Mutating cancer cells

New Topic Post Reply Printable Version
[ << Previous Thread | Next Thread >> ]

BB_Fan
Veteran Member


Date Joined Jan 2010
Total Posts : 1011
   Posted 6/5/2011 7:41 AM (GMT -6)   
Is there any solid information on this? Or is it yet other of the issues with prostate cancer that gets debated but never resolved? The first medical oncologist that I saw told me that it did not matter when HT started. Each man had a certain number of HRPC cells that would grow unhindered until they ultimately killed you, or you died of other causes. It didn't matter if you started early or latter, HT would only be effective for a certain period of time based upon the composition of your PCa cells. I know other doctors believe that cancer cells mutate over time, and that larger, or more widespread, cancer has a greater persentage of HRPC cells. HT started later will be effective for a shorter period of time. This leads to conclusion, is that often debated here, that earlier treatment will prolong ones life. I am not looking to open this debate, but I know that many of you have done a great deal of research on PCa and have acqiured a lot on knowledge. If you can point me to any good studies or artcles on this topic, I would appreciate it. Thanks, BB

logoslidat
Veteran Member


Date Joined Sep 2009
Total Posts : 5816
   Posted 6/5/2011 9:24 AM (GMT -6)   
Your second sentence is the one closer to the truth. Im coming to the opinion, that nobody really knows much about anything, not just talking pca here, but some think they they do, some know they don't. I mean, we all know something til convinced otherwise and this process just builds on itself. Heck we cant even agree on the beginning of life or the finality of death. I, m sure this post has added nothing. Oh I for got we do know nothing. Think I'll go for a run and , heck I don.t know!
Diagnosed 8/14/09 psa 8.1 66,now 67
2cores 70%, rest 6-7 < 5%
gleason 3+ 3, up to 3+4 @ the dub
RPP U of Wash, Bruce Dalkin,
pathology 4+3, tertiary5, 2 foci
extensive pni, prostate confined,27 nodes removed -, svi - margins -
99%continent@ cath removal. 1% incont@gaspass,sneeze,cough 18 mos, squirt @ running. psa std test reported on paper as 0.0 as of 12/14/10 ed improving

John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4225
   Posted 6/5/2011 10:04 AM (GMT -6)   
BB fan,
I know that Dr Myers has written about starting early because of cell mutation (a recent video explains his thoughts) and so has Dr Strum and Dr Scholz. All of these doctors feel that HT is more effective while the tumor burden is low. These doctors have probably the most experience of any doctors in the US, seeing many more advanced PC patients than other doctors. This would be a good place to start to find reference material. You can also look at Dr Liebowitsz's papers on ADT3 as a primary treatment.
On the late side Walsh mentions late starts and many patient's doctors on this forum have also recommended late starts, but I don't know what it is based on or on what basis they have formed their opinions. I have never seen any evidence that starting later gives a better outcome and the entire basis of oncology for any cancer is to start treatments earlier rather than later.
Good luck in your research and let us know what you have found.
JohnT
66 years old, rising psa for 10 years from 4 to 40; 12 biopsies and MRIS all negative. Oct 2009 DXed with G6 <5%. Color Doppler biopsy found 2.5 cm G4+3. Combidex clear. Seeds and IMRT, 4 weeks of urinary frequency and urgency; no side affects since then. 2 years of psa's all at 0.1.

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 6/5/2011 10:52 AM (GMT -6)   
I think this is a good article on the other side of the coin:

advancedprostatecancer.net/?p=1375


david in sc

Post Edited By Moderator (James C.) : 6/5/2011 11:39:30 AM (GMT-6)


logoslidat
Veteran Member


Date Joined Sep 2009
Total Posts : 5816
   Posted 6/5/2011 12:41 PM (GMT -6)   
Thanks for the article.
Diagnosed 8/14/09 psa 8.1 66,now 67
2cores 70%, rest 6-7 < 5%
gleason 3+ 3, up to 3+4 @ the dub
RPP U of Wash, Bruce Dalkin,
pathology 4+3, tertiary5, 2 foci
extensive pni, prostate confined,27 nodes removed -, svi - margins -
99%continent@ cath removal. 1% incont@gaspass,sneeze,cough 18 mos, squirt @ running. psa std test reported on paper as 0.0 as of 12/14/10 ed improving

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3742
   Posted 6/5/2011 1:01 PM (GMT -6)   
Walsh and many other doctors believe this: After PC metastasizes, your termination date is pretty much fixed, all other things remaining equal...The PC cells that need testosterone to multiply will all die without multiplying once deprived of "T"..However, all PC victims have a certain percentage of cells that can reproduce without the need for testosterone. These are the cells that will eventually kill you and since HT has no effect on them, it makes no difference when you start HT....

