Hormone therepy- can we list some comparison discussion?

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James C.
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Date Joined Aug 2007
Total Posts : 4462
   Posted 8/4/2010 3:01 PM (GMT -6)   
We currently have some whiz-bang experts here who have really researched the current and alternatives to HRT as old versus new, cheaper versus costlier and cutting edge versus the old standards. Could we have some listing of different approaches to what could be considered as a path to follow for those who may come later looking for info on this subject. I'm thinking along the lines of listing the latest/greatest modern marvels protocols and then the older ones that may have been pushed to the side as newer and more expensive ones came online. Also so alternatives completely outside the normal path, such as the female one mentioned just last week. Listed by cost,maybe, for those who may be struggling with no insurance or under insured. What was the latest and greatest 10 or 20 years ago. You know what I'm saying, I hope. Let's see if we can get some good info listed in some sort of order, so people can compare their options when they come here, rather than maybe missing some vital bit they didn't turn up in their own research, whether from not as good searching skills, or whatever. So, how about it, you HT non professional guru's. Got any list, words of wisdom and suggestions of steps to follow in any particular course of treatment?
James C. Age 63
Gonna Make Myself A Better Man www.youtube.com/watch?v=a6cX61oNsRQ&feature=channel
4/07: PSA 7.6, Recheck after 4 weeks Cipro-6.7
7/07 Biopsy: 3 of 16 PCa, 5% involved, left lobe, GS3+3=6
9/07: Nerve Sparing open RRP, 110gms, Path Report- Stg. pT2c, 110 gms., margins clear
3 Years: PSA's .04 each test since surgery, ED continues: Bimix- .3ml PRN, Trimix- .15ml PRN

zufus
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Date Joined Dec 2008
Total Posts : 3149
   Posted 8/5/2010 7:13 AM (GMT -6)   
LOL- Guru guy, (no way)....the cable guy...blue collar comic...typical dude, probably in that category. I don't know if in total everyone is ready for the huge debates that likely will occur on this, as it also questions the authority and established system called mainstream treatments. Old mainstream vs. New mainstream....in the old I believe profits were not the main feature or agenda of practicing (even had house calls at one time, nobody got rich doing those)...in the new techno era it seems almost everything has huge price tags on them and proceedures are ready to do asap, without total disclosures or advising one of second opinions or possible better protocols for there own ailment(which happened to me when seeking my own 8 opinions), it is more of make that sale. (I could be wrong, but currently question everything)

James I am feeling almost baited to answer this, but will wait for perhaps a real guru to pop up (LOL)? Lots of choices in ways to fight PCa, sooooo many variables in disease levels, Pca variant types (18+), gleasons scorings, ploidy analysis, missed biopsies (which people may not realize could harbor different Gleasons scores or volumes)...very complex and one size does not fit all...thus the reasons you see so many protocols, all can be valid. Figuring out which one might be best for ones condition or assessment......priceless. :-)
Youth is wasted on the Young-(W.C. Fields)

Fairwind
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Date Joined Jul 2010
Total Posts : 3741
   Posted 8/5/2010 9:48 AM (GMT -6)   
I'm no expert, but castration is castration whether done surgically or chemically..The surgical approach is a one-time relatively inexpensive procedure, VERY effective but of course is irreversible.

It should be noted that the fastest area of growth in Medicare payments is for prostate HT drugs!. $1.5 Billion last year just for that! The drugs used to achieve chemical castration are all unbelievably expensive!

