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Posted 11/8/2007 5:46 PM (GMT -6)
The following article relates to a promising new drug which is in the testing stages for advanced prostate cancer patients whose prostate cancer can no longer be helped by the presently available drugs for Hormone Therapy.

 

Hormone Refractory Prostate Cancer Trial

PR Newswire

November 5, 2007

SAN FRANCISCO -- Medivation, Inc. today announced that its selective androgen receptor modulator, MDV3100, to date has reduced serum levels of prostate specific antigen (PSA), a marker of tumor growth, in the six patients enrolled in the first two dose groups of its ongoing Phase 1-2 trial in hormone refractory prostate cancer. PSA declines were seen in a dose-dependent manner in these patients. In the lowest dose group, after two months of treatment PSA levels declined 45 percent to 66 percent. PSA levels in the second lowest dose group declined 75 percent to 89 percent after the first month of treatment. MDV3100 has been well tolerated to date in both dose groups.

The ongoing Phase 1-2 trial is an open-label U.S. study enrolling prostate cancer patients who have failed standard hormonal therapies. The study is enrolling patients in up to seven dose groups of three patients each at escalating doses, with each group continuing treatment for at least three months barring any safety issues. The six patients enrolled to date comprise the two lowest dose groups, which to date have completed one and two months of treatment. Patient accrual for higher dose groups is ongoing. Once a maximum tolerated dose has been established, treatment at that dose level will be expanded to 20 patients. The study endpoints include safety, tolerability, pharmacokinetics, effects on serum PSA levels and disease progression.

"While these results are still preliminary, the declines in PSA observed at these lowest doses are encouraging and provide proof of concept that castration resistant prostate cancers can still be sensitive to alternative hormone therapies like MDV3100," said the study's principal investigator Howard Scher, MD, Chief of the Genitourinary Oncology Service and the D. Wayne Calloway Chair in Urologic Oncology at Memorial Sloan-Kettering Cancer Center.

"The significant, rapid onset PSA declines experienced to date by our first six hormone refractory prostate cancer patients treated with MDV3100 mark an auspicious beginning to this trial," said David Hung, MD, president and chief executive officer of Medivation. "These declines occurred in a clearly dose-dependent manner at the lowest doses of MDV3100 tested, which suggests that higher doses may produce even greater PSA declines."

"It is important to consider these data in their proper context," continued Dr. Hung. "These PSA reductions are early data from a small number of patients. We do not yet know whether they will be confirmed at the end of the study, and even if they are confirmed we do not know if PSA reductions will correlate with an improvement in overall survival, the standard registration endpoint used in most pivotal Phase 3 studies for hormone-refractory prostate cancer. Nonetheless, we believe these early data provide strong proof of concept for MDV3100, and we eagerly await additional study data from these first two groups as well as from the higher dose groups still to come."

Medivation expects to complete the study, and report final top-line study results, in 2008. If these results are positive, Medivation expects to seek U.S. Food and Drug Administration (FDA) agreement in 2008 to enter pivotal Phase 3 registration studies in hormone refractory prostate cancer.

 

 

Posted 5/15/2008 8:59 AM (GMT -6)

I think this is useful information to this forum.  While the FDA has not yet approved HI FU treatment in this country, they are permitting clinical trials.  Inasmuch as I had proton radiation therapy, I am interesting to keeping up to date as to treatment possibilites for failed radiation therapy (i.e., the PSA starts to rise again sometime after treatment). I have also included a description of HI FI treatment. I know that many members have posted threads on HI FU treatment.  Dave

FDA Approves HIFU Clinical Trial For Recurrent Prostate Cancer (for men who have failed external beam radiation therapy)

PR Newswire

May 13, 2008

DELAND, Fla., -- USHIFU, LLC, the clinical trial management provider for Focus Surgery, Inc. (Indianapolis, IN), is pleased to announce conditional written approval pending minor changes to the protocol from the FDA to begin a pivotal trial for the treatment of recurrent prostate cancer with the Sonablate(R) 500 in men who have failed external beam radiation therapy.

