17% increase in prostate cancer death predicted by NCI for 2010

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Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 6/15/2010 6:19 PM (GMT -6)   
ZERO - The Project to End Prostate Cancer has launched a campaign against the US Preventive Services Task Force and the ACS because of their stance on prostate cancer screening. I spoke to Skip Lockwood, the CEO at ZERO, at the AUA so I wasn't surprised to see this announcement. In the last five years there has been an increase in the number of AS patients and a decrease in the number of men being screened has also been observed.

I personally do not align myself with the conclusions drawn, at least not completely. It makes sense that if you are going to decrease screening, and tell more men to delay or not treat their prostate cancer, that the death rate will go up. One has to balance this logic against men who have indeed been over treated. Certainly anyone who loses their life when it could have been prevented won't care too much about avoiding side effects. But I think that it is way too early to attribute a 17% increase in the mortality rate solely to changes in whether to treat or not and screening. But one will have to ask, what has changed in the last 15 years in treating prostate cancer that the death rate is expected to climb for the 5th year in a row, with the largest annual increase in 15 years.

Here is what ZERO is saying...

www.zerocancer.org/site/News2?page=NewsArticle&id=11611&news_iv_ctrl=1001

Text below...

Prostate Cancer Deaths Up 17 Percent
Testing debate to blame as mortality hits 10-year high
by Ashley Nagaoka | ZERO - The Project to End Prostate Cancer | 06.15.2010

Prostate cancer deaths are expected to jump 17 percent this year, according to estimates based on National Cancer Institute data.

The alarming 2010 statistics, released just prior to Father’s Day, has ZERO – The Project to End Prostate Cancer urging families to encourage Dad to get tested for the disease this Father's Day because prostate cancer is the second leading cancer among Amercan men.

“If prostate cancer is diagnosed before it spreads, a patient has a 99 percent survival rate for five years,” ZERO Chief Operating Officer Jamie Bearse said.

“You can only diagnose cancer early through annual testing. This is the sad result of the PSA controversy created by the American Cancer Society and the U.S. Preventative Services Task Force. We need a better biomarker for the disease to distinguish slow growing tumors from deadly ones but in the meantime, we need to keep testing.”

The new numbers predict a 17 percent jump in deaths and a more than 13 percent rise in diagnosed cases this year as compared to 2009. It marks the greatest percentage increase since the mid-1990s.


Source: The Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute (NCI)

“The American Cancer Society claims it’s the official sponsor of birthdays, but it is condemning more men to their funerals because of its stance against the PSA test,” Bearse added.

“It’s not too late, however, and we can change these predictions. Encourage your Dad to get tested and give him the gift of life on this Father’s Day.”

Copyright ZERO - The Project to End Prostate Cancer 2010


Tony
Disease:
Advanced Prostate Cancer at age 44 (I am 47 now)
pT3b,N0,Mx (original PSA was 19.8) EPE, PM, SVI. Gleason 4+3=7

Treatments:
LARP ~ 2/17/2007 at the City of Hope near Los Angeles.
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.

Status:
"I beat up this disease and took its lunch money! I am in remission."
I am currently not being treated, but I do have regular oncology visits.
I am the president of an UsTOO chapter in Las Vegas

Blog : www.caringbridge.org/visit/tonycrispino

Post Edited (TC-LasVegas) : 6/15/2010 5:35:59 PM (GMT-6)


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 6/15/2010 6:25 PM (GMT -6)   
Here is a reply from the New Prostate Cancer InfoLink...

I get to have the author of this post out for dinner on Thursday.

tinyurl.com/2dqq8zn


Tony
Disease:
Advanced Prostate Cancer at age 44 (I am 47 now)
pT3b,N0,Mx (original PSA was 19.8) EPE, PM, SVI. Gleason 4+3=7

Treatments:
LARP ~ 2/17/2007 at the City of Hope near Los Angeles.
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.

Status:
"I beat up this disease and took its lunch money! I am in remission."
I am currently not being treated, but I do have regular oncology visits.
I am the president of an UsTOO chapter in Las Vegas

Blog : www.caringbridge.org/visit/tonycrispino


Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4183
   Posted 6/15/2010 6:55 PM (GMT -6)   

Tony, thanks for sharing.  However I am surprised and disappointed that you would lump men choosing AS in with lack of screening or connect AS with these articles. There was no mention of AS (that I could find) in either article you posted,  And, as you well know, if AS patients are properly chosen and properly monitored there is no difference in efectiveness of treatment if one is needed.

I guess what I'm saying is that you threw the baby out with the bath water by dumping on AS at the same time you dumped on lack of screening.  I am a big fan of routine testing AND a big fan of AS and do not believe they are mutually exclusive.

Tudpock (Jim)


Age 62, Gleason 3 + 4 = 7, T1C, PSA 4.2, 2 of 16 cores cancerous, 27cc
Brachytherapy December 9, 2008.  73 Iodine-125 seeds.  Procedure went great, catheter out before I went home, only minor discomfort.  Regular activities resumed, everything continues to function normally as of 4/10/10.  6 month PSA 1.4 and now 1 year PSA at 1.0.  My docs are "delighted"!

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 6/15/2010 7:22 PM (GMT -6)   
I can't exclude it. AS started becoming more popular 12 years ago with a heavy increase since I joined this ranks of survivors. There is very little information that indicates that AS does not increase mortality though I acknowledge there is some data that says delayed therapy is safer than first thought. Besides I also stated that there are other reasons contributing to the trend.

The point is 17% increase is not to be scoffed at. We should be open to all possible contributing factors...from changes in treatment modalities to social-economics. I believe that an increase in death rate in 2010 has a lot to do with what changed over 10 years or longer...

Thus why I do not like 10 year studies in prostate cancer...

Tony
Disease:
Advanced Prostate Cancer at age 44 (I am 47 now)
pT3b,N0,Mx (original PSA was 19.8) EPE, PM, SVI. Gleason 4+3=7

Treatments:
LARP ~ 2/17/2007 at the City of Hope near Los Angeles.
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.

Status:
"I beat up this disease and took its lunch money! I am in remission."
I am currently not being treated, but I do have regular oncology visits.
I am the president of an UsTOO chapter in Las Vegas

Blog : www.caringbridge.org/visit/tonycrispino


John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4237
   Posted 6/15/2010 7:53 PM (GMT -6)   
This just doesn't make any sense. We have an increase in screening and we have an increase in treatment and still get a 17% increase in deaths reguardless of all the advances in treatments. This sound like an agenda driven statistic without a lot of reality behind it.
The report cleary state than the 17% increase will happen this year. This is way too soon to conclude that the increase in AS or recent drop in screening has any impact.
If it indicates anything it indicates that the treatment we are getting are not effective.
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


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 6/15/2010 8:05 PM (GMT -6)   
I understand what you're saying, John. And I really agree with your last sentence.

But there it is. We knew that SEER was getting ready for a big announcement, but it's hard to call them biased. They are merely a statistics group. I know that AS has been around a lot longer than recent however. PCRI has been pushing it for over ten years but don't be mad at me for stating that. We also saw almost three years ago that the USPSTF said stop screening men over 75. This can indeed be a very real contributor.

Also, all, if you don't know already, please understand my position. I am for more screening, and better education. I acknowledge that this has to come with the understanding that more men will be on an active surveillance (AS) protocol. I prefer DT (Delayed Therapy) over AS because AS in and of itself is not at all effective against prostate cancer. It merely side steps side effects from treatment for a while.

Tony
Disease:
Advanced Prostate Cancer at age 44 (I am 47 now)
pT3b,N0,Mx (original PSA was 19.8) EPE, PM, SVI. Gleason 4+3=7

Treatments:
LARP ~ 2/17/2007 at the City of Hope near Los Angeles.
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.