While I'm not a candidate (yet) for HT, my R-doc told me that after being on drugs like Lupron for 2 or 3 years, the effect of the drug becomes more or less permanent, T-levels never recover much, so if you are paying for HT yourself, surgical castration is not as bad a choice as it seems on the surface..For men who will likely be on HT for the rest of their lives, there is no reason to enrich the drug industry by getting regular, wildly expensive injections..Lets face it...A rising testosterone level is the LAST thing men with advanced PCa need...
Age today: 68. Married, 6', 215 pounds, active, no health issues.
PSA at age 55: 3.5, DRE negative. Advice, "Keep an eye on it".
PSA at age 58: 4.5
PSA at age 61: 5.2
PSA at age 64: 7.5, DRE "Abnormal"
PSA at age 65: 8.5, DRE " normal", biopsy, 12 core, negative...
PSA at age 66 9.0 DRE "normal", BPH, Finesteride. (Proscar)
PSA at age 67 4.5 DRE "normal" second biopsy, negative.
PSA at age 67.5 5.6, DRE "normal" U-doc worried..
PSA at age 68, 7.0, third biopsy positive for cancer in 4 cores, 3 cores Gleason 6, one core Gleason 9. Finesteride discontinued, still no urinary symptoms, never had any..From age 55 to 65 I had no health insurance.

I have a date with the robo surgeon on Sept 3 but I'm keeping my options open. I'm also looking at seeds combined with IGRT which seems to be having good results with high-risk patients..

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 8/5/2010 10:30 AM (GMT -6)   
zufus, i actually agree with the tone and direction of your post above. when it's all said and done, no matter how much one researches, no matter how many opinions you gather, no matter how many experts a person's resources affords them, when push comes to shove, in those advanced PC situations, how do you really, really ever know if you are doing the right thing? Even if you take money out of the equation, how is any common run of the mill male patient's like us (educated or not), really have the in-depth skill to make such critical decisions, decisions that could vastly effect both the quality and remaining quantity of a person's life? I ask this with an honest heart. At what point do you simply have to make a decision, informed or otherwise?

you are right, just so many complex variables at work in those situation, but again, since patients aren't doctors, there will always be a risk in any decision.

david in sc
Age: 58, 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: Aug 3
Latest:  7/9 cath #6 - 41 days, 8/9 2nd corr surgery, 8/9 cath #7 - 38 days, mapped  9/9, 10/1 - 3rd corr. surgery - SP cath, 10/5 - 11/27 IMRT SRT 39 sess/72 gys ,cath #8 33 days, Cath #9 35 days, Cath #10 43 days, 1/19 - Corr Surgery #4,  Caths #11 and #12 ,Cath #11 - 21 days,  Cath #12 - 41 days, 3/2- Corr Surgery #5, Cath #13 - 4 days, Cath #14- 27 days, Cath #15 - 26 days, Cath #16 - 31 days, Cath #17 - 39 days, 7/2 - Corr Surgery #6, Cath #18 - 13 days, Cath #19 - 17 days, Total Blockage, Cath # 20 - 7/19

zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 8/5/2010 11:01 AM (GMT -6)   
Thanks Dave I understand what you are putting forth, some of this requires leap of faith, some requires knowing what options exist and seeing how they might have faired in others and weighing your decision as to taking a stand, I fired one doc early on for not letting me take proscar (an onco-doc too) she was stern about it and I questioned her to support why not??? (she had no replies), I decided with my riduculous high enough stats I was going to hit it hard up front with ADT3(Zoladex-casodex-proscar), my (information influences by Leibowitz, Strum, Scholz, Barken, Myers, Paactnewsletter, some other patients using such, etc.). Have no regrets trying that as my start, after 2 yrs. decided it looked like it was failing some...8 consecutive very small increases in psa(I monitored them monthly), this being post ADT3 & radiations...should not be rising at all, unless it was losing effectiveness, those 3 drugs block basically all possible manufactured 'T' including Di-hydra. T.  I also, totally hated the side effects over that time period and did not like energy loss, weight gain and plenty more.  Looked for an alternative, found it and has been a wonderful thing for many years (5) thus far.  Happy camper these 5 yrs. yeah

The fact remains that if you were to observe these high risk patients and their treatments, posted on some places like www.hrpca@yahoogroups.org or such. Alot of variations as to responses, durations of control, side effects, choices, and survival and on going long term survivals. The leading onco docs are even surprized at the strides in oncology that they are handling at this time. Plus shared information on the internet is I believe making a difference in education of patients and knowing about choices, many that were never mentioned to them. Why hide choices from needing patients????? (you decide).
Youth is wasted on the Young-(W.C. Fields)

