Re: Thanks to all; also, MRI results

[Guest guest]

There is a third alternative. If your prostate is enlarged, you might want to consider a course of treatment with the generic equivalent of proscar or the brand name avodart, combined with an alpha blocker. Once the prostate enlargement is gone, then go for another biopsy. It has been reported that the above two prostate shrinkage medications may have some cancer inhibiting properties. If this is the case, then there is the possibility that the cancer may be very much diminished or even disappear! If the biopsy shows otherwise, then treatment will be necessary. If, for instance brachytherapy is chosen, then the need to have to use ADT (like Lupron), with all of its undesirable side effects, to shrink the prostate will have been avoided.

Louis. . .

To: ProstateCancerSupport Sent: Sun, May 23, 2010 1:18:38 PMSubject: Thanks to all; also, MRI results

I knew I would get some excellent feedback, and I did. Thanks to everyone. I have already contacted one person directly, and may respond to others individually if it seems appropriate. Now...to update, for those who haven't read my previous post, I went for a transrectal MRI this past Monday to see what's up, because despite minimal biopsy results (3+3 in <5% of 18 cores, t1c) my PSA had risen from 3.8 in February 2009 to 7.83 at the end of April 2010. By the way, this was a steady rise, not a spike, and it was not due to exercise (I do run, but I've not been told that affects anything) or sexual activity, as I've been careful to control for that factor. The results were, infuriatingly, mixed: there was "no abnormality" shown in the prostate; BUT (and this may be a big or an insignificant "but"), there was a "questionable lesion" on my sacrum. I am now

scheduled for a bone scan mid-June (the earliest time available), followed by a visit with my urologist to discuss the current situation. In the meantime, I will seek out a good location for a second opinion, most likely Duke Cancer Center, and once my bone scan results are in, have them look over everything. What all this has to do with my PSA is STILL unknown. At the same time, the proton beam approach is something I'm going to look into; sounds like very good reports so far there. I do want to be prepared should it appear treatment is necessary; what's scary is the possibility that there may be something even more ominous than PCa lurking in my body. Looking stuff up online without knowing specifically what I'm looking for can be dangerous as well, as one always seems to find the worst-case scenario...especial ly if you're as prone to catastrophizing as I am.Sometimes I say "getting old sucks", but frankly, it beats the alternative. I'm 55

now and plan to be a feisty old fart come, say, 2045...

Dennis

[Guest guest]

> There is a third alternative. If your prostate is enlarged, you might

> want to consider a course of treatment with the generic equivalent of

> proscar or the brand name avodart, combined with an alpha blocker.

Just for clarification, an alpha blocker is often used to treat

hypertension. But there are other uses, such as Flomax to aid in

urination. I don't quite understand its application in this

situation.

> Once the prostate enlargement is gone, then go for another biopsy.

The " book " use of finasteride (eg Proscar) and dutasteride

(Avodart) is to relieve the symptoms of BPH (benign prostatic

hyperplasia) and ease urination. The " side effect " that we PCa

patients are most interested in is that they inhibit the enzyme

5-alpha reductase from converting T to the much more powerful DHT

(dihydrotestosterone).

Finasteride inhibits only the Type 2 enzyme. Dutasteride inhibits

both types 1 and 2.

NB: If the gland is smaller, it is possible (and has happened)

that more PCa might be discovered in the biopsy. Same number of

PCa cells, less gland.

> It has

> been reported that the above two prostate shrinkage medications may have

> some cancer inhibiting properties.

That would be the result of preventing conversion of T to DHT.

> If this is the case, then there is

> the possibility that the cancer may be very much diminished or even

> disappear!

Maybe......

> If the biopsy shows otherwise, then treatment will be

> necessary. If, for instance brachytherapy is chosen, then the need to

> have to use ADT (like Lupron), with all of its undesirable side effects,

> to shrink the prostate will have been avoided.

Maybe.....

As with life itself, there is no certainty when trying to cope

with PCa.

Sorry to rain on the parade.

I have two recommendations:

(1) Objective, encyclopedic and reliable information is available

on the website of the Prostate Cancer Research Institute (PCRI) at:

http://www.prostate-cancer.org/pcricms/

Including two excellent articles on how to cope with SEs of ADT.

(2) _A Primer on Prostate Cancer_ 2nd ed., subtitled " The

Empowered Patient's Guide " by medical oncologist and PCa

specialist B. Strum, MD and PCa warrior Donna Pogliano.

It is available from the PCRI website and the like, as well as

Amazon (30+ five-star reviews), & Noble, and bookstores. A

lifesaver, as I very well know.

Regards,

Steve J

[Guest guest]

The alpha blocker use is for the purpose of relaxing the prostate muscles to ease the symptoms of an enlarged prostate. If the gland is enlarged but is not causing bothersome symptoms in urination, it can be omitted. However, the possible cancer inhibition of the actual shrinkers, generic equivalent of proscar, and the brand name avodart, is what is important. Some urologists claim that the more costly avodart works faster than proscar, but some studies have shown promise of cancer inhibition in this regard. However, should, after the six month period to one year course of treatment, after the prostate has been shrunk, repeat biopsy still shows significant cancer, having to avoid Lupron treatment prior to brachytherapy, or if surgery is chosen, chances of side effects from surgery are decreased,

the prostate treatment via proscar (or its generic equivalent) or Avodard will have been well worthwhile.

