Things That Puzzle Me About PCa # 14 in an unlimited series

[Guest guest]

I have written before about my puzzlement as to why

prostate cancer is not treated as the chronic disease which it is in so many

cases. Why there is such a difference in attitudes to heart conditions when the

mortality rate for heart failure in men is about ten times that for prostate

cancer? Note, before any takes me to task, I am not saying that all men

diagnosed with prostate cancer have an indolent form of the disease. There are

very dangerous types of prostate cancer that need early attention, but as so

many studies are now confirming, the majority of cases are never likely to

develop into life threatening situations.

Given that, why is there no focus on early,

non-invasive management by way of intermittent ADT (Androgen Deprivation

Therapy) for early stage tumours? Current theory is that ADT will starve very

much larger populations of tumours that are well advanced – even

metastasised disease can be managed well for many years with this therapy. So

why not hit the small, contained populations before they get going? Steve J

often quotes Dr Strum, if a man is hesitant about having early therapy, as

saying:

" There is NOWHERE in oncology where waiting for

the tumor cell population to increase (and to mutate) is in the better

interests of the patient. "

If Dr Strum is correct, and as an oncologist he

certainly knows a good deal more about the disease than I ever will, why do we

not launch an early attack on early stage prostate cancer using ADT? This would

surely deal with the tumour cells contained in the gland very effectively. And

if the theory that prostate cancer is a systemic disease by the time it is

diagnosable is correct, any cells that may have populated the rest of the body

would also be dealt with. There might be a very small risk of mutation from

androgen dependent cells to androgen independent cells, but this risk appears

to be significantly reduced with intermittent therapy even in large tumour

populations.

Of course there are side effects to ADT, as there are

with all therapies. But in most early stage, low aggressive cases if an

intermittent therapy is applied – and especially if it is what might be

termed “ADT-lite” – just one form of ADT instead of the real

heavyweight CAB or ADT3 - the permanent side effects will be few and far

between.

It makes sense to me in my dithering way – does

it make sense to anyone else. And if not, why not?

All the best

Terry Herbert

I have no medical qualifications but I was diagnosed

in ‘96: and have learned a bit since then.

My sites are at www.yananow.net and www.prostatecancerwatchfulwaiting.co.za

Dr

“Snuffy” Myers : " As a

physician, I am painfully aware that most of the decisions we make with regard

to prostate cancer are made with inadequate data "