Status:
"I beat up this disease and took its lunch money! I am in remission."
I am currently not being treated, but I do have regular oncology visits.
I am the president of an UsTOO chapter in Las Vegas

Blog : www.caringbridge.org/visit/tonycrispino

Post Edited (TC-LasVegas) : 6/16/2010 12:54:41 AM (GMT-6)


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 6/15/2010 8:14 PM (GMT -6)   
If this stat of increased deaths due to PC comes to bear, its a sad testimony and I would agree a lot with JohnT's opinion. Kind of doesn't make sense on the surface.

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 - 31 days, 5/24 put in Cath #17


BB_Fan
Veteran Member


Date Joined Jan 2010
Total Posts : 1011
   Posted 6/15/2010 9:08 PM (GMT -6)   
Is the increase in PCa deaths merely a function of men living longer. Decline in smoking, use of seat belts, better diet, etc...
Dx with PC Dec 2008 at 56, PSA 3.4


Biopsy: T1c, Geason 7 (3+4) - 8 cores taken with 4 positive for PCa, 30% of all 4 cores.

Robotic Surgery March 2009 Hartford Hospital, Dr Wagner
Pathology Report: T2c, Geason 8, organ confined, negitive margins, lymph nodes negitive - tumor volume 9%
nerves spared, no negitive side effects of surgery

One night in hospital, back to work in 3 weeks

psa Jun 09 <.01
psa Oct 09 <.01
psa Jan 10 .07 re-test one week later .05
psa Mar 10 .28 re-test two weeks later .31
psa May 10  .50

Aril 10 MRI and Bone Scan show lesion on lower spine, false positive. 
 
Started HT 5/25/10 with 3 month shot of Trelstar. SRT scheduled for late July


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 6/15/2010 9:49 PM (GMT -6)   
I would not solely attribute a 17% increase to just social economics, but I would not be surprised to see that the bad economy has led to less people being treated when they should have been.

Tony
Disease:
Advanced Prostate Cancer at age 44 (I am 47 now)
pT3b,N0,Mx (original PSA was 19.8) EPE, PM, SVI. Gleason 4+3=7

Treatments:
LARP ~ 2/17/2007 at the City of Hope near Los Angeles.
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.

Status:
"I beat up this disease and took its lunch money! I am in remission."
I am currently not being treated, but I do have regular oncology visits.
I am the president of an UsTOO chapter in Las Vegas

Blog : www.caringbridge.org/visit/tonycrispino

Post Edited (TC-LasVegas) : 6/16/2010 12:57:01 AM (GMT-6)


ChrisR
Veteran Member


Date Joined Apr 2008
Total Posts : 826
   Posted 6/16/2010 7:05 AM (GMT -6)   
Guys, guys, guys.... This is a "prediction."   You are all talking like this is a fact that is going to happen.  Why don't you wait until the year is over and see what the numbers actually are.  Are there already a lot more deaths this year from prostate cancer year to date then last year?  The article mentions nothing of any numbers to back up what they are claiming.  Where is the data for this...

Dx 42
Gleason 6 (tertiary score 0)
OPEN RP 10/08  Johns Hopkins
pT2 Organ confined Gleason 6
PSA Undetectable as of 10/15/09
Next PSA 10/15/2010


Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4183
   Posted 6/16/2010 7:44 AM (GMT -6)   

Tony, your statement:  "...so I wasn't surprised to see this announcement. In the last five years there has been an increase in the number of AS patients...".  There has also been a great increase in the number of men selecting da vinci robotic surgery rather than open....do you also think that is a contributor to this statistical prediction?  C'mon...now you're using "predictions" to bash a treatment choice?  Your conclusions are not sound, IMHO, and do a disservice to men who choose or may consider choosing AS as their option.