The studies that point to the possibility of the cancer inhibition of Avodart or Proscar (or its generic equivalent) are quite recent and may have become available after the publication of the handbooks.

Louis. . .

To: ProstateCancerSupport Sent: Sun, May 23, 2010 3:31:08 PMSubject: Re: Thanks to all; also, MRI results> There is a third alternative. If your prostate is enlarged, you might> want to consider a course of treatment with the generic equivalent of> proscar or the brand name avodart, combined with an alpha blocker.Just for clarification, an alpha blocker is often used to treat hypertension. But there are other uses, such as Flomax to aid in urination. I don't quite understand its application in this situation.> Once the prostate enlargement is gone, then go for another

biopsy.The "book" use of finasteride (eg Proscar) and dutasteride (Avodart) is to relieve the symptoms of BPH (benign prostatic hyperplasia) and ease urination. The "side effect" that we PCa patients are most interested in is that they inhibit the enzyme 5-alpha reductase from converting T to the much more powerful DHT (dihydrotestosterone).Finasteride inhibits only the Type 2 enzyme. Dutasteride inhibits both types 1 and 2.NB: If the gland is smaller, it is possible (and has happened) that more PCa might be discovered in the biopsy. Same number of PCa cells, less gland.> It has> been reported that the above two prostate shrinkage medications may have> some cancer inhibiting properties.That would be the result of preventing conversion of T to DHT.> If this is the case, then there is> the possibility that the cancer may be very much diminished or

even> disappear!Maybe......> If the biopsy shows otherwise, then treatment will be> necessary. If, for instance brachytherapy is chosen, then the need to> have to use ADT (like Lupron), with all of its undesirable side effects,> to shrink the prostate will have been avoided.Maybe.....As with life itself, there is no certainty when trying to cope with PCa.Sorry to rain on the parade.I have two recommendations:(1) Objective, encyclopedic and reliable information is available on the website of the Prostate Cancer Research Institute (PCRI) at:http://www.prostate-cancer.org/pcricms/Including two excellent articles on how to cope with SEs of ADT.(2) _A Primer on Prostate Cancer_ 2nd ed., subtitled "The Empowered Patient's Guide" by medical oncologist and PCa specialist B. Strum, MD and PCa warrior Donna Pogliano. It is available

from the PCRI website and the like, as well as Amazon (30+ five-star reviews), & Noble, and bookstores. A lifesaver, as I very well know.Regards,Steve J------------------------------------There are just two rules for this group 1 No Spam 2 Be kind to othersPlease recognise that Prostate Cancerhas different guises and needs different levels of treatment and in some cases no treatment at all. Some men even with all options offered chose radical options that you would not choose. We only ask that people be informed before choice is made, we cannot and should not tell other members what to do, other than look at other options. Try to delete old material that is no longer applying when clicking replyTry to change the title if the content requires it

[Guest guest]

Dennis Humphries wrote:

....

> Now...to update, for those who haven't read my previous post, I

> went for a transrectal MRI this past Monday to see what's up,

> because despite minimal biopsy results (3+3 in <5% of 18 cores,

> t1c) my PSA had risen from 3.8 in February 2009 to 7.83 at the

> end of April 2010. By the way, this was a steady rise, not a

> spike, and it was not due to exercise (I do run, but I've not

> been told that affects anything) or sexual activity, as I've

> been careful to control for that factor. The results were,

> infuriatingly, mixed: there was " no abnormality " shown in the

> prostate; BUT (and this may be a big or an insignificant

> " but " ), there was a " questionable lesion " on my sacrum. I am

> now scheduled for a bone scan mid-June (the earliest time

> available), followed by a visit with my urologist to discuss

> the current situation. In the meantime, I will seek out a good

> location for a second opinion, most likely Duke Cancer Center,

> and once my bone scan results are in, have them look over

> everything. What all this has to do with my PSA is STILL

> unknown. At the same time, the proton beam approach is

> something I'm going to look into; sounds like very good reports

> so far there. I do want to be prepared should it appear

> treatment is necessary; what's scary is the possibility that

> there may be something even more ominous than PCa lurking in my

> body. Looking stuff up online without knowing specifically what

> I'm looking for can be dangerous as well, as one always seems

> to find the worst-case scenario...especially if you're as prone

> to catastrophizing as I am.

I will be very surprised if the bone scan shows anything. See:

http://www.prostatevideos.com/prostate-cancer/grading-and-staging-of-prostate-ca\

ncer/bone-scan-for-assessing-cancer-spreading-to-the-bones/

Another option which I don't recall anyone mentioning is to see

if the simple supplements sometimes recommended for PCa have any

positive effect for you. The evidence for their efficacy is

pretty flimsy, but they're cheap, safe (as far as we know), and

if the effect they have is very small, it might be most useful to

a guy like you who apparently has only a very small amount of

cancer.