Therefore Walsh et-al claim, you might as well postpone the huge quality of life hit that comes with HT as long as possible before engaging the enemy in that last, final, battle...

The percentage of hormone dependent verses hormone independent cancer cells varies greatly among PC victims. Therefore, so does survival time..When you START HT does not seem to alter survival times significantly..

Men stricken with aggressive, metastasized PC have a mean survival time of less than 5 years. When they start HT does not change their spot on that chart...

In the background we have a cornucopia full of new drugs, dietary supplements, treatment programs all claiming to offer 'breakthroughs" in cancer treatment and survival..

But, like always, the key number for those whose primary, curative, treatment has failed is PSA doubling time..

Something to consider...Not long ago, HT was seldom used unless it was thought that an effort to CURE the cancer was not possible, that it was too late...But today, HT, combined with other treatments is being used as part of a curative effort. This fact alone muddies the water as to whether sooner is better than later as sooner does indeed work better in these cases...This sooner is better than later approach is gaining traction in the later stages of PC treatment also...

As always, JMHO....
Age 68.
PSA age 55: 3.5, DRE normal.
age 58: 4.5
61: 5.2
64: 7.5, DRE "Abnormal"
65: 8.5, " normal", biopsy, 12 core, negative...
66 9.0 "normal", 2ed biopsy, negative, BPH, Proscar
67 4.5 DRE "normal"
68 7.0 3rd biopsy positive, 4 out of 12, G-6,7, 9
RALP Sept 3 2010, pos margin, one pos vesicle nodes neg. Post Op PSA 0.9 SRT, HT. 2-15-'11 PSA 0.0

logoslidat
Veteran Member


Date Joined Sep 2009
Total Posts : 5816
   Posted 6/5/2011 3:00 PM (GMT -6)   
Fairwind and Ohio State, Thank you for 2 very interesting posts. It feeds into my personal beliefs, that life, in the sense we are talking about, is not over until it is over. Its all a matter of different elements intermingling with each other at different times under different circumstances, playgrounds and emotional paradigms. There are lines of reason, for awhile stable and then the butterfly effect of the micro universe comes into play and all bets are off, both in a negative and a positive way.
Diagnosed 8/14/09 psa 8.1 66,now 67
2cores 70%, rest 6-7 < 5%
gleason 3+ 3, up to 3+4 @ the dub
RPP U of Wash, Bruce Dalkin,
pathology 4+3, tertiary5, 2 foci
extensive pni, prostate confined,27 nodes removed -, svi - margins -
99%continent@ cath removal. 1% incont@gaspass,sneeze,cough 18 mos, squirt @ running. psa std test reported on paper as 0.0 as of 12/14/10 ed improving

John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4225
   Posted 6/5/2011 4:52 PM (GMT -6)   
Here is something from Dr Myers that has the data you may be looking for.
 

John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4225
   Posted 6/5/2011 5:00 PM (GMT -6)   
More data; You can dig into the primary references mentioned at the end of the article.

JNF
Veteran Member


Date Joined Dec 2010
Total Posts : 3746
   Posted 6/5/2011 7:09 PM (GMT -6)   
You think Dr. Walsh might visit Dr. Lee (some 29 years surviving PCa with mets) and explain what will and won't work? I think if Dr. Walsh would visit Dr. Lee he just might learn something.

What I like about guys like Meyers, Scholz, Sartor, and the like is that they keep trying different things. That is where their experience is very important compared to the ones that really don't have the exoperience with advanced cases. A t1, G6, PSA 4 should go to Walsh. With my stats I would waste my time with Walsh but would be welcomed by Meyers as he has seen hundreds of me and kept many going a long time....including himself.

