2004 Intermittant Triple Hormone Blockade/Leibowitz Protocol ~ Now 2007 looking for option B??

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New Member

Date Joined Jul 2007
Total Posts : 3
   Posted 7/17/2007 8:42 AM (GMT -6)   
I'm new here and not too sure what I'm into.  I am a 59 year old living in Sarasota, Fla.  I was diagnosed in 2004 through psa testing and a psa at 6ish before my first treatment.  I was a t1c with a gleason of 3+3 and very low mircoscopic tumor development on both sides.  The pressure to go for the "gold standard of surgery" was pretty clearly represented by the local treatment choice.  After lots of research and being educated by the PAACT newsletters, I talked a local urologist into treating me with the Intermittant Triple Hormone Blockade/Leibowitz Protocol.  For those unfamiliar, that is a 13 month blockade with LHRH shots, use of antiadrogen (casodex) and finasteride with the finasteride maintained after the 13 month blockade is completed.
At first I celebrated my good fortune when the blockade worked so well.  Three years later my psa is in the 5's, my gleason is up to 7 and I am pondering option b.  Right now I am leaning toward DaVinci surgury at Ohio State University with Dr. Vipal Patel (over 1700 procedures under his belt).  I have read just enough to be concerned that with a 7 gleason, it might not make sense to pursue surgury.  I need to finalize a decision soon as my last biopsy was july 2, 2007 and two months must pass before surgury.  My local urologist wants to give me just the LHRH shot for the interval. 
Any word of wisdom?  Prayers appreciated
Bob scool

Post edited to add a title to this thread J


Post Edited By Moderator (bluebird) : 7/17/2007 7:53:46 PM (GMT-6)

New Member

Date Joined Jul 2007
Total Posts : 11
   Posted 7/17/2007 10:02 AM (GMT -6)   


I can tell you that I recently had surgery with Dr. Patel and everything went fine. I am a few years younger- 52 with a PSA of 3.1 and a pre-opt gleason of 6(post op-7). I can only speak to the procedure and post operative results. My surgery was July 2nd, I was released from the hospital on july 3rd and I am back at work on the 16th. In my case I wanted the stuff out of me and was concerned with the risk of not being able to have surgery if I opted for radiation now. Only time will tell but all indications are pretty favorable.

With regard to Dr. Patel, he is one of a few that has done this many procedures. In fact, he was doing approx. 5 per day.  The administrative side of things was not as smooth as I would have liked to see. We were told that their practice has grown so quickly in the last 6 months or so the administrative side has not necessarily caught up. Other than that I wa taken very good care of.  The biggest benefit I found with the robotic surgery was the recovery time due in part to less blood loss (I lost only about a cup) and less invasive incisions. I am still working on the continence issue but that seems to be improving everyday. If you need more detailed info let me know I would be glad to share

good luck with what ever you decide


New Member

Date Joined Jul 2007
Total Posts : 3
   Posted 7/17/2007 10:09 AM (GMT -6)   

Thanks for the reply. I will stay in touch if I can figure this site out. I have heard that Dr. Patel is excellent also, but also was warned that OSU is a "teaching" hospital and that a new resident might actually be doing the surgery. Did you inquire about this?

New Member

Date Joined Jul 2007
Total Posts : 11
   Posted 7/17/2007 6:03 PM (GMT -6)   
Hi, Yes, I spoke to Dr. Patel about this. He does all of his own surgeries. I think you will be happy. Let me know if you have any other questions. If you would like you can e-mail directly at
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Post Edited By Moderator (bluebird) : 7/17/2007 7:37:56 PM (GMT-6)

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Date Joined May 2006
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   Posted 7/17/2007 8:28 PM (GMT -6)   

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April 3, 2006  53 on surgery day

RRP / Radical Retropubic Prostatectomy with "wide excision"

PSA 4.6   Gleason  3+3=6    T2a   Confined to Prostate

2nd PSA 02-06-2007 Less than 0.1 Non-Detectable :)


Post Edited (bluebird) : 7/17/2007 7:58:53 PM (GMT-6)

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Date Joined May 2006
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   Posted 7/17/2007 8:59 PM (GMT -6)   



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Post Edited (bluebird) : 7/19/2007 7:33:34 AM (GMT-6)

Regular Member

Date Joined Jan 2007
Total Posts : 165
   Posted 7/17/2007 9:14 PM (GMT -6)   

I highly recommend going with the surgery.  As you can see by my signature line, I was very similar to you at diagnosis, but went with the surgery.  I was very surprised at my post surgery pathology report, but at least I know how much cancer I have/had.  Now I'm going with my plan B, adjuvant radiation with hormones.  I always go back to the quote from my surgeon after he told me of the pathology report, "The best news is it's sitting in a jar of formaldeheide somewhere!"

Good luck with your decision.

PSA 4.7 (up from 3.2 one year ago)
Biopsy November 8, 2006
1 of 10 cores positive 5% LEFT Side
2 others questionable (small gland proliferation)
Gleason 3+3
Robotic surgery January 19, 2007
Post Surgery Pathology
     Stage T3a, Gleason 3+4, positive margins and
     capsular penetration RIGHT Side
Post Surgery PSA:  March 5:  0.01
5 month PSA, June 13, 2007:  0.08
Adjuvant therapy began June 26 with Zoladex injection
     Radiation to commence in late August

New Member

Date Joined Jul 2007
Total Posts : 3
   Posted 7/17/2007 10:36 PM (GMT -6)   

Thanks for the information and support. I'm sorry to hear that you are also looking for a plan B. Like you're glad you did the surgery first, I also would easily choose the Leibowitz protocol as my first primary treatment. It was a "systemic" approach and has worked for many men in his practice. I could "stay the course" and block again with some exotic cocktails added in, but now am looking forward to surgery. I'm glad to read in your stream of posts that your rising PSA does not mean re-occurance. I'm not sure how useful the adjuctive HB will be. I "triple" blocked for 13 months, knocking my Psa down to 0.1 and stayed in the normal zone until a few months ago (I started the 13 month blockade in April of 2004. After coming off the blockade my testosterone quickly rose to higher levels than pre-treatment, and have enjoyed a good sex life. There were a few negatives as well as positives about being non adrogen driven in life. I would be happy to share more of my experience if you would like.

Live Long and Prosper as Dr. Bob would say
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