BB-Fan that was important to ask and be known, now a castrate level 'T' and psa is rising in short term injection useage (noted also), means you have some amount of PCa cells that are HRPCa (androgen inpendent- AIDPC). It should get worse over time, so monitor psa very closely.
Youthful Sailor (-: casodex or proscar or similar may or may not impact your PCa and the psa changes, your doc may suggest trying such and see if you get the intended response. The androgen receptors can change and DNA of PCa morph to whereby eventually Lupron and some others are ineffective, at some juncture...it can take time to be totally ineffective. Then comes the artistry of some of the onco-docs as to what receptor paths can effect the PCa or certain genes that may be the issue. Then drugs like Ketoconazole, Abiraterone, MDV3100, estradiol patches-gels (DES or emcyt), Leukine, Provenge and many others can be used against the war and usually found effective in HRPCa patients, how long varies alot and is always the next real question. You may do well enough on Lupron and/or the other standard drugs for some time, but you can expect to see them fail you down the road, this is not uncommon in PCa. You can elect to hold out till a certain level of PSA is achieved or stated by your doctor and/or he may have you try and jump into chemo and other remaining protocols. There are choices that you may not have mentioned to you...I know...been there and did so.
If you can comprehend this information from Dr. Bonkhoff it is your clue as to pathology and what can actually be known now or upfront or later, but usually is not tested for, but explains plenty as to which drug protocols can be the most useful for a specific patient (huge information that the whole PCa community is not fully using), Dr. Strum has recommended him like 10 yrs. ago, what a clue:http://www.prostapath.org/download/prognostic-predictive-markers.pdf
This extensive analysis on PCa to this level, is not even done by Bostwick or anyone else, they may do some of these analysis's. He has identified certain genetic defects in a persons pathology that have known treatments, that can work on the specific genetic disorder atleast for awhile. This information is usually not harvested or utilized as much as it can be, the leading onco-docs are keyed in on these concepts and treat the PCa, even without knowing Bonkhoff's pathology. We are sitting in a jungle in the PCa world.
Post Edited (zufus) : 3/14/2011 8:06:04 PM (GMT-6)