I don't know what the right things to try are. I know that a

friend of mine who was treated by Dr. " Snuffy " Myers, a

well known medical oncologist, was told by him to take

pomegranate extract and resveratrol pills. Other supplements

that I have seen mentioned are lycopene, green tea extract

( " EGCG " ), vitamin C, and vitamin D.

Do they work? Who knows? Maybe they do some good for some

patients. Maybe they don't. There have been positive reports on

all of them in the medical journals but, as often happens, the

follow up reports don't always find any benefit. It's a crap

shoot, but the amount you're risking is probably very small.

Best of luck.

Alan

[Guest guest]

Please keep us updated....you sure have some interesting procedures going on. Sounds like you could be prime candidate for the Proton procedure. GOOD LUCK...will be anxious to hear what is found. You've selected some good places for your procedures and 2nd opinions.

Jim

To: ProstateCancerSupport Sent: Sun, May 23, 2010 10:55:59 PMSubject: Re: Thanks to all; also, MRI results

Dennis Humphries wrote:...> Now...to update, for those who haven't read my previous post, I> went for a transrectal MRI this past Monday to see what's up,> because despite minimal biopsy results (3+3 in <5% of 18 cores,> t1c) my PSA had risen from 3.8 in February 2009 to 7.83 at the> end of April 2010. By the way, this was a steady rise, not a> spike, and it was not due to exercise (I do run, but I've not> been told that affects anything) or sexual activity, as I've> been careful to control for that factor. The results were,> infuriatingly, mixed: there was "no abnormality" shown in the> prostate; BUT (and this may be a big or an insignificant> "but"), there was a "questionable lesion" on my sacrum. I am> now scheduled for a

bone scan mid-June (the earliest time> available), followed by a visit with my urologist to discuss> the current situation. In the meantime, I will seek out a good> location for a second opinion, most likely Duke Cancer Center,> and once my bone scan results are in, have them look over> everything. What all this has to do with my PSA is STILL> unknown. At the same time, the proton beam approach is> something I'm going to look into; sounds like very good reports> so far there. I do want to be prepared should it appear> treatment is necessary; what's scary is the possibility that> there may be something even more ominous than PCa lurking in my> body. Looking stuff up online without knowing specifically what> I'm looking for can be dangerous as well, as one always seems> to find the worst-case scenario...especially if you're as prone> to catastrophizing as I

am.I will be very surprised if the bone scan shows anything. See:http://www.prostatevideos.com/prostate-cancer/grading-and-staging-of-prostate-cancer/bone-scan-for-assessing-cancer-spreading-to-the-bones/Another option which I don't recall anyone mentioning is to seeif the simple supplements sometimes recommended for PCa have anypositive effect for you. The evidence for their efficacy ispretty flimsy, but they're cheap, safe (as far as we know), andif the effect they have is very small, it might be most useful toa guy like you who apparently has only a very small amount ofcancer.I don't know what the right things to try are. I know that afriend of mine who was treated by Dr. "Snuffy" Myers, awell known medical oncologist, was told by him to takepomegranate extract and resveratrol pills. Other supplementsthat I have seen mentioned are lycopene, green tea extract("EGCG"),

vitamin C, and vitamin D.Do they work? Who knows? Maybe they do some good for somepatients. Maybe they don't. There have been positive reports onall of them in the medical journals but, as often happens, thefollow up reports don't always find any benefit. It's a crapshoot, but the amount you're risking is probably very small.Best of luck.Alan

[Guest guest]

Fortunately, mine is not enlarged. Actually had NO SYMPTOMS at all...except for the rapid psa rise...

2 to 16 in 9 months..

To: ProstateCancerSupport Sent: Sun, May 23, 2010 2:31:08 PMSubject: Re: Thanks to all; also, MRI results> There is a third alternative. If your prostate is enlarged, you might> want to consider a course of treatment with the generic equivalent of> proscar or the brand name avodart, combined with an alpha blocker.Just for clarification, an alpha blocker is often used to treat hypertension. But there are other uses, such as Flomax to aid in urination. I don't quite understand its application in this situation.> Once the prostate enlargement is gone, then go for another

biopsy.The "book" use of finasteride (eg Proscar) and dutasteride (Avodart) is to relieve the symptoms of BPH (benign prostatic hyperplasia) and ease urination. The "side effect" that we PCa patients are most interested in is that they inhibit the enzyme 5-alpha reductase from converting T to the much more powerful DHT (dihydrotestosterone).Finasteride inhibits only the Type 2 enzyme. Dutasteride inhibits both types 1 and 2.NB: If the gland is smaller, it is possible (and has happened) that more PCa might be discovered in the biopsy. Same number of PCa cells, less gland.> It has> been reported that the above two prostate shrinkage medications may have> some cancer inhibiting properties.That would be the result of preