Even my onco doc doesn't pooh-pooh this line of thinking and of course being the nice inquistive type whom enjoys the transparency of what is really going on in patient care, have this to contemplate. So you are a newbie to usually a uro-doc because of the prostate issues envolved (not always a uro though). Now when it comes the time to have the patient put on any PCa controlling drugs, the choice is often narrowed down just to Lupron and seldom are patients given casodex or its equals, prior to prevent 'T' flare issues which can be real and in some rarer cases even threatening or debilitating.
Is it ignorance, is it arrogance, is it for other nice reasons. Remember these uro-docs and others go to seminars and junkets from drug companies and have salemen pushing their drug sales in fun incentive like ways (all because they love you the patient). So, at these meetings that sometimes include their question and answer sessions, I believe the subject is well known...how to maximize profits...today it is all about business...only a chump or sucker would attempt to be altruistic is the mentality (now zufus that is harsh-LOL). So, I believe they know plenty and play dumb to patients, we noticed this happen numerous times when talking about estrogenic drugs, alternative medicines, special scannings, color doppler, knowledge of their PCa specialist competitors (who?)- Leibowitz, Scholz, Strum, Myers? Kind of like playing the foreign language cards, no comprendo (LOL). So then let's contemplate why is this happening, books and things say to prevent 'T' flare, one guy died from complications of such in Dr. Strum's book.
Well if the doc risks putting you on casodex or generic versions of it, the person while waiting the 14 days or longer before you get than excellent Lupron (LHRH) injection, what if the dumb patient gets a psa test somewhere? He might find out hey it works well, my psa dropped decent already and the side effects are tolerable it seems and less doctor office visits= NO profit syndrome setting in for the uro-doc or perveyor of the drugs. This revenue loss is huge per year, then add up the number of patients you could have doing this drug and so sad your life style is inflicted big time. Remember we are running a business, Dr. Premoli in Argentina is using estradiol patches on his patents and getting excellent results, however here it must be illegal to consider such thinking (no profits).
In Dr. Strum's book he points out that in non-refractive patients (not hrpca patients), so like newbies and HT naivee patients, these two drug scenarios were found equal in effectives (do look at the comparison):
casodex+proscar (choice 'A') no profits for the docs period, pharma make some $$$
Lupron(LHRH)+casodex (choice 'B') even with those 2 combined, which is not commonplace in patients, many just get the LHRH
Those patients results were almost perfectly equal, in non-refractive scenarios. Gee no wonder your uro-doc doesn't mention various choices....loss of revenue. Just for fun try telling your uro-doc (or other supplier), hey I want casodex instead of Lupron and then listen to his argument, how valid is it...perhaps he is well trained in sales from the seminars how to handle objections. Anyway you get to contemplate everything in PCa and the medical world, notice the new PCa drugs even for pills ('Abby') around $5000 per month, of course as the new vista in acceptable charges for your issues. Just sayin cash is king, we need a patients lobby to set it on a straighter course, or be the door mat. Just a thought, hopefully I am totally wrong.
Post Edited (zufus) : 6/13/2011 5:18:16 AM (GMT-6)