Question on HT

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Regular Member

Date Joined Mar 2007
Total Posts : 460
   Posted 9/5/2010 9:48 AM (GMT -6)   
This may be a stupid question but I cannot seem to find the answer and hopefully one of our experts here will know.  My Oncologist has told my wife and I that the average time HT works is 2.5 to 5 years, some men much longer some much shorter.  The research at this time shows no difference in survial time if someone starts HT early or waits until something is seen on a scan or PSA is over 10.  If this is so are they saying that once you start HT the average is up to 5 years, which would make me think the longer I put it off the longer I will live after I start HT.  Is this correct or are they talking about 2.5 to 5 years after recurrance and it makes no difference when HT is started?
Hope someone knows the answer trying to do my homework since things are not looking real good on the PSA front.

Elite Member

Date Joined Oct 2008
Total Posts : 25393
   Posted 9/5/2010 10:00 AM (GMT -6)   
Good luck, Jerry, hope you get some good, sound answers. Several of us are pondering the same question.
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos marg
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06 11/10 ?
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, on Catheter #21, will be having Ileal Conduit Surgery in Sept.

Regular Member

Date Joined Nov 2009
Total Posts : 486
   Posted 9/5/2010 10:18 AM (GMT -6)   
Jerry,  The PCRI web site has an excerpt from Dr. Myers book titled "Beating Prostate Cancer With Hormonal Therapy and Diet".  I believe he answers your questions about life expectancy with HT.  This is the link:  I hope you can beat this thing.

Diagnosed 2/2008 at age 71, PSA 9.1, Gleason score 5+3, stage T1c.
Robotic surgery 5/2008, nerves spared, stg. pT2c, N0, MX, R0, Gleason 5+3
PSA <0.1 at 26 months and at all tests since surgery.

Regular Member

Date Joined Mar 2007
Total Posts : 460
   Posted 9/5/2010 10:35 AM (GMT -6)   
Thanks Carlos very good article however, did not like the part about a Gleason 8 with a rapid doubling time havingHT failure much sooner than others with less aggressive cancer.

Veteran Member

Date Joined Jul 2010
Total Posts : 3892
   Posted 9/5/2010 12:51 PM (GMT -6)   
In Walsh's book, in the chapter that deals with treating advanced PC, there is a chart that predicts survival after metastasis has been diagnosed and HT started..

Basically, it's pretty grim. !0% die within one year and 10% live ten years or longer...Everyone else falls somewhere in between.. 60% or a number close to that have succumbed by the fifth year..

Now is the time to say goodbye to your urologist and find an oncologist who deals with PC..

Walsh feels you should wait until symptoms appear and you MUST start HT. He feels there is no advantage to starting HT early as it does not extend overall survival time. His figures show survival time is the same..But there are others like Dr. Mark Scholz who feel just the opposite. They concentrate their studies on the 10% who make it to the ten year mark and beyond....

Post Edited (Fairwind) : 9/5/2010 12:01:10 PM (GMT-6)

Veteran Member

Date Joined Dec 2008
Total Posts : 3149
   Posted 9/5/2010 1:11 PM (GMT -6)   
There are generalities in PCa and thrown around by some docs, written as such in some books. As Fairwind points out it looks like a Bell Curve concept and probably is a good comparison. There are problems with some generalities or guessing on HT or further which type(s) of HT or drug protocols. There it varies even more, and especially in the patients that did protocols that are outside of conservatism that is usually found by like the urologists, whom believe perhaps that 2-3 drugs are to be used, and that is over. Many patients never knew or went outside of these conservative protocols and maybe for them 2-5 yrs. is alittle more accurate. I have seen cases blow those odds away and posted some of them.

On the optimistic side of HT and drugs and hoping for longer survival, perhaps look at what other patients have done that seemed effective and what specialists onco-docs are doing and finding further longevity. I have been watching this world for 8+ years not only on my own protocols and choices, but always looking at others with an objective and very open mind. The other side of PCa is this: too many variables at work, 24 types of PCa variants (who knows if they identified yours correctly), 3 types of DNA strands, ploidy analysis on any PCa found (diploid is the most normal in pairs like normal cells and responds best to drugs) this costs extra in pathology and is usually never done, proper Gleason grading, you could have missed biopsies and they can harbor a different Gleason grade, I have 3 different grades found), etc. Point being all PCa's are not equal and you can see that by how certain patients respond, one man on this forum is having it looks like a not good enough response to only 3 months of HT.  This is far from simplistic world in PCa.

Couple examples:  (first one herein is astounding 27 yrs., 25 yrs. of known micromets & alive)
Moderator at hrpca group H. H. has journery of 17 yrs. and still going, various protocols used.
Dx-2002 total urinary blockage, bPsa 46.6 12/12 biopsies all loaded 75-95% vol.; Gleasons scores 7,8,9's (2-sets), gland size 35 normal, ct and bone scans appearing clear- ADT3 5 months prior to radiations neutron/photon 2-machines, cont'd. ADT3, quit after 2 yrs. switched to DES 1-mg, off for 1 yr., controlled so well, resumed, using intermittently, pleased with results

Post Edited (zufus) : 9/5/2010 12:36:50 PM (GMT-6)

John T
Veteran Member

Date Joined Nov 2008
Total Posts : 4269
   Posted 9/5/2010 1:29 PM (GMT -6)   
Get another oncologist. As Zufus pointed out there are many different types of PC and they all react differently to HT. Some men are still going strong after 15 or 20 years. A good oncologist will know when it is not working pretty quickly and adjust to different meds that may work better.
It is always better to start HT as soon as possible, when the tumor burden is low and the cancer cells have not yet had a chance to mutate. I think your oncologist is giving you some bad information that is 15 to 20 years old when it was generally thought that HT wasn't that effective.
Dr Strum's book "Primer on Prostate Cancer" and Dr Myers' book that Zufus suggested are must reads for anyone thinking about HT. Dr Scholz's book "Invasion of the Prostate Snatchers" has a good section on HT and how to minimize the side affects. After reading these books you will be much more informed than your present oncologist about HT and prostate cancer.

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.


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