Dr. Herbert Lepor, Chairman of Urology at NYU School of Medicine and medical monitor for the trial said, "It is my pleasure to serve as the medical monitor for the prostate cancer clinical trial program evaluating the safety and effectiveness of the Sonablate(R) 500 HIFU device."

"I have personally reviewed the preliminary data and observed the Sonablate(R) 500 in action and I am impressed with this advanced technology for ablating the prostate. These rigorous clinical trials will help define the appropriate role of the Sonablate(R) 500 device in the treatment of prostate cancer," Lepor added.

This trial will be conducted at various sites across the U.S. and is expected to enroll approximately 202 subjects and 10 clinical centers. This clinical trial is based on results from the feasibility trial completed in October 2007 which enrolled 11 subjects from two clinical research sites within the U.S. Ten of the eleven subjects had failed external beam radiation therapy prior to participating in the clinical trial. The results of this feasibility trial provided a basis for the pivotal study. Additional studies are still needed to satisfy the safety and effectiveness standards, including long term outcomes, set by the FDA for marketing approval.

The Sonablate(R) 500 is not approved for use in the U.S. The Sonablate(R) 500 remains investigational in the U.S. and is being studied for the treatment of prostate cancer in clinical trials in the U.S. FDA has made no decision as to the safety or efficacy of the Sonablate(R) 500 for the treatment of prostate cancer.

The Sonablate(R) 500 was developed by Focus Surgery, Inc. and is manufactured by Misonix, Inc. who also holds distribution rights in Europe. Takai Hospital Supply Ltd. and THS International distribute the Sonablate(R) 500 in Southeast Asia and the Middle East.

http://www.cancercompass.com/cancer-news/1,14157,00.htm?c=1004:5:1:2

*********************************************************

Subject: RE: Brachytherapy or High Intensity Focused Ultrasound(HIFU)
Date: 05/13/2008

I have just taken my Sonablate HIFU treatment on March 29, 2008. When I researched that various types of prostate procedures, my biggest concern was incontinence. The problem with radiation treatment was that it could damage so much of the surrounding tissue including the bladder and urinary sphincters and rectal wall and rectal sphincter as well. With Brachytherm one source stated that the patient should not be near children or pregnant women. If the radiation coming off the patient could create a problem for those persons than what could it also do to other organs within the man's body. I was talking to a member of a prostate cancer support group who has not had his treatment and his urologist after discussing various options commented that the beads in Brachytherm can move by getting into the blood stream. The urologist stated that he had a patient who had a couple of beads move through the blood stream from the prostate to the lung.

    I had initially chose the Albatherm for my treatment but my prostate was too large, 72 cc, so I had to reduce it using hormone treatment, Androgen deprivation therapy using a Zoladex implant and Casodex pills and later Avadart. Needless to say the prostate did not get below the 40cc size needed for the Albatherm. I had stated to look at the Sonablate system which can treat prostates that are 50 cc, mine was at this time 43.5cc. I wasn't too sure about the Sonablate system as the write up gave me the impression that the doctor was moving the machine for each treatment and I could not see how a doctor could move the probe one to two millimeters. After a more detailed examination of the system I realized that the doctor only positioned the probe in the rectum then locked it down. The transducer, the component that emits the ultrasound, moved within a cylinder in the probe. The Albatherm had the probe move back and forth in the rectum for each plane of treatment.

Differences and similarities

Both machines include a motion detector and a rectal temperature monitor. Because the machine is taking such as small strip of tissue and heating it to 80 to 90 degrees Celius you cannot have any movement as that would cause the machine to hit the wrong target. The motion detector causes the machine to shut off thus protecting the wrong tissue from being destroyed.

Both machines have the probe covered by a condom that has degassed water pumped in to swell the condom to make a tight fit to the rectal wall. The water is cooled to keep the transducer and rectal wall cool. This avoids any heat damage that may occur to the rectal wall.

The Sonoblate machine has its transducer ( the sound emitting device) in a cylinder attached to the end of the probe. The transducer consists of two transducers one for deeper treatment and one for shallower treatment. The transducer moves within a cylinder at the end of the probe so the probe does not move once it is positioned. Both probes can be used to for treatment or imaging. The Sonablate machine takes images after each treatment shot so the doctor has a continuous upto date image of the prostate and any changes that occur during treatment. The prostate will swell with the first shot to increase in size about 10% at least that is what happened with my prostate. As pointed out the Sonablate has a doppler imaging system to give good color and identification of the nerve and vascular (blood vessel) bundles.

