

Diagnosed 2/2008 at age 71, Gleason score 5+3=8, stage T1c, PSA 9.1. 
Robotic surgery 5/2008, nerves spared, All margins, SV and lymph nodes negative. 
Staged pT2c, Gleason score 5+3=8.  PSA <0.1 at 20 months, Jan. 4, 2010.


zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 4/24/2010 2:15 PM (GMT -6)   
Hey Carlos good information how ever you got it, hey if you need the $4 deductible (LOL) I will cover it for you and make it free trial basis.  Thanks for showing us da money (trail)...ha-ha. I have gotten DES 1-mg 90 days worth for $30 including delivery by mail, my onco-doc knew apparently one of the cheaper sources, gee $120 per year (LOL) and outperformed ADT3 combo (that was about $13,000+ billed to my insurance company back in 2002-2003). Also, little to no side effects and found to be a picnic and fun compared to ADT3...LOL. Would any uro-doc tell you this??????? Yeah...show me da money$$$$$. They want all to believe only the high priced stuff is your only salvation. It speaks volumes as to controlling the patients choices, wallet and life. I like having choices and knowing them and it has made significant differences that I can even measure.


Youth is wasted on the Young-(W.C. Fields)

Post Edited (zufus) : 4/24/2010 1:18:36 PM (GMT-6)


Sonny3
Veteran Member


Date Joined Aug 2009
Total Posts : 2448
   Posted 4/24/2010 5:33 PM (GMT -6)   
Zufus,

If you are willing I may want to talk with you in person about your experiences. I'll know more in a few weeks when I have the PSA test. If the numbers continue to go down the decision will be put off for a while. If not, I have to think about things to insure that I am around to be caregiver to my wife.

This thread and the other I started about this latest study sure has brought some valuable information to the board about HT.

Thank you and the others so much for the input. I am sure it answered a lot of questions for folks that haven't participated or gotten to the HT decision path yet.

Thanks,

Sonny
60 years old when diagnosed
PSA 11/07 3.0
PSA 5/09 6.4
Diagnosis confirmed July 9, 2009
12 Needle Biopsy = 9 clear , 3 postive
Gleason Score (3+4) 7 in all positive cores
da Vinci 9/17/09
Post Surgery Pathology: GS 4+3=7
Stage: T3a
Tumor Volume 12.5%
positive margin, extra-prostatic extension
30 day PSA 0.4, 50 day psa 0.53, 64 day psa 0.6
IMRT completed 1/15/10 35 treatments- 70Gy

2/24/10 FIRST POST RAD PSA 1.0---CARRRP --waiting for the next test.
3/22/10 Second Post RAD PSA 1.5 Dammmmnnn stubborn son of a gun
4/19/10 YAHOO PSA dropped to 1.2 Moving in the right direction.

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