Next chapter in my odyssey

17mo's after salvage radiation my psa is on the rise (see below). The
med onc I saw at MSKCC suggests I participate in trial. For guys like
me...high doubling time, psa>0.1, no mets, primary therapies failed
etc, etc.

It's a randomized study - 2 arms:

Arm A) Docetaxel every 3 weeks for 10 treatments, Leuprolide - every 3
months for 18 mo's and Bicalutamide - 1st month orally.

Arm B)Leuprolide - every 3 months for 18 mo's
Bicalutamide - 1st month orally.

With Arm A patients receive a steriod (dexamethasone) several times a
week to lessen to docetaxel.

Spoke to my rad onc who is a great guy thinks hitting this thing hard
is probably smart. Also thinks worthwhile to see what other Natl Care
Centers have going just to due my diligence. So I'm probably going
back to Hopkins to see a the med onc who I sought a 2nd opinion before
I chose salvage radiation.

Curious if anyone out there has any experience with these meds/ I
presume I should be able to work thru this? As always I appreciate
input, feedback, suggestions.


CURRENT AGE = 51, Overall good health (need to lose weight).
6/03 - PSA 2.0, 6/04 - PSA 2.5, 8/05 - PSA 4.2, 11/05 - PSA 5.89
BIOPSY 8/16/05, T2A, 3+5 = 8
RP 12/13/05
PATHOLOGY GLEASON 3+5=8
TERTIARY 4, SEMINAL & LYMPH - NEG
EXTRACAPSULAR EXTENSION TO MARGIN
POSITIVE MARGIN - RIGHT APEX
PSA POST RP 1/26/06 = 0.5, 2/1/06 = 0.55
PSA on 3/27/06 = 0.95
START SRT ON 3/27/06
FINISHED SRT 5/19/06
06-20-06 - PSA 0.24
07-08-06 - PSA 0.15
09-14-06 - PSA 0.10
12-19-06 - PSA 0.08
02-07-07 - PSA 0.09
08-17-07 - PSA 0.31
10/02/07 - PSA 0.48

"DominicM" <dmarrese@gmail.com> wrote in message
news:1191721412.294801.262410@y42g2000hsy.googlegr oups.com...
> 17mo's after salvage radiation my psa is on the rise (see below). The
> med onc I saw at MSKCC suggests I participate in trial. For guys like
> me...high doubling time, psa>0.1, no mets, primary therapies failed
> etc, etc.
>
> It's a randomized study - 2 arms:
>
> Arm A) Docetaxel every 3 weeks for 10 treatments, Leuprolide - every 3
> months for 18 mo's and Bicalutamide - 1st month orally.
>
> Arm B)Leuprolide - every 3 months for 18 mo's
> Bicalutamide - 1st month orally.

I'm not a doctor or any kind of expert. My admittedly inexpert
and superficial opinion is that there are some good reasons to be
in this trial and some good reasons not to. Which reasons apply
to you, only you can say.

----- Here are the reasons I can think of for it:

There is apparently some evidence that hormone therapy is more
effective when given early. As I understand it, men who get HT
early live longer than men who wait. Not all doctors agree with
that, but there are many that do and there are some significant
studies that support it.

It is conceivable that chemotherapy plus hormone therapy will
kill off very large amounts of cancer, perhaps giving you extra
years of life, perhaps giving many extra years. I don't know.
Clearly, no one knows for sure or else there wouldn't be this
trial.

Even if you are assigned to the arm that does not receive chemo,
the odds are good that the HT alone will keep the cancer from
progressing much during the 18 months of the trial. At the end
of that time, if it looks like the chemo was doing some good, you
could ask for it and perhaps be in just as good, or almost as
good, a position to benefit from it as at the start of the trial.
You need to ask the trial adminstrators whether you will be
offered chemo at the end of the 18 months if you are in arm B and
arm A is successful.

Participation in a clinical trial often gives you access to a
higher level of expertise, and more sophisticated testing, than
most men get via their regular insurers.