The Albatherm has one transducer at the end of the probe and it is fixed. The whole probe moves back and forth in the rectum during the treatment phase. The Albatherm can take only one picture at the beginning of the procedure as it requires a different transducer to take the image. That transducer must slide out into position while the treatment transducer is retracted. The imaging system can identify the nerve and vascular bundles.

The Sonablate procedure has the man lying on his back with his legs up in stirrups. You are under a spinal but can also be under a sedation to make you sleep. However, in the Sonablate procedure a patient can in fact not take the sedation and so be awake through the whole process. I was awake during my procedure.

The Albatherm procedure has the man lying on his right side on the Albatherm table and he has both the spinal and the sedation for the procedure. No option to be awake.

Both have good result with incontinence and erectile dysfunction. The Sonablate procedure has stats of 0.6% incontinence. The Albatherm stats shows a 5 to 6% with most of that type I or II incontinence which means the man will get a drop or two when he exerts himself in activities like lift a weight or swinging a golf club. Their stats show that a very small number may show a more serious type of incontinence but this is very rare. Remember that Albatherm has better stats data that Sonablate as the Albatherm has been monitoring for a long time and Sonablate systems have not. Erectile dysfunction is stated at 20% but I think this is too high as the updated technology has improved the systems and the use of Cialis after the catheter is out will help regain the erectile function. I know that Sonablate treatment includes Cialis but the Albatherm as far as I have seen does not.

The Albatherm frequently will have the patient undergo a TURP (transurethral resection of the Prostate) in order to reduce the size of the prostate and apparently this also eliminates the pain after the treatment. The Sonablate system does not use the TURP. The TURP can cause its own problems and there is a risk of damaging the sphincters that control urine flow even though this maybe a low risk.

The Sonablate machine takes a treatment strip that is 1 to 2 mm by 10 to 15 mm long while the Albatherm machine takes a strip that is 1 to 2 mm by 18 to 24mm long. The Sonablate system divides the prostate into 3 zones with each zone consisting of two blocks. The Albatherm does not appear to have zones but only blocks across the entire prostate. The Sonablate with its smaller strip length can get into tighter corners of the prostate.

I hope this will help you. If you check www.yanonow.net site you can see various people stories on all the treatments. Mine is there too under TV.

http://www.cancercompass.com/message-board/message/single,23957,2.htm

 

 

Posted 5/15/2008 10:16 AM (GMT -6)

Long-Term Hormone Treatment After Radiation Helps Men with High Risk Prostate Cancer Live Longer

November 1, 2005 --Doctors in Canada say that treating high-risk prostate cancer patients with radiation therapy and adding hormone therapy for more than one year allows the patients to live longer, have better control of their prostate specific antigen levels and lowers the rate of death specifically from prostate cancer.

A total of 307 patients with a PSA level greater than 20 were split into two groups, both with a similar demographic of age, Gleason score and tumor stage. The first group had 151 patients receiving hormone therapy for less than 12 months (short term) and the second set had 156 patients receiving hormone therapy for more than 12 months (long term). Both groups were treated with hormone therapy in conjunction with external beam radiation therapy.

In the long-term hormone therapy group, 62.5 percent of patients showed a greater control over their PSA level, compared with 37 percent in the short-term group. The five-year overall survival rate was 87.5 percent for the long-term group and 75 percent in the short-term group. The chance of dying of prostate cancer was reduced from 18 percent to 6 percent in the long-term group.

"Other randomized trials have shown the benefit of combining radiation and hormone therapy in the treatment of prostate cancer. However, some of those reports appear to be restricted to patients with a high Gleason score," said Eric Berthelet, M.D., lead author of the study and a radiation oncologist at the BC Cancer Agency in Victoria, British Columbia, Canada. "This study proves that long-term hormone therapy used in consort with radiation therapy improves survival rates for high-risk patients, regardless of their Gleason score or tumor stage."

