Without much ado, I think Gene Kwon's presentation was great. Though I did not agree with everything he stated. Missing:
12. A PSA can safely rise to 0.2 before starting salvage approaches. At least two doctors I know that presented at PCRI do not agree with that. That earlier intervention once a velocity is determined is a better approach. For example if a patient goes from 0.06 to 0.12 in just four weeks why wait? That's an aggressive doubling time. It's possible in just 6 weeks it will be at 0.5.
The metformin question is still unanswered but it is in trial. metformin can have the following side effects: symptoms of lactic acidosis: unusual tiredness, dizziness, severe drowsiness, chills, blue/cold skin, muscle pain, fast/difficult breathing, slow/irregular heartbeat, stomach pain with nausea, vomiting, or diarrhea.
Even more, metformin has about
a 6 hours half life in blood plasma and is typically completely undetectable in blood plasma within 24 hours. So dosing and monitoring is difficult if a certain level of it is required for it's off label use in prostate cancer.
I'll stay on the fence about
Please note: While I work daily with the medical research teams on PCa, I am not a medical doctor. Please talk to your doctor before making decisions.