----- And here are the reasons I can think of against it:

If your PSA is rising slowly, it is possible that you could go
for years without needing any therapy at all. During that
period, you will not suffer any of the side effects of HT, which
can be significant. There will also be no side effects of chemo.

Some doctors, including the well regarded Dr. Walsh of Hopkins,
believe there is little or no benefit of early HT as compared to
late HT.

It is conceivable that you will last long enough without
treatment that some new, more effective and/or less deleterious
treatment than the ones available today will become available.

-----

Unfortunately, either decision involves risks and unknowns.

> With Arm A patients receive a steriod (dexamethasone) several times a
> week to lessen [the side effects] to docetaxel.
>
> Spoke to my rad onc who is a great guy thinks hitting this thing hard
> is probably smart. Also thinks worthwhile to see what other Natl Care
> Centers have going just to due my diligence. So I'm probably going
> back to Hopkins to see a the med onc who I sought a 2nd opinion before
> I chose salvage radiation.

Your rad onc knows more than I do and is in favor of aggressive
treatment. That's a point for it. Seeing another expert whom
you already know to be good for a second opinion also seems like
an excellent idea.

> Curious if anyone out there has any experience with these meds/ I
> presume I should be able to work thru this? As always I appreciate
> input, feedback, suggestions.

Lots of us have experience with leuprolide (Lupron, Zoladex,
etc.) and bicalutamide (Casodex).

They suppress testosterone, which has more effects on the body
and the mind than one might think. If you search the net for
information on "hormone therapy" or "androgen deprivation
therapy" for prostate cancer and "side effects", you'll find a
lot. There's also a lot in the archives of this newsgroup.

Initially, the drugs have very little visible effect. But after
a month on leuprolide, you will find a great drop in libido, some
loss of energy, hot flushes, possible gain of weight, possible
depression, and possibly other symptoms. After a while, there
may also be joint pain and other side effects. There are ways to
fight against all of these side effects and, it is my experience,
that you have to fight them. A depressive reaction is no good.

Most of the men offered chemotherapy have been offered it only in
the last months of their lives. Traditionally, it has not been
given until HT is exhausted and symptoms are developing strongly.

The experience of such men may not be a good guide for what a
relatively healthy young man can expect. However, you should
be able to find some information on the net, and there may be
others in the newsgroup who can offer advice.

> CURRENT AGE = 51

You are relatively young to have to go through all this. I'm
sorry that it's happening to you.

I have not (yet at least) failed my primary radiation treatment.
For what it's worth, if I do and am in the same position as you,
I _think_ (I don't know for sure what I would do until I have to
make the choice for real), I would go for the aggressive
treatment. To me, life is very precious. Hot flushes, reduced
energy, even total loss of libido (it's a strange sensation to
look at a beautiful woman and feel no physical response) are a
price I am willing to pay for extra years of life.

Whatever you do, keep up your spirits. There is a huge amount to
live for. Cancer limits our lives, but it can also reveal to us
how precious it is.

Best of luck.