My docs all agreed that the most agressive early treatment is what I needed and I agreed. Hopefully in 15 or 20 years I can report that allthough the intermitent HT is a PITA we are still doing fine becuse we got as much as we could quickly and weakened what wasn't killed..
PSA 59 on 8-26-2010 age 60. Biopsy 9-8-2010 12/12 positive, 20-80% involved, PNI in 3 cores, G 3+3,3+4,and 4+3=G7, T2b.
Eligard shot and daily Jalyn started on 10-7-2010.
IMRT to prostate and lymph nodes 25 fractions started on 11-8-2010
HDR Brachytherapy December 6 and 13-2010.
PSA <.1 and T 23 on 2-3-2011.
PSA <.1 on 4-7-2011
Second Eligard shot on 4-7-2011

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3742
   Posted 6/5/2011 8:13 PM (GMT -6)   
Dr. Myers is as guilty as all the other practitioners / book-writers..He promotes his specialty with unequaled expertness, but he avoids or glosses over the HEAVY side-effects those on HT must endure..He promotes HT as being far less invasive as if being turned into a eunuch was a minor inconvenience..

The EFFECTIVENESS of HT on PC patients whose primary Gleason grade is 3 is well known and has been well known for many years..Dr. Myers does manage to blurt out that if your primary grade is four, the picture is not quite as rosy.. He gives Dr. Walsh a little dig, pointing out that he is very selective in choosing his patients to achieve better outcomes while he himself is guilty of much the same thing... At least Snuffy is willing to work with his patients to minimize those side-effects while maximizing the effect of the treatment, working the edges of the envelope if necessary..Not many medical oncologists are willing or able to do that..But then again, not many of them are PC survivors..
Age 68.
PSA age 55: 3.5, DRE normal.
age 58: 4.5
61: 5.2
64: 7.5, DRE "Abnormal"
65: 8.5, " normal", biopsy, 12 core, negative...
66 9.0 "normal", 2ed biopsy, negative, BPH, Proscar
67 4.5 DRE "normal"
68 7.0 3rd biopsy positive, 4 out of 12, G-6,7, 9
RALP Sept 3 2010, pos margin, one pos vesicle nodes neg. Post Op PSA 0.9 SRT, HT. 2-15-'11 PSA 0.0

BB_Fan
Veteran Member


Date Joined Jan 2010
Total Posts : 1011
   Posted 6/6/2011 1:31 PM (GMT -6)   
Thank you all for your information. I was aware of the positions of Drs Myer and Strum on this issue, but was not sure how main stream this thinking was. I have become a bit concerned lately by reading posts where Drs at places like John Hopkins and MSK where having their patients wait until PSA reached 10 before starting HT. My initial medical oncologist that suggested deferring HT was generally acknowledged to be the best in the area.
 
I was also very interested in reading the thread started by Ralfinaz on this topic. Clarified a lot of the issues for me.
 
We often recommend Dr Walsh's book to new members to the forum. It truely has a great deal of valuable information on PCa. I read it cover to cover when I was first diognosed. However, it paints a very bleak, and I believe inaccurate picture, of the impact of HT on survival for advanced PCa. Including the strong suggestion that HT should be deferred. I honestly wish he would update it.
 
Again thanks, BB
 
 
Dx Dec 2008 at 56, PSA 3.4
Biopsy: T1c, Geason 7 (3+4)
Robotic RP March 2009
Path Report: T2c, G8, organ confined, neg margins, lymph nodes - tumor vol 9%
PSA's < .01, .01, .07, .28, .50. ADT 3 5/10. IMRT 7/10.
PSA's post HT/SRT .01, < .01
End ADT3 5/11 PSA < .01
New Topic Post Reply Printable Version
Forum Information
Currently it is Wednesday, June 20, 2018 5:19 PM (GMT -6)
There are a total of 2,973,827 posts in 326,134 threads.
View Active Threads


Who's Online
This forum has 161119 registered members. Please welcome our newest member, Jude777.
458 Guest(s), 8 Registered Member(s) are currently online.  Details
1yrinVA, Jasperilla, torontolyme, floathead, Lwill351, Noah2112, RobLee, Busted1