Post Edited (zufus) : 8/5/2010 11:35:24 AM (GMT-6)


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 8/5/2010 11:17 AM (GMT -6)   
I agree totally, all options or semblences of options should be on the table in those dire situations. Nothing should be held back, and an open mind should be willing to think about whats availabe, whether it be the tried and true, or the absurd on the surface. It's a hell of a fight, even on a good day
Age: 58, 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: Aug 3
Latest:  7/9 cath #6 - 41 days, 8/9 2nd corr surgery, 8/9 cath #7 - 38 days, mapped  9/9, 10/1 - 3rd corr. surgery - SP cath, 10/5 - 11/27 IMRT SRT 39 sess/72 gys ,cath #8 33 days, Cath #9 35 days, Cath #10 43 days, 1/19 - Corr Surgery #4,  Caths #11 and #12 ,Cath #11 - 21 days,  Cath #12 - 41 days, 3/2- Corr Surgery #5, Cath #13 - 4 days, Cath #14- 27 days, Cath #15 - 26 days, Cath #16 - 31 days, Cath #17 - 39 days, 7/2 - Corr Surgery #6, Cath #18 - 13 days, Cath #19 - 17 days, Total Blockage, Cath # 20 - 7/19

zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 8/6/2010 9:20 AM (GMT -6)   
Ok hi James...nobody jumped back into this pit yet, so will say what I know in my own case as truthful and fact in my experience. Nobody has to agree or like such. Also will mention other observations in alternative hormone users.

ADT drugs- I prefer Zoladex over Lupron even though 'Z' will leave a nice black n blue mark on your stomach for a month or more, my uro doc switched me after about 9 mos. and hedidn't ask me if I wanted to be switched..the billing statement I saw at the counter that the gal handles showed Zoladex $1300 and Lupron was like $2100 or around that area, I remember seeing back in 2002-2003. (is that a CLUE??)

The side effects were pretty nasty for 2 yrs. using such- hot flashes, sweats, muscle fatigue, muscle atrophy you can see happening, weight gain you didn't ask for, then to know it can cause done density loss (long term can be really significant), memory loss and such. However it usually controls psa pretty well...for awhile, some high risk patients may only get 1-2-3 yrs. out of usefulness, then witness it failing to control psa levels.

Zufus- trys DES 1-mg in early 2005 after onco-doc gave me a Journal article on DES that was most enlighting to read. Took the drug the first month without boobs radiated(then radiated with electron rays and appears to stop that) or another drug to prevent gynecomastia side effect (breast can enlarge...can happen on casodex or avodart/proscar perhaps). Took only with aspirin the first month as written in Journal article, changed that for additional safety to use coumadin/warfarin with it a blood thinner to prevent possible dvt's or maybe a clot scenario. You do an INR Pro-time test on your blood as to co-augulation times to determine level of coumadin that might be used.
 
Well cancelled side effects from Lupron that was still in me at that time (nice). Found it has basically no side effects for me, except occassional breast nipples tenderness (bumping them actually hurts). Excellent control and lowered psas, stabilized well enough I went off it for one year as my own tests (leap of faith program). Nice to hear in Journal of Urology article all the benefits on this drug that has been in use since like 1940, bone density is not depleted and may actually help bone density, memory loss is not associated with this drug, weight gain is not happening (my weigh is excellent on this 162 lbs. 5'11"), strenght is improved, compared to ADT useage blanking night and day difference. Not to mention 4-5 yrs. of control on my psa that ADT3 should was starting to fail psa control. Then let's mention it cost around $125 per year(I have likely the lowest cost source)...no patents on this...the drug companies(was patented) stopped making it about the time Lupron was introduced.(hmmm..)

Today you can only get the man made DES, compounding pharmacies make it...some call it veterinary grade (cool make me an apha male then and bark or howl). It works basically is the message, it was used for decades in VACBURG VA useage as primary therapy..the bad press on this was dumbies gave patients 5-mg (to much) and no blood thinner or aspirin...so some patients got dvt's or blood clots...which helped kill its useage. Most docs today who are actually unfamilar with the Journal Article I mentioned, will say it is dangerous and will cause clots...thus no Rx or I don't use it. Well there is no money in it and doc might assume a risk in a rarer patient and get a lawsuit scenario...so many avoid the whole thing by bad mouthing its useage. (totally objective?)

I had a guy contact me and his doc was willing to prescribe such but leary. He wondered if 1/2 mg would work on PCa....I said yes without having any medical schooling...his doc (whom should be the expert) says it is to low a doseage and probably won't work. The friend decided to try it 1/2 mg use (split the capsule apparently), and guess what it worked for him and he says his doc was surprized and probably more surprized that a dumb @#@*^ layperson said it would work. I get a kick out that as being the under educated cable guy vs. the expert.

As further evidence of people using estrogenics with good things to say on them, the leader of UStoo.org has written (Wichita posting we got a while back)..has done estrogenic gel or patch method (estradiol) for 5 yrs. now...maybe contact him and ask about it.

Dr. Fred Lee a PCa for many years uses estrogenic emcyt with fabulous results and wrote about his PCa journey. Gee and informed guy like that and no Lupron or LHRH (hmmm).

Dr. Premoli in Argentina uses estradiol patches as primary therapy on most of his PCa patients, I have talked with him in the past, he claims no dvt's and blood clots or events and patients are doing very well using such. Same kind of info is written about this in the UsToo.org (Wichita) posted message on this forum not long ago.

Also how many docs will ask you do you prefer to take casodex mono therapy or Lupron (LHRH) therapy??? Both usually work well in patients(for awhile), right now OhioState-Andrew is doing excellent on mono therapy with casodex (plus tamoxifen), so well he took holiday and is off drugs for months so far and monitoring psa. Dr. Lee has said his case appeared to be the worst case of PCa he has seen (into bladder and such). So why not casodex or nilandron and other flutamides offered more??? There is no profits on these drugs for the uro-doc or doc to get. Dr. Labrie has written many PCa studies on mono therapy with casodex.

One could switch drugs as a choice or do both for added possible control and some do just that. Casodex should be given prior to any LHRH drug given, as Dr. Strum elaborates on the issue of PCa flare up, while LHRH downreglates maybe after 14 days of T level spikes.

Degarelix (GnRH) similar concept to Lupron, but does not have the flare issue and drops T level in like 24-48 hrs., new and FDA approved, so how many docs are putting this forth right now??? Some talk that it may work when LHRH drug is failing, that is interesting factor.

Some people use proscar or avodart and get results, especially in the after doing ADT3 intially like the Leibowitz protocol. Those drugs used as maintenance thereafter and they usually have little side effects wintessed. Maybe breast enlargement might occur or other minor issues, you could read about.

Ketoconazole- found useful in patients trying such (may have some side effects to worry about)

There are other drugs I have not mentioned that are found useful and patients can talk about their useage on them and I didn't even touch on chemo world, it has is own various combos, protocols, types to chose from, etc.

Vaccines are the future, get to the genes level and eventually fix the issues or restore it to normal...they are working on that.
Now is PCa a Jungle, Twilight Zone and patients living in limbo land???  Bizzaro land!
Youth is wasted on the Young-(W.C. Fields)

Post Edited (zufus) : 8/7/2010 7:49:57 PM (GMT-6)


dkob131
Regular Member


Date Joined Apr 2008
Total Posts : 364
   Posted 8/6/2010 10:53 PM (GMT -6)   
 A little more information on the "lupron flare".  The flare actually begins within 48 hours of injection and most individuals T level spikes an average of 65% plus whatever your level already is.  The flare actually spikes for 6-7 days and then begins tapering off.  At 14 days most indivlduals T level is back to normal and heading downward.  28 days is when most guys reach their nadir level or close to it. 
 
As most of us know, Casodex should be started a week or two ahead of the first lupron shot, the timeline depends on what amount of Casodex is being prescribed.  
 
Degarelix is usually saved for the very advanced individuals because of, who'd  a thought it, the prohibitive cost.  
 
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.

12/31/09- SRT completed, still on HT and will be for 2 years, PSA is <0.01

7/30/10- PSA still <0.01, on HT 1 year with 1 to go.

zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 8/7/2010 4:35 AM (GMT -6)   
Dave you got a price on Degarelix for comparison purposes, FDA approved it this year. Don't know of anyone personally on this, one guy from another forum and I did't inquire as to cost and/or exact side effects as it is not actually an LHRH, but comparable. Thanks for more on the flare thing, it is significant that such happens.
 
Ohhhhhhhhhhh! let me mention a few drugs used in PCa therapies- I missed prior:
 
Thalidomide, revlamid, cytoxan, leukine, dexamethasone, sunitinib, prednisone, triamcinolone, aminogluthimide, vadur, trelstar, eligar, abarelix, buserelin, nafarelin, acetate, eulexin, nilandron, magace, tamoxiphen, mitroxantrone, carboplatin, alpharadin, strontium, samarium, apatone, astrsentan, sunlindac, exisulind, IMC-A12, Ixempra, epothilone, MDV3100(super casodex in trials now), noscapine, phenoxodial, quadramet, OGX-011, satraplatin, valporic acid, provenge, dcvax, xinaly, tarceva, ertinolib, gleevec, prostvac-vf, vitaxin, zd4054, ixabepilone, iressa, kos-862, satraplatin
 
I know my list is not complete too, feel free to find other drugs used and mention them. Is this an arsenal or what?  Surely our local uro-doc would know how to use all these???(LOL)
Some onco-docs actually know alot on these, go figure.
Youth is wasted on the Young-(W.C. Fields)

Post Edited (zufus) : 8/7/2010 5:43:49 AM (GMT-6)


dkob131
Regular Member


Date Joined Apr 2008
Total Posts : 364
   Posted 8/7/2010 7:31 AM (GMT -6)   
Zufus:  I was told about a year ago by a oncologist when Degraelix was authorized that it was much more expensive than Lupron but after your question I googled it and found that it's being sold out of the Canadian pharmacy for much cheaper than Lupron.  The longer lasting injection was $999(I'm thinking its a 4 month harpoon) which was actually cheaper than the Lupron injection $1,695, by far.
 
These are obviously prices that don't include the actual injection( it would be a do-it-yourself deal) but why not go with the Degraelix from here on out.  
 
Live and learn.
 
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.

12/31/09- SRT completed, still on HT and will be for 2 years, PSA is <0.01

7/30/10- PSA still <0.01, on HT 1 year with 1 to go.

dkob131
Regular Member


Date Joined Apr 2008
Total Posts : 364
   Posted 8/7/2010 9:39 AM (GMT -6)   
  Dr. Meyers weighs in and agrees with Zufus.  Estrogen is the topic.
 
I hope the link works for everyone.
 
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.

12/31/09- SRT completed, still on HT and will be for 2 years, PSA is <0.01

7/30/10- PSA still <0.01, on HT 1 year with 1 to go.

Ralph Alfalfa
Regular Member


Date Joined Nov 2008
Total Posts : 469
   Posted 8/7/2010 7:29 PM (GMT -6)   
Thanks for the discussion, guys. I printed it...just in case.
Bob
 AGE:58
 Dx: October,27, 2008(the day after my birthday)
 Psa 14.5
 Gleason:(4+3) 7 T2c
 Bone scan:Negative
 Cat scan: Negative
 Biopsy: 4 of 12 positive
 Confined to prostate.
 DaVinci Jan. 19th, 2009. No lymph node involvement, all margins clear.
 8 week PSa <0.01
 Gleason downgraded to (3+4)7
 6 month Psa , 0.1 
 9 month Psa,  0.2  Doubled! Criminy!
 Started RT 10/28...one year since diagnosis.  RT over 12/22.
 3 month post RT Psa 0.1. 6month post RT Psa 0.1

zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 8/7/2010 7:59 PM (GMT -6)   
David (dkob)- since that is the do it yourself price in Canada it is substantially higher than lupron because lupron in Canada costs this in USA dollars from us:

3.75 mg 1 injection= $199
3.75 mg 3 injections= $525
7.5 mg 3 inecjtions=$899

Zoladex (Canada) USA prices: 3.6 mg 1 = $245
10.8 mg 1= $695

Of course these are like 50% cheaper than USA price, and they don't include installation (LOL) the docs office visit and a smile or nurse...so we see prices much higher, in our own scenarios, if you witness the billing or pay with cash. Some patients have gotten discounts, some by asking or pleading they have no insurance or issues...and get price lowered sometimes (good to hear).

Post Edited (zufus) : 8/7/2010 8:02:39 PM (GMT-6)


Arno
Regular Member


Date Joined Apr 2010
Total Posts : 54
   Posted 8/9/2010 1:29 AM (GMT -6)   
zufus said...


Thalidomide, revlamid, ...,

I know my list is not complete too, feel free to find other drugs used and mention them. Is this an arsenal or what? Surely our local uro-doc would know how to use all these???(LOL)


I saw an interesting article www.jurology.com/article/S0022-5347%2808%2903053-X/abstract

where hormone therapy was combined with thalidomide in an intermittent treatment: on-period 6 months HT, then stop, and off-period with thalidomide. The off-period became 2.6 times longer !!

This is exactly the way Leibowitz's protocol works, but then with a (combi-) chemo therapy: 4 months chemo's, then stop, continue for 1 to 2 years (!) with (a combi-) thalidomide+Revlimid.
But he claims that in the following cycles: a) the on-period will be still 4 months, b) the off-period will be still as long as in the previous cycles. What he calls: 'Succesfully live with Advanced Prostate Cancer'.
Lenalidomide (brandname Revlimid) has been called the '2nd-generation thalidomide'.

The Casodex is not working for me anymore, so I am now asking for thalidomide, which was sold over the counter from 1957 to 1961 as a sedative drug and sleeping pil, but forbidden since then because of severe birth defects when used by pregnant women. You now need an exemption to be allowed to use it.

The advantage of combination therapies is that combinations of drugs can be found that:
a) enhance the response rate, e.g. with mono-therapies having 60%, a combi of 2 might have 80%, a combi of 3 have 90%, and even a combi of 4 has been found which had close to 100% response.
b) the reduction of PSA can be much stronger for the combi's. For example, the combi of 4 chemo's had a PSA reduction of 99.3%, on average.
c) Because the drugs enhance each others efficacies, you can lower the doses. And that makes all the difference when it comes to side-effects.
Leibowitz uses also a combination of anti-angiogenics, such as thalidomide, lenalidomide (brandname Revlimid) and bevacizumab (brandname Avastin).

And although numerous phase I and II trials of combination therapies have been done from 1994 until today, e.g. jco.ascopubs.org/cgi/content/abstract/28/12/2070,
when you ask for it, none of it is available to us. The only thing offered is to join yet an other trial, with 50% chance of getting a placebo.
When the results of 16 years of research in the industry had not reached the market then it certainly would have not continued that long. How is it possible that research oncologists can go on with these randomized, double-blinded studies for ever without ever delivering anything to us, PC patients ??
March'06: PSA 3.6
Diagnosed at age 63 Sep'09: PSA 575, GS 7 (4+3)
3 positive cores in 6
Bone scan: as a fully lit christmas tree
With Zoladex+150mg Casodex PSA <0.1
Additionally 4-weekly Zometa (zoledronin acid)

Post Edited (Arno) : 8/9/2010 2:32:16 AM (GMT-6)

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