Alan

On Oct 7, 11:35 pm, "Alan Meyer" <amey...@yahoo.com> wrote:
> "DominicM" <dmarr...@gmail.com> wrote in message
>
> news:1191721412.294801.262410@y42g2000hsy.googlegr oups.com...
>
> > 17mo's after salvage radiation my psa is on the rise (see below). The
> > med onc I saw at MSKCC suggests I participate in trial. For guys like
> > me...high doubling time, psa>0.1, no mets, primary therapies failed
> > etc, etc.
>
> > It's a randomized study - 2 arms:
>
> > Arm A) Docetaxel every 3 weeks for 10 treatments, Leuprolide - every 3
> > months for 18 mo's and Bicalutamide - 1st month orally.
>
> > Arm B)Leuprolide - every 3 months for 18 mo's
> > Bicalutamide - 1st month orally.
>
> I'm not a doctor or any kind of expert. My admittedly inexpert
> and superficial opinion is that there are some good reasons to be
> in this trial and some good reasons not to. Which reasons apply
> to you, only you can say.
>
> ----- Here are the reasons I can think of for it:
>
> There is apparently some evidence that hormone therapy is more
> effective when given early. As I understand it, men who get HT
> early live longer than men who wait. Not all doctors agree with
> that, but there are many that do and there are some significant
> studies that support it.
>
> It is conceivable that chemotherapy plus hormone therapy will
> kill off very large amounts of cancer, perhaps giving you extra
> years of life, perhaps giving many extra years. I don't know.
> Clearly, no one knows for sure or else there wouldn't be this
> trial.
>
> Even if you are assigned to the arm that does not receive chemo,
> the odds are good that the HT alone will keep the cancer from
> progressing much during the 18 months of the trial. At the end
> of that time, if it looks like the chemo was doing some good, you
> could ask for it and perhaps be in just as good, or almost as
> good, a position to benefit from it as at the start of the trial.
> You need to ask the trial adminstrators whether you will be
> offered chemo at the end of the 18 months if you are in arm B and
> arm A is successful.
>
> Participation in a clinical trial often gives you access to a
> higher level of expertise, and more sophisticated testing, than
> most men get via their regular insurers.
>
> ----- And here are the reasons I can think of against it:
>
> If your PSA is rising slowly, it is possible that you could go
> for years without needing any therapy at all. During that
> period, you will not suffer any of the side effects of HT, which
> can be significant. There will also be no side effects of chemo.
>
> Some doctors, including the well regarded Dr. Walsh of Hopkins,
> believe there is little or no benefit of early HT as compared to
> late HT.
>
> It is conceivable that you will last long enough without
> treatment that some new, more effective and/or less deleterious
> treatment than the ones available today will become available.
>
> -----
>
> Unfortunately, either decision involves risks and unknowns.
>
> > With Arm A patients receive a steriod (dexamethasone) several times a
> > week to lessen [the side effects] to docetaxel.
>
> > Spoke to my rad onc who is a great guy thinks hitting this thing hard
> > is probably smart. Also thinks worthwhile to see what other Natl Care
> > Centers have going just to due my diligence. So I'm probably going
> > back to Hopkins to see a the med onc who I sought a 2nd opinion before
> > I chose salvage radiation.
>
> Your rad onc knows more than I do and is in favor of aggressive
> treatment. That's a point for it. Seeing another expert whom
> you already know to be good for a second opinion also seems like
> an excellent idea.
>
> > Curious if anyone out there has any experience with these meds/ I
> > presume I should be able to work thru this? As always I appreciate
> > input, feedback, suggestions.
>
> Lots of us have experience with leuprolide (Lupron, Zoladex,
> etc.) and bicalutamide (Casodex).
>
> They suppress testosterone, which has more effects on the body
> and the mind than one might think. If you search the net for
> information on "hormone therapy" or "androgen deprivation
> therapy" for prostate cancer and "side effects", you'll find a
> lot. There's also a lot in the archives of this newsgroup.
>
> Initially, the drugs have very little visible effect. But after
> a month on leuprolide, you will find a great drop in libido, some
> loss of energy, hot flushes, possible gain of weight, possible
> depression, and possibly other symptoms. After a while, there
> may also be joint pain and other side effects. There are ways to
> fight against all of these side effects and, it is my experience,
> that you have to fight them. A depressive reaction is no good.
>
> Most of the men offered chemotherapy have been offered it only in
> the last months of their lives. Traditionally, it has not been
> given until HT is exhausted and symptoms are developing strongly.
>
> The experience of such men may not be a good guide for what a
> relatively healthy young man can expect. However, you should
> be able to find some information on the net, and there may be
> others in the newsgroup who can offer advice.
>
> > CURRENT AGE = 51
>
> You are relatively young to have to go through all this. I'm
> sorry that it's happening to you.
>
> I have not (yet at least) failed my primary radiation treatment.
> For what it's worth, if I do and am in the same position as you,
> I _think_ (I don't know for sure what I would do until I have to
> make the choice for real), I would go for the aggressive
> treatment. To me, life is very precious. Hot flushes, reduced
> energy, even total loss of libido (it's a strange sensation to
> look at a beautiful woman and feel no physical response) are a
> price I am willing to pay for extra years of life.
>
> Whatever you do, keep up your spirits. There is a huge amount to
> live for. Cancer limits our lives, but it can also reveal to us
> how precious it is.
>
> Best of luck.
>
> Alan

