So why was this not breaking news ?

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Date Joined Apr 2010
Total Posts : 54
   Posted 8/10/2010 4:51 AM (GMT -6)   
I just find out about this report, and I find it incredibly important.
Intermittent androgen deprivation (IAD) therapy until now (see ) suffers from a progressive decline in the duration of the off-therapy phase and an increase in the duration of the on-therapy phase in subsequent cycles. Patients spent an average of 45% of the time not receiving therapy.
The most important question is the potential impact on survival of IAD in comparison with continuous androgen deprivation CAD. There was no statistically significant difference in time to progression between the two arms of a particular study. However, in the off-treatment phase of IAD, greater than 90% of patients recovered normal testosterone levels and that allows the body to recover from the treatment and has psychological and physiological advantage to the patients.
So there remain at least 2 advantages to giving breaks off of the hormone therapy instead of staying on it continuously: quality of life in the off-period is better and money is saved. These facts seem not of much importance to the medical society, because CAD is still there.
And now this study from Figg, et al. proves that the off-period can be made longer and  the progressive decline in the duration of it can actually be halted by using thalidomide !
Using it in the 1st cycle increased the off-period from 9.6 (for the placebo) to 15 months for using thalidomide. Because of the wide range of participating patients (with on-study PSA's avg. 5.1, range 0.9–311.8, and Gleason avg. 5.1, range 3 -10), the accuracy obtained was not good enough to call this a significant difference (there were a total of 159 patients involved).
But in the 2nd cycle, where traditionally you would expect the off-period to become shorter, the results were that the off-period of 17.1 months for thalidomide increased compared to that in the 1st cycle, but it declined to 6.6 months for the placebo. That was certainly significant. It must be said that the gruop that got thalidomide during this cycle's off-period was the group that had a placebo in the 1st cycle.
Am I correct in thinking that the results had been even better when they had gotten thalidomide twice ?
So it looks that, with thalidomide, the IAD cycle can be repeated many more times, maybe indefinitely ?
Should not everybody on hormone therapy demand that he gets thalidomide ?
(Thalidomide was an over the counter sleeping pil from 1957 till 1961, when it was forbidden because of serious birth defects when used by pregnant women).
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) : 8/10/2010 5:52:20 AM (GMT-6)

Veteran Member

Date Joined Dec 2008
Total Posts : 3149
   Posted 8/10/2010 6:25 AM (GMT -6)   
With you buddy as you are heavily looking into everything, which people have choices they don't even know about such as you just mentioned, how many knew about it. We have all these forces against us: profit motives, cashin on patients (more scans, tests, zometa, Provenge $93K, adt3...etc.), biases, possible agendas, undereducated docs, docs afraid of lawsuits, docs whos hospital boards decide on protocols and there profit and risks scenarios, thus offer limited choices because of that platform agenda (no lawsuits zone). Hey we can't offer estrogenic drugs, what would that do to the rest of patients finding out it works and is cheap. We can't offer (whatever) like thalidomide (etc.) as it is risky, if someone dies, we lose the lawsuit automatically almost. I contend these types of things are part of the hurdles put into our path.

Not to mention any useage of natural, herbal, nutritional values...what medical establishment is going to spend money or time on that? (few or none). One needs to become there own advocate to some degree so as to know what possible choices are out there, or accept whatever Doc Hyde says is your protocol or treatment and never question anything and let him have his way with you. (sounds wonderful like that-LOL)
Youth is wasted on the Young-(W.C. Fields)

Veteran Member

Date Joined Nov 2009
Total Posts : 1100
   Posted 8/10/2010 9:51 AM (GMT -6)   
Was the Thalidomide given during the ADT on-period, or the off-period? (I guess I am just being lazy - I should read the article).
Age 46.  Father died of p ca. 
My psa starting age 40: 1.4, 1.3, 1.43, 1.74, 1.7, 1.5, 1.5

Veteran Member

Date Joined Oct 2006
Total Posts : 1211
   Posted 8/10/2010 1:37 PM (GMT -6)   
Hi Arno,
Thanks for this interesting report. It maybe of value for those brothers that are into or just starting HT. Perhaps down the road it would effect me as well. I think as Medved, that a bit more detail as to how the Thalidomide was administered and in what doses, would have been helpful. I read the report, but was not able to get to many details out of that. Anyway, looks promising as far as HT treatments go.
All the best to you.

Born Sept 1936
PSA 7.9
-ve DRE
Gleason's Score 3+4=7, 2 of 8 positive
open RP 28 Nov 06 (nerve sparing), Post op staging T3a
Gleasons still 3+4=7
Seminal vesicles and lymph nodes clear
Catheter out 15 Dec 06, Dry since 11 Feb 07
All PSA tests in 2007 (4) <.04
PSA tests in 2008: Mar.=.04; Jun.=.05; Sept.=.08; 3 days before Rad Start=0.1
Salvage RT completed (33 days - 66 Grays) on the 19th Dec., 08.
PSA in Jan., 09=0.05; July 09 <0.04; JAN 10 <0.04; Jul 10 <.04

Veteran Member

Date Joined Jul 2010
Total Posts : 3892
   Posted 8/10/2010 10:17 PM (GMT -6)   
Many men on HT have been diagnosed as "terminal" and as such they should be given ANY DRUG THEY WANT!! It's as simple as that..
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 12 core 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..
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