Dr. Bethelet's study was published in the November 1, 2005, issue of the International Journal of Radiation Oncology*Biology*Physics, the official journal of ASTRO, the American Society for Therapeutic Radiology and Onocology. View the abstract of Dr. Eric Bethelet's article at PubMed.

http://www.psa-rising.com/med/hirisk/longhormone_ebr05.htm

Posted 6/19/2008 6:33 PM (GMT -6)
This study appears to be a significant finding for those who have to face recurrent prostate cancer after surgery.

Radiation Therapy Prolongs Life in Men With Recurrent Prostate Cancer

AScribe News

June 17, 2008

BALTIMORE -- Men whose tumors recur after prostate cancer surgery are three times more likely to survive their disease long term if they undergo radiotherapy within two years of the recurrence. Surprisingly, survival benefits were best in men whose new tumors were growing fastest, according to results of a "look-back" study of 635 men by Johns Hopkins Medical Institutions researchers reported June 18 in the Journal of the American Medical Association.

Previous studies of radiation therapy for recurrent prostate cancer found that it reduced disease progression, but this study demonstrates that it significantly prolongs survival, as well, according to Bruce J. Trock, Ph.D., associate professor of urology, epidemiology, oncology, and environmental health studies, and director of the Division of Epidemiology in the Brady Urological Institute at Johns Hopkins.

"What this new study tells us is that even men with aggressive disease that has recurred after surgery appear to benefit from radiation therapy. It also means that we may be able to give radiation selectively to those who are really likely to benefit from it," advises Trock.

"I found the results of this study remarkable," says Patrick C. Walsh, M.D., University Distinguished Service Professor of Urology at the Brady Urological Institute. "Previously, we believed that these men -- who have aggressive disease defined by a rapid doubling of PSA in six months or less -- had distant metastases and would not benefit from any form of local salvage therapy."

PSA, or prostate specific antigen, is the blood-based protein shed by the organ that signals the likely presence of cancer. Rapid rises in PSA levels after surgical removal of the prostate signal the recurrence of cancer and often convey a poor prognosis.

Approximately 30 to 40 percent of men with high-risk tumors experience no recurrence of their cancers after surgery and can be spared the side-effects, that is, urinary and bowel problems, that may come with radiation. So, the Johns Hopkins researchers were looking to determine whether radiation could improve survival in men with recurrent prostate cancer and the optimal timing for the therapy.

In the new study, the researchers reviewed records of 635 men who developed recurrent cancer following radical prostatectomy at Johns Hopkins Medical Institutions between June 1982 and August 2004. Of these, 397 received no salvage radiation therapy, 160 received only salvage radiation, and 78 received both salvage radiation and hormonal therapy. Median follow-up was six years after recurrence.

Among men who had received radiotherapy for prostate cancer recurrence, the probability of surviving 10 years was 86 percent, compared to 62 percent among those who did not have radiation. For patients with rapidly growing tumors, defined by a PSA doubling time of less than six months, the benefits of salvage radiation therapy existed regardless of Gleason score, a numerical value that measures prostate cancer aggressiveness.

"This review suggests that even patients with aggressive cancer at the time of surgery not only benefit from salvage radiation therapy, but also actually live longer without a second prostate cancer recurrence," says Theodore L. DeWeese, M.D., professor and chairman of the Department of Radiation Oncology and Molecular Radiation Sciences. "This is the most important news for this group of patients in a long time."

DeWeese suggests that radiation oncologists and urologists now consider salvage radiation therapy for a broader group of patients with recurrent prostate cancer following surgery.

In addition to Trock, Walsh and DeWeese, the research team included Misop Han, M.D., of the Brady Urological Institute at Johns Hopkins; Stephen J. Freedland, M.D., of the Surgery Section, Durham Veterans Affairs Medical Center and Duke Prostate Center, Departments of Surgery and Pathology, Duke University School of Medicine; Elizabeth B. Humphreys, M.S. of the Brady Urological Institute at Johns Hopkins; and Alan W. Partin, M.D., Ph.D., of the Brady Urological Institute at Johns Hopkins.