Thanks Alan ...... you know as you go through this it comforting to
get input even if not from an M.D. to make sure you are looking at all
aspects and to validate your feelings etc at from a fellow PCa
survivor. Gonna see what the 2nd med onc says especially given that
he's at Hopkins (given Walsh's feelings about ADH).

On Oct 7, 11:35 pm, "Alan Meyer" <amey...@yahoo.com> wrote:
> "DominicM" <dmarr...@gmail.com> wrote in message
>
> news:1191721412.294801.262410@y42g2000hsy.googlegr oups.com...
>
> > 17mo's after salvage radiation my psa is on the rise (see below). The
> > med onc I saw at MSKCC suggests I participate in trial. For guys like
> > me...high doubling time, psa>0.1, no mets, primary therapies failed
> > etc, etc.
>
> > It's a randomized study - 2 arms:
>
> > Arm A) Docetaxel every 3 weeks for 10 treatments, Leuprolide - every 3
> > months for 18 mo's and Bicalutamide - 1st month orally.
>
> > Arm B)Leuprolide - every 3 months for 18 mo's
> > Bicalutamide - 1st month orally.
>
> I'm not a doctor or any kind of expert. My admittedly inexpert
> and superficial opinion is that there are some good reasons to be
> in this trial and some good reasons not to. Which reasons apply
> to you, only you can say.
>
> ----- Here are the reasons I can think of for it:
>
> There is apparently some evidence that hormone therapy is more
> effective when given early. As I understand it, men who get HT
> early live longer than men who wait. Not all doctors agree with
> that, but there are many that do and there are some significant
> studies that support it.
>
> It is conceivable that chemotherapy plus hormone therapy will
> kill off very large amounts of cancer, perhaps giving you extra
> years of life, perhaps giving many extra years. I don't know.
> Clearly, no one knows for sure or else there wouldn't be this
> trial.
>
> Even if you are assigned to the arm that does not receive chemo,
> the odds are good that the HT alone will keep the cancer from
> progressing much during the 18 months of the trial. At the end
> of that time, if it looks like the chemo was doing some good, you
> could ask for it and perhaps be in just as good, or almost as
> good, a position to benefit from it as at the start of the trial.
> You need to ask the trial adminstrators whether you will be
> offered chemo at the end of the 18 months if you are in arm B and
> arm A is successful.
>
> Participation in a clinical trial often gives you access to a
> higher level of expertise, and more sophisticated testing, than
> most men get via their regular insurers.
>
> ----- And here are the reasons I can think of against it:
>
> If your PSA is rising slowly, it is possible that you could go
> for years without needing any therapy at all. During that
> period, you will not suffer any of the side effects of HT, which
> can be significant. There will also be no side effects of chemo.
>
> Some doctors, including the well regarded Dr. Walsh of Hopkins,
> believe there is little or no benefit of early HT as compared to
> late HT.
>
> It is conceivable that you will last long enough without
> treatment that some new, more effective and/or less deleterious
> treatment than the ones available today will become available.
>
> -----
>
> Unfortunately, either decision involves risks and unknowns.
>
> > With Arm A patients receive a steriod (dexamethasone) several times a
> > week to lessen [the side effects] to docetaxel.
>
> > Spoke to my rad onc who is a great guy thinks hitting this thing hard
> > is probably smart. Also thinks worthwhile to see what other Natl Care
> > Centers have going just to due my diligence. So I'm probably going
> > back to Hopkins to see a the med onc who I sought a 2nd opinion before
> > I chose salvage radiation.
>
> Your rad onc knows more than I do and is in favor of aggressive
> treatment. That's a point for it. Seeing another expert whom
> you already know to be good for a second opinion also seems like
> an excellent idea.
>
> > Curious if anyone out there has any experience with these meds/ I
> > presume I should be able to work thru this? As always I appreciate
> > input, feedback, suggestions.
>
> Lots of us have experience with leuprolide (Lupron, Zoladex,
> etc.) and bicalutamide (Casodex).
>
> They suppress testosterone, which has more effects on the body
> and the mind than one might think. If you search the net for
> information on "hormone therapy" or "androgen deprivation
> therapy" for prostate cancer and "side effects", you'll find a
> lot. There's also a lot in the archives of this newsgroup.
>
> Initially, the drugs have very little visible effect. But after
> a month on leuprolide, you will find a great drop in libido, some
> loss of energy, hot flushes, possible gain of weight, possible
> depression, and possibly other symptoms. After a while, there
> may also be joint pain and other side effects. There are ways to
> fight against all of these side effects and, it is my experience,
> that you have to fight them. A depressive reaction is no good.
>
> Most of the men offered chemotherapy have been offered it only in
> the last months of their lives. Traditionally, it has not been
> given until HT is exhausted and symptoms are developing strongly.
>
> The experience of such men may not be a good guide for what a
> relatively healthy young man can expect. However, you should
> be able to find some information on the net, and there may be
> others in the newsgroup who can offer advice.
>
> > CURRENT AGE = 51
>
> You are relatively young to have to go through all this. I'm
> sorry that it's happening to you.
>
> I have not (yet at least) failed my primary radiation treatment.
> For what it's worth, if I do and am in the same position as you,
> I _think_ (I don't know for sure what I would do until I have to
> make the choice for real), I would go for the aggressive
> treatment. To me, life is very precious. Hot flushes, reduced
> energy, even total loss of libido (it's a strange sensation to
> look at a beautiful woman and feel no physical response) are a
> price I am willing to pay for extra years of life.
>
> Whatever you do, keep up your spirits. There is a huge amount to
> live for. Cancer limits our lives, but it can also reveal to us
> how precious it is.
>
> Best of luck.
>
> Alan