You also say, "There is very little information that indicates that AS does not increase mortality though I acknowledge there is some data that says delayed therapy is safer than first thought."  As discussed in another thread, Johns Hopkins says this regarding mortality of AS patients: "Of the men who have undergone surgery to treat their prostate cancer at the time the follow-up biopsy showed adverse findings, the proportion with curable disease appears to be similar to those men who would have qualified for the program but chose to undergo surgery immediately instead of expectant management. Thus, it would appear that when men are carefully selected for expectant management, the window of opportunity for cure is unlikely to close with monitoring." 

ChrisR is clearly right, in my opinion, when he states this is only a prediction anyway.  As the New Prostate Cancer InfoLink noted:

The estimated numbers of new cancer cases and deaths in the current year are model-based and may produce numbers that vary considerably from year to year. For this reason, the use of our estimates to track year-to-year changes in cancer occurrence or deaths is strongly discouraged. Incidence and mortality rates reported by the Surveillance, Epidemiology, and End Results (SEER) program and NCHS are more informative statistics to use when tracking cancer incidence and mortality trends for the US. Rates from state cancer registries are useful for tracking local trends.

Tony, the bottom line for me is that I'm certainly with you on the need for screening but I seriously object when you use questionable predictive data to bash active surveillance.

Tudpock (Jim)


Age 62, Gleason 3 + 4 = 7, T1C, PSA 4.2, 2 of 16 cores cancerous, 27cc
Brachytherapy December 9, 2008.  73 Iodine-125 seeds.  Procedure went great, catheter out before I went home, only minor discomfort.  Regular activities resumed, everything continues to function normally as of 4/10/10.  6 month PSA 1.4 and now 1 year PSA at 1.0.  My docs are "delighted"!

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 6/16/2010 1:41 PM (GMT -6)   
The prediction is based on SEER data of men with advanced cases, and a disturbing trend of annual increases in deaths and certainly not a Ouiga board. The only thing left to be determined is whether 17% was a high or low number when we see the SEER epidemiology data in 2012 for the calendar year 2010. Time will tell us if we have good definitive information or not that we could have acted on.

I am not bashing AS, nor completely against it and have stated above other possible contributors, but I will not back off for one minute that AS is still a possible likely contributor, but I cannot quantify how much so. However, while I am for more of DT it's with the caveat provided to us last week from Johns Hopkins. If anyone didn't see my counter post from Trock et al released at the AUA conference, Johns Hopkins has revised their AS study with another study that clearly states that a patient recommended for AS needs to be told that he will indeed face increased risk for advanced disease progression and possibly death resulting from delaying treatment.

What would be really disappointing to me is anyone recommending AS from the first JHU study on AS without mentioning this recommendation from the second JHU study!

RALP has been around and approved for treatment for 9 years. There is no data available that shows that RALP is contributing to this trend that has existed for more than 5 years. But I am open to it because I know of a lot of surgeons using it that shouldn't be. Some doctors probably should not be doing ANY surgeries for that matter. Same with every treatment modality, there are some that are not good at it.

The one thing I do agree with is that screening guidelines from the ACS are not the cause on the increase in this prediction. That stated, if we are seeing a continuing increase in PCa related deaths, then I ask if it is appropriate to have such guidelines that are very confusing? I believe this is the point ZERO is trying to make...

Tony
Disease:
Advanced Prostate Cancer at age 44 (I am 47 now)
pT3b,N0,Mx (original PSA was 19.8) EPE, PM, SVI. Gleason 4+3=7

Treatments:
LARP ~ 2/17/2007 at the City of Hope near Los Angeles.
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.

Status:
"I beat up this disease and took its lunch money! I am in remission."
I am currently not being treated, but I do have regular oncology visits.
I am the president of an UsTOO chapter in Las Vegas

Blog : www.caringbridge.org/visit/tonycrispino


Paella
Regular Member


Date Joined May 2010
Total Posts : 52
   Posted 6/16/2010 2:19 PM (GMT -6)   

I don't understand the math that shows a 17.1 % increase in deaths.

 

The way I read this is:

1.  Of the men diagnosed in 2009, 14.23% will die.

2.  Of the men (predicted to be) diagnosed in 2010, 14.72% will (are predicted to) die.

 

Isn’t that a .03% increase in the number of deaths?

 

Paella

 


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 6/16/2010 2:47 PM (GMT -6)   
Paella,
Those numbers are part of the confusion. What you are reading is that the trend is that 14% of men diagnosed will EVENTUALLY die of the disease. Not necessarily, and unlikely the same year they were diagnosed. Yearly data shows how many people will be diagnosed that year, and how many people will die of it, and they were likely diagnosed in previous years. Many men who will die this year have lived with the disease for many years.

This prediction in my post is based on the number of people that have actually died of the disease last year, and the expected increase we will see in 2010.

Tony
Disease:
Advanced Prostate Cancer at age 44 (I am 47 now)
pT3b,N0,Mx (original PSA was 19.8) EPE, PM, SVI. Gleason 4+3=7

Treatments:
LARP ~ 2/17/2007 at the City of Hope near Los Angeles.
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.

Status:
"I beat up this disease and took its lunch money! I am in remission."
I am currently not being treated, but I do have regular oncology visits.
I am the president of an UsTOO chapter in Las Vegas

Blog : www.caringbridge.org/visit/tonycrispino


Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4183
   Posted 6/16/2010 6:04 PM (GMT -6)   
Tony, I went back and read the Trock study that you referenced.  One of the co-authors was Dr. Ballentine who heads up the AS program at Hopkins.  Shown below is verbatim from the study which anyone can read by looking at the May 31, 2010 supplement to The Journal of Urology. I don't know what else to say except that the conclusions from the study that you referenced do not support your supposition that AS is part of the cause of a predictive increase in PCa deaths.  Maybe it is and maybe it is not...just as the movement to robotic surgery from open surgery may be part of the cause.  The fact is that there is no statistical data that supports either of those conclusions and we should not pretend that data exists to substantiate our personal beliefs.
 

CONCLUSIONS: Men who undergo delayed RP after initial management with AS have similar pathological outcomes to those men who are candidates for AS but undergo immediate surgery when matched for Gleason score. These data suggest that active surveillance is associated with a low risk of stage progression.

 

Tudpock (Jim)


Age 62, Gleason 3 + 4 = 7, T1C, PSA 4.2, 2 of 16 cores cancerous, 27cc
Brachytherapy December 9, 2008.  73 Iodine-125 seeds.  Procedure went great, catheter out before I went home, only minor discomfort.  Regular activities resumed, everything continues to function normally as of 4/10/10.  6 month PSA 1.4 and now 1 year PSA at 1.0.  My docs are "delighted"!

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 6/16/2010 6:45 PM (GMT -6)   
My mistake, the Trock abstract that I am referring to was five days later at the ASCO ~ It clearly outlines that the patient needs to be informed of the risks of AS...

abstract.asco.org/AbstView_74_50542.html

Conclusions: In the largest cohort to date, AS patients who undergo delayed RP in the absence of biopsy grade progression have similar risk of adverse pathology as matched men who undergo immediate RP. The message to men considering AS must balance the overall low rate of adverse pathology with the knowledge that a small fraction of men upgraded at biopsy will have a potentially noncurable tumor.

Seems to me that the entire medical institution can't come to agreement on this, but I believe they will and unfortunately through hindsight. A grand total 348 AS patients in this abstract in a country that has 3,000,000 men diagnosed and living with prostate cancer. And this is the largest cohort? Still this study I believe trumps the earlier one...

Tony
Disease:
Advanced Prostate Cancer at age 44 (I am 47 now)
pT3b,N0,Mx (original PSA was 19.8) EPE, PM, SVI. Gleason 4+3=7

Treatments:
LARP ~ 2/17/2007 at the City of Hope near Los Angeles.
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.

Status:
"I beat up this disease and took its lunch money! I am in remission."
I am currently not being treated, but I do have regular oncology visits.
I am the president of an UsTOO chapter in Las Vegas

Blog : www.caringbridge.org/visit/tonycrispino


midi
Regular Member


Date Joined Apr 2010
Total Posts : 122
   Posted 6/16/2010 7:22 PM (GMT -6)   
I wish I would've been tested sooner - I just git injected with Eligard on Monday and so far the cure seems worse than the PCa. Feeling very tired, weak & depressed. I was OK on the Casodex alonbe but the combination is really doing me in.

I want to exercise some but the fatigue is just over-whelming.I called the Uro office about it and he said it takes up to 7 days to feel the effects so the fatigus must be from something else.

All I've been doing is sitting around the house feeling sorry for my-self. Still have to self-cath some so don't want to leave much. Tried to go for a walk last night but was in bed by 11pm and woke up around 6:30 am but then fell back asleep until 11:30.

Should I be this tired? Don't want to hijack this thread - I can start a new one if you want - thanks!
White Male 55 otherwise healthy until this year :-(
 
January PSA: 17.4
March PSA: 36.8
 
Cipro: three weeks
Macrobid: one week
Levaquin: 10 days
 
Cystoscopy: April 19th 2010
 
Self-cath still 4-6 times a day
 
PCa Biopsy performed May 17th 2010 100% positive
 
Size: 54 grams
 
Gleason Score 4+5
 
Hospitalized May 30th - June 4th for severe pain/fever & infection.
 
Bone scan on May 31st showed its spread to pelvic area, ribs & sternum.
 
Stage: T4M+
 
Taking 50mg Casodex daily, 5mg Percoset as needed, 1st Eligard shot June 14th!
 
Will I still be a man afterwards? :-(


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 6/16/2010 7:30 PM (GMT -6)   
It's ok midi,
Your fatigue will improve but i caution to be aware that this treatment is capable of causing depression. I had it and it was terrible. But once i understood it, I was able to correct the depression and cope well with the fatigue.

I was like you in that I wished I had been tested earlier. I was 44 when Dx'd with advanced disease. i should have been screened at 40...

Tony
Disease:
Advanced Prostate Cancer at age 44 (I am 47 now)
pT3b,N0,Mx (original PSA was 19.8) EPE, PM, SVI. Gleason 4+3=7

Treatments:
LARP ~ 2/17/2007 at the City of Hope near Los Angeles.
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.

Status:
"I beat up this disease and took its lunch money! I am in remission."
I am currently not being treated, but I do have regular oncology visits.
I am the president of an UsTOO chapter in Las Vegas

Blog : www.caringbridge.org/visit/tonycrispino


John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4237
   Posted 6/16/2010 9:14 PM (GMT -6)   
Tony,
I reread the conculsion a couple of times. It says that a small fraction of those choosing AS will have incurable tumors, but so will men that have been treated. Klotz determined that 1.7% of those meeting the AS criteria will have non curable PC REGARDLESS of treatment. So having treatment for these rare varients will not increase your chances of a cure.
It is common sense that the rate of adverse pathology is the same for those who are treated and not treated; this is why I think it is imperitive that anyone considering AS get either a 3D Saturation Biopsy or a Color Doppler Ultrasound to reduce this risk.
This is reminder that nothing in the PC world is 100% and there are risks with and without treatments that every patient must deal with these risks. There is no treatment that has a 100% cure rate and all treatments have a 100% chance of side affects, a large percentage of which will be permenant.
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


el perro
Regular Member


Date Joined Mar 2010
Total Posts : 46
   Posted 6/17/2010 10:59 AM (GMT -6)   
If PCa mortality really is increasing, I would think the "obesity epidemic" of the last 20+ years is a significant factor. A link between obesity and PCa mortality has been demonstrated: www.cancer.gov/cancertopics/prostate/weightgain0307.
Dx 11/2008, Gleason 3+3
Active surveillance for now

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