Funding for this study was supported in part by the National Cancer Institute, gifts by Dr. and Mrs. Peter S. Bing, the Department of Defense Prostate Cancer Research Program, and the American Urological Association Foundation's Astellas Rising Star in Urology.

http://www.cancercompass.com/cancer-news/1,14377,00.htm?c=1004:5:1:2

Posted 6/19/2008 10:41 PM (GMT -6)
Great to hear from you Dave,
I am still awaiting results for those who chose to have HT and radiation pre-recurrance. I am doing well, but stand in uncertainty.

I hope you are still doing well. We missed you!

Tony
Posted 6/20/2008 12:34 AM (GMT -6)
Hi Tony

Nice to get your message. While I may be out of sight from time to time, I am not out of mind about the many wonderful members here, especially you! You have contributed so much to this forum and have had to face major challenges with your PCa. I continue to hope and pray that you and others like you will be winners. Hopefully PCa research will eventually produce miracles for those who have to face advanced prostate cancer. Your uplifting and positive outlook on life is a total inspiration to all of us. I know that the uncertainty you have to live with is not easy, but keep the faith. God Bless!

Dave
Posted 6/20/2008 5:26 PM (GMT -6)
been there done that will advise next month Positively speaking
Posted 6/20/2008 5:50 PM (GMT -6)
Dave,
Many thanks for posting that. I have been doing a bit of reading on post surgery radiation and it was most helpful.
Bill
Posted 6/20/2008 6:17 PM (GMT -6)
I have always wondered why recurrent cancer after surgery is called "failed surgery". If it comes back after radiation do they call it "failed radiation"?

Jim
Posted 7/3/2008 9:33 PM (GMT -6)
While HIFU treatment has not yet been approved by the FDA for use in the U.S., they have approved trials for this treatment which are now underway.  HIFU treatment, which is relatively new (especially outside of the U.S.) looks like a promising initial treatment for PCa.  HIFU apparently also has the potential for treating recurrent prostate cancer in men who have failed external beam radiation therapy. 

ABC News Nightline Features HIFU With Sonablate 500 As Non Invasive Treatment Option For Prostate Cancer

PR Newswire

June 27, 2008

CHARLOTTE, N.C. -- USHIFU, LLC, the exclusive distributor of the minimally invasive Sonablate(R) 500 for prostate cancer treatment in North and South America, announced that the June 16, 2008 edition of ABC News NIGHTLINE featured a segment on high intensity focused ultrasound (HIFU) for treating prostate cancer outside of the United States using the Sonablate(R) 500.

According to the segment, men diagnosed with prostate cancer have the ability to travel outside of the United States to receive HIFU, a non invasive, outpatient procedure for prostate cancer.

The segment failed to mention that the Sonablate(R) 500 HIFU treatment is currently involved in two different FDA-approved clinical trials in the United States to gather data important for analysis of the technology by the FDA. The first is a pivotal trial for the treatment of primary organ confined prostate cancer that will enroll 466 participants at 24 different centers. A second pivotal trial will begin for the treatment of recurrent prostate cancer in men who have failed external beam radiation therapy.

Dr. Herbert Lepor, Chairman of Urology at NYU School of Medicine and medical monitor for the trials said, "I have personally reviewed the preliminary data and observed the Sonablate(R) 500 in action and I am impressed with this advanced technology for ablating the prostate. These rigorous clinical trials will add to the international data already available and will further help define the appropriate role of the Sonablate(R) 500 device in the treatment of prostate cancer," Lepor added.

If patients meet the enrollment criteria they may qualify to enroll in the U.S. HIFU clinical trials. For more information about the clinical trials eligibility criteria call USHIFU at 1-877-874-4389.

"HIFU offers non invasive treatment option for men who are looking for a therapy that will not completely disrupt their lives. A story on a prominent news program, such as ABC, NIGHTLINE increases awareness of the procedure and encourages people to conduct personal research to see if HIFU is a treatment option they should consider," said Steve Puckett, Jr., USHIFU Chief Executive Officer.

In the program, NIGHTLINE followed HIFU patient Richard Brightmire, as he traveled to Cancun, Mexico to have HIFU in February. According to the story, Brightmire chose HIFU because he wanted to preserve his quality of life and he was not satisfied with the other treatment options that were presented to him.

Four months after his procedure, Brightmire's PSA is zero and he has maintained his quality of life. "I'm doing fine since the HIFU procedure. Everything is back to normal," Brightmire said.

"I think that NIGHTLINE stressed sexual preservation as the main reason for going with HIFU. It's my belief that sexual preservation is only one of several important aspects," Brightmire continued. "For me, I went with the procedure because of the results outside the U.S. that show it to be non-invasive and show a lower risk of long-term hospitalization, and a lower risk of incontinence as well as impotence especially compared to surgery and other treatments available today."

USHIFU recognizes that, as the segment mentions, not all physicians are advocates of new prostate cancer therapies, "We understand that there is a very high bar of scrutiny for new prostate cancer treatment modalities, as there should be," Puckett said. "We highly encourage physicians to evaluate the technology for themselves and explore the international clinical outcomes that exist."

"In the program I found it particularly interesting that Dr. Patrick Walsh, of John Hopkins University was referenced as an expert with regards to HIFU. To my knowledge he has never seen or used our technology. We extend an invitation for him, as well as any other physician, to come see HIFU firsthand and learn," Puckett added.

The Sonablate(R) 500 was developed by Focus Surgery, Inc. and is manufactured by Misonix, Inc. (Nasdaq: MSON) who also holds distribution rights in Europe. Takai Hospital Supply Ltd. and THS International distribute the Sonablate(R) 500 in Southeast Asia and the Middle East.

Dr. Herbert Lepor, Chairman of Urology at NYU School of Medicine and medical monitor for the trials said, "I have personally reviewed the preliminary data and observed the Sonablate(R) 500 in action and I am impressed with this advanced technology for ablating the prostate. These rigorous clinical trials will add to the international data already available and will further help define the appropriate role of the Sonablate(R) 500 device in the treatment of prostate cancer," Lepor added.

If patients meet the enrollment criteria they may qualify to enroll in the U.S. HIFU clinical trials. For more information about the clinical trials eligibility criteria call USHIFU at 1-877-874-4389.

"HIFU offers non invasive treatment option for men who are looking for a therapy that will not completely disrupt their lives. A story on a prominent news program, such as ABC, NIGHTLINE increases awareness of the procedure and encourages people to conduct personal research to see if HIFU is a treatment option they should consider," said Steve Puckett, Jr., USHIFU Chief Executive Officer.

In the program, NIGHTLINE followed HIFU patient Richard Brightmire, as he traveled to Cancun, Mexico to have HIFU in February. According to the story, Brightmire chose HIFU because he wanted to preserve his quality of life and he was not satisfied with the other treatment options that were presented to him.

Four months after his procedure, Brightmire's PSA is zero and he has maintained his quality of life. "I'm doing fine since the HIFU procedure. Everything is back to normal," Brightmire said.

"I think that NIGHTLINE stressed sexual preservation as the main reason for going with HIFU. It's my belief that sexual preservation is only one of several important aspects," Brightmire continued. "For me, I went with the procedure because of the results outside the U.S. that show it to be non-invasive and show a lower risk of long-term hospitalization, and a lower risk of incontinence as well as impotence especially compared to surgery and other treatments available today."

USHIFU recognizes that, as the segment mentions, not all physicians are advocates of new prostate cancer therapies, "We understand that there is a very high bar of scrutiny for new prostate cancer treatment modalities, as there should be," Puckett said. "We highly encourage physicians to evaluate the technology for themselves and explore the international clinical outcomes that exist."

"In the program I found it particularly interesting that Dr. Patrick Walsh, of John Hopkins University was referenced as an expert with regards to HIFU. To my knowledge he has never seen or used our technology. We extend an invitation for him, as well as any other physician, to come see HIFU firsthand and learn," Puckett added.

The Sonablate(R) 500 was developed by Focus Surgery, Inc. and is manufactured by Misonix, Inc. (Nasdaq: MSON) who also holds distribution rights in Europe. Takai Hospital Supply Ltd. and THS International distribute the Sonablate(R) 500 in Southeast Asia and the Middle East.

http://www.cancercompass.com/cancer-news/1,14415,00.htm?c=1004:5:1:2

Posted 7/5/2008 12:32 PM (GMT -6)

Fernc please contact me or any moderator by email concerning your posts to these 3 threads here and the one in Breast Cancer concerning ambiolife.com.  Forum rules state spamming isn't allowed and describe what is considered spamming. Your posts seem to be doing that, but you have no email address available for me to contact you privately.  If I don't receive a response, I will have to delete your posts to these threads. Thank you... 

Posted 8/27/2010 10:04 AM (GMT -6)
I started with a psa of 21 two years after a physical that was normal. My biopsy indicated 16 positive samples out of 16. Gleason scores were all 9's and 10's. A radical prostatectomy was scheduled and it was unsuccessful. I lost all nerves, ducts and am 100% incontinent. This was followed by 39 surgical salvage radiation treatments. I subsequently contracted a staff infection that was nearly fatal. 18 months after radiation my psa began to elevate. Three month readings were .1, .18, .23, 1.4, 1.8, 2.6. Our plan is to wait until the psa hits 5.0 and then begin fragmented hormone treatments. This may be followed by Provenge and Chemo.

I have a loving wife, a daughter in college, one more to start and a little boy who is 12. I am still working and will continue until I'm prevented from working.

I would like to know if this is the proper treatment plan and I'm buying as much time as possible.
Posted 8/27/2010 6:45 PM (GMT -6)
Thanks,this hepl us to get knowlodge about p.c. yeah

Posted 8/28/2010 8:33 AM (GMT -6)
eHigh:

It would be best to repost as a new topic rather than at the tail of a 3 year old thread.
Nonetheless: I am unfamiliar with the term "fragmented" used with hormone therapy. This sounds like radiation language. Also, the Provenge treatment has been approved for men who are hormone refractory and after chemo fails. This is far, far from where you stand at this time. The cost of Provenge, ~100,000$, means that any man seeking it outside of the approved qualifications is unlikely to find it paid by insurance, and even within the trial standards it is just now undergoing a Medicare cost analysis to determine if it will be covered by public funds.
What does your doctor advise? You should not base your treatment plan based on comments from anyone here.
Posted 8/30/2010 8:40 AM (GMT -6)
Thank you. tarhoosier. I have followed my doctor's advise. It's just difficult to watch the psa increase and do nothing.
Posted 9/3/2010 9:40 AM (GMT -6)
Dave,
I know there is no talk about Clinical Trials allowed at this site. I am confused as to why. After prostate removal in 2005 I started HT (known cancerous Lymphnodes) and continue the Casodex/Lupron treatment today. Recurrent cancer was found 4/2010 by my GP (A 3'5" tumor in my abdomen and yet my PSA was under 1) and I started chemo emmidiately. The cancer continues to grow and I am currently going thorugh RT for a couple weeks in preperation of Clinical Trials (to start 9/13/2010).
I know nothing about CT's becuase my Oncologist will not discuss it, my Radiaology team won't discuss it and the HealingWell forum won't discuss it. I was told to wait till I meet with my new Oncologist to see if I qualify and furthur get an explanation of what CT's are.
Age 47, 34 PSA Gleason 4.5 + 4.5 =9
Prostate removed 2005
Casodex/Lupron Treatment 2005 to current
PSA remained under 2 through-out the treatment.
April 2010 Tumor discover PSA .08
Chemo 4/2010 till 8/2010
RT 8/2010 through 9/10/2010
Meeting with CT Oncologist 9/13
Posted 9/3/2010 10:41 AM (GMT -6)
ahiinc, I am sorry, but you must be confused a little. Talking about clinical trials is fine, even recommended. Maybe you mixed that up with the rules about surveys?
Posted 9/7/2010 10:52 AM (GMT -6)
JamesC
As a new member I did read the Rules for Posts and item # 6 was not to discuss Clinical Trials with-out first clearing it with the Moderator. Since I was informed my best chance for survival was Clinical Trials I have been trying to learn as much as possible. I've not seen much in the way of postings and I am still looking for a source for info. I definetly feel like I am out of the loop relative to this subject and I feel I am alone in my quest to find info on Clinical Trials. In my search on the Forum I have been unable to find a thread specific to Clinical Trials. Any help would be appreicated.
SteveC
Posted 9/7/2010 12:57 PM (GMT -6)
Steve, well I'll be darned, I never noticed that before. I always just saw research projects and surveys. I interpret the clinical trials part the same as the other, as someone coming here to find people to participate in their research, survey or clinical trial. I find no problem or way to interpret it that members can't discuss current or proposed clinical trials for information purposes. I have posted info on at least one, by the American Cancer Society dealing with ED drugs, and severl other trials have been discussed, covering a vast area.

As to why there isn't much discussion about them, maybe this exchange will serve as a tease or tickler to get some of the more knowledgeable to share.
Posted 8/8/2011 7:26 PM (GMT -6)
I just finished SRT with 12 months of ADT3. My results were very good, so far. Side effects of HT were many, but merely annoying for me. Will post more details tomorrow. Hitting the sack now.
Posted 10/6/2012 1:39 PM (GMT -6)
Dave great post!
My husband had Radical surgery 18 months ago. His PSA has been 0.01 for 18 months then went to 0.03 one month later .013 two month 0.19. He has started Trelstar and radiation will start in another week. 12 0f 12 cores positive 4+5=9 and 5+4=9, Final Gleason 9, T3b. invaded the seminal vesicles right side. Positive margin right side. The oncologist thinks it is still in the prostate bed, We shall see.
Thank you for all of this information.
Diane
Posted 3/8/2013 9:43 PM (GMT -6)
Diagnosis in 2009 (Feb) with a psa of 7.9 and gleason 7 (3+4) and 6 (3+3).
Radiation treatment followed with non seed brachy therapy.

November 2012 PSA 17
December 2012 PSA 18.43
January 2013 PSA 24.98

No biopsy, mri or CTscan. Bone scan was negative.

No alternatives were offered. Went directly to hormone therapy of Casodex and Eligard.

Asked doctor to have some sort of scan done and they have refused. I have no idea of where the cancer is or if it is still in the prostate, lymph nodes, or some other organ. Not very happy about that. Somehow seems incomplete to me.
Posted 3/9/2013 12:35 AM (GMT -6)
hlc1948,

I think you are absolutely right to want to locate where the cancer is. It might be micrometastatic, in which case you won't be able to locate it with any current imaging. However, in case it's oligometastatic (localized in just a few places) it may still be treatable with SBRT radiation.

A few suggestions:

I don't know where you're located, but if you're in the US, I would suggest you contact Dr. Mukesh G. Harisinghani at Mass. General who is the expert on lymph node imaging techniques, including feraheme MRIs and others.

If you're in Europe, the place to go is Dr. Fortuin at Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.

USPIO MRI is available thru Dr Myers or Dr Dattoli at Sand Lake imaging in FL.

Not as good as the above but still lots better than a bone scan, are C11 PET scans. C11 Choline PET scans are only available at the Mayo Clinic, as far as I know. C11 Acetate PET scans are available at Arizona Molecular Imaging, U Kansas, UCLA and perhaps a few other places. C11 only has a half-life of 20 minutes, so they have to make it fresh in a cyclotron, produce the molecule, and inject you with it quickly.

Next best would probably be F18 Choline PET scans, and then NaF18 PET scans.

You will have to come off ADT and let your PSA rise a bit before any of these will be able to detect any metastases.

I hope you are able to find and nuke the suckers.

- Allen
Posted 3/9/2013 2:22 PM (GMT -6)
pc dave good thread. What makes this thread so good is the way you framed initial post. You touched an important point here.
Posted 3/9/2013 3:58 PM (GMT -6)
I must read the dates of these " new posts " I understand why they are bumped, I just always feel I have been punked. I end up writing a post complementing the originator, and am in fact complimenting the mysterious bumper. Its unsettling. PCdave if you are out there in the cybrbased past thank you. Bumper if you are out there thank you…. I guess!
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