Thanks Alan ...... you know as you go through this journey it's
comforting to
get input (even if not from an M.D.) to make sure you are looking at
all
aspects and to validate your feelings etc from a fellow PCa survivor's
perspective.

Gonna see what the 2nd med onc says . It'll be interesting especially
given that
he's at Hopkins (and Walsh's feelings about ADH).

All the best to you.

On Oct 7, 11:35 pm, "Alan Meyer" <amey...@yahoo.com> wrote:
> "DominicM" <dmarr...@gmail.com> wrote in message
>
> news:1191721412.294801.262410@y42g2000hsy.googlegr oups.com...
>
> > 17mo's after salvage radiation my psa is on the rise (see below). The
> > med onc I saw at MSKCC suggests I participate in trial. For guys like
> > me...high doubling time, psa>0.1, no mets, primary therapies failed
> > etc, etc.
>
> > It's a randomized study - 2 arms:
>
> > Arm A) Docetaxel every 3 weeks for 10 treatments, Leuprolide - every 3
> > months for 18 mo's and Bicalutamide - 1st month orally.
>
> > Arm B)Leuprolide - every 3 months for 18 mo's
> > Bicalutamide - 1st month orally.
>
> I'm not a doctor or any kind of expert. My admittedly inexpert
> and superficial opinion is that there are some good reasons to be
> in this trial and some good reasons not to. Which reasons apply
> to you, only you can say.
>
> ----- Here are the reasons I can think of for it:
>
> There is apparently some evidence that hormone therapy is more
> effective when given early. As I understand it, men who get HT
> early live longer than men who wait. Not all doctors agree with
> that, but there are many that do and there are some significant
> studies that support it.
>
> It is conceivable that chemotherapy plus hormone therapy will
> kill off very large amounts of cancer, perhaps giving you extra
> years of life, perhaps giving many extra years. I don't know.
> Clearly, no one knows for sure or else there wouldn't be this
> trial.
>
> Even if you are assigned to the arm that does not receive chemo,
> the odds are good that the HT alone will keep the cancer from
> progressing much during the 18 months of the trial. At the end
> of that time, if it looks like the chemo was doing some good, you
> could ask for it and perhaps be in just as good, or almost as
> good, a position to benefit from it as at the start of the trial.
> You need to ask the trial adminstrators whether you will be
> offered chemo at the end of the 18 months if you are in arm B and
> arm A is successful.
>
> Participation in a clinical trial often gives you access to a
> higher level of expertise, and more sophisticated testing, than
> most men get via their regular insurers.
>
> ----- And here are the reasons I can think of against it:
>
> If your PSA is rising slowly, it is possible that you could go
> for years without needing any therapy at all. During that
> period, you will not suffer any of the side effects of HT, which
> can be significant. There will also be no side effects of chemo.
>
> Some doctors, including the well regarded Dr. Walsh of Hopkins,
> believe there is little or no benefit of early HT as compared to
> late HT.
>
> It is conceivable that you will last long enough without
> treatment that some new, more effective and/or less deleterious
> treatment than the ones available today will become available.
>
> -----
>
> Unfortunately, either decision involves risks and unknowns.
>
> > With Arm A patients receive a steriod (dexamethasone) several times a
> > week to lessen [the side effects] to docetaxel.
>
> > Spoke to my rad onc who is a great guy thinks hitting this thing hard
> > is probably smart. Also thinks worthwhile to see what other Natl Care
> > Centers have going just to due my diligence. So I'm probably going
> > back to Hopkins to see a the med onc who I sought a 2nd opinion before
> > I chose salvage radiation.
>
> Your rad onc knows more than I do and is in favor of aggressive
> treatment. That's a point for it. Seeing another expert whom
> you already know to be good for a second opinion also seems like
> an excellent idea.
>
> > Curious if anyone out there has any experience with these meds/ I
> > presume I should be able to work thru this? As always I appreciate
> > input, feedback, suggestions.
>
> Lots of us have experience with leuprolide (Lupron, Zoladex,
> etc.) and bicalutamide (Casodex).
>
> They suppress testosterone, which has more effects on the body
> and the mind than one might think. If you search the net for
> information on "hormone therapy" or "androgen deprivation
> therapy" for prostate cancer and "side effects", you'll find a
> lot. There's also a lot in the archives of this newsgroup.
>
> Initially, the drugs have very little visible effect. But after
> a month on leuprolide, you will find a great drop in libido, some
> loss of energy, hot flushes, possible gain of weight, possible
> depression, and possibly other symptoms. After a while, there
> may also be joint pain and other side effects. There are ways to
> fight against all of these side effects and, it is my experience,
> that you have to fight them. A depressive reaction is no good.
>
> Most of the men offered chemotherapy have been offered it only in
> the last months of their lives. Traditionally, it has not been
> given until HT is exhausted and symptoms are developing strongly.
>
> The experience of such men may not be a good guide for what a
> relatively healthy young man can expect. However, you should
> be able to find some information on the net, and there may be
> others in the newsgroup who can offer advice.
>
> > CURRENT AGE = 51
>
> You are relatively young to have to go through all this. I'm
> sorry that it's happening to you.
>
> I have not (yet at least) failed my primary radiation treatment.
> For what it's worth, if I do and am in the same position as you,
> I _think_ (I don't know for sure what I would do until I have to
> make the choice for real), I would go for the aggressive
> treatment. To me, life is very precious. Hot flushes, reduced
> energy, even total loss of libido (it's a strange sensation to
> look at a beautiful woman and feel no physical response) are a
> price I am willing to pay for extra years of life.
>
> Whatever you do, keep up your spirits. There is a huge amount to
> live for. Cancer limits our lives, but it can also reveal to us
> how precious it is.
>
> Best of luck.
>
> Alan


Thanks Alan ...... you know as you go through this it comforting to
get input even if not from an M.D. to make sure you are looking at
all
aspects and to validate your feelings etc from a fellow PCa
survivor.

Gonna see what the 2nd med onc says especially given that
he's at Hopkins (given Walsh's feelings about ADH).

All the best. Stay healthy.

On Oct 6, 9:43 pm, DominicM <dmarr...@gmail.com> wrote:
> 17mo's after salvage radiation my psa is on the rise (see below). The
> med onc I saw at MSKCC suggests I participate in trial. For guys like
> me...high doubling time, psa>0.1, no mets, primary therapies failed
> etc, etc.
>
> It's a randomized study - 2 arms:
>
> Arm A) Docetaxel every 3 weeks for 10 treatments, Leuprolide - every 3
> months for 18 mo's and Bicalutamide - 1st month orally.
>
> Arm B)Leuprolide - every 3 months for 18 mo's
> Bicalutamide - 1st month orally.
>
> With Arm A patients receive a steriod (dexamethasone) several times a
> week to lessen to docetaxel.
>
> Spoke to my rad onc who is a great guy thinks hitting this thing hard
> is probably smart. Also thinks worthwhile to see what other Natl Care
> Centers have going just to due my diligence. So I'm probably going
> back to Hopkins to see a the med onc who I sought a 2nd opinion before
> I chose salvage radiation.
>
> Curious if anyone out there has any experience with these meds/ I
> presume I should be able to work thru this? As always I appreciate
> input, feedback, suggestions.
>
> CURRENT AGE = 51, Overall good health (need to lose weight).
> 6/03 - PSA 2.0, 6/04 - PSA 2.5, 8/05 - PSA 4.2, 11/05 - PSA 5.89
> BIOPSY 8/16/05, T2A, 3+5 = 8
> RP 12/13/05
> PATHOLOGY GLEASON 3+5=8
> TERTIARY 4, SEMINAL & LYMPH - NEG
> EXTRACAPSULAR EXTENSION TO MARGIN
> POSITIVE MARGIN - RIGHT APEX
> PSA POST RP 1/26/06 = 0.5, 2/1/06 = 0.55
> PSA on 3/27/06 = 0.95
> START SRT ON 3/27/06
> FINISHED SRT 5/19/06
> 06-20-06 - PSA 0.24
> 07-08-06 - PSA 0.15
> 09-14-06 - PSA 0.10
> 12-19-06 - PSA 0.08
> 02-07-07 - PSA 0.09
> 08-17-07 - PSA 0.31
> 10/02/07 - PSA 0.48



************************************************** *************************************************
CORRECTION PSA MUST BE GREATER THAN 1.0 FOR PARTICIPATION IN STUDY.

"DominicM" <dmarrese@gmail.com> wrote in message
news:1191891507.224354.101370@o80g2000hse.googlegr oups.com...

> CORRECTION PSA MUST BE GREATER THAN 1.0 FOR PARTICIPATION IN STUDY.

My immediate suspicion is that the researchers want to be absolutely
certain that each participant really has cancer.

However you still have to make some decisions about whether to get
on HT / ADT. So you still would do well to consult with the oncologist
at Hopkins.

Unfortunately, most doctors who perform primary treatment for PCa
really don't know much about hormone therapy.

Some don't know any more than, you give the guy an injection
every three months. They can't tell you anything about double
or triple ADT, about intermittent ADT, about the full panoply of
side effects that one might experience, or about any of the many
techniques that can be used to counter those side effects.

They also may know little or nothing about chemotherapy or about
second line hormone therapy with estradiol, ketoconazole, or other
drugs.

So, if possible, you want to find a medical oncologist who is really
up on prostate cancer.

When the hormone therapy eventually fails, this chemotherapy
study may be complete and you will have some info about the
value of early chemo. If the HT you get suppresses the cancer
until then, you will still be able to get "early" chemo since you won't
yet have significant metastatic cancer, and may not have metastatic
cancer at all.

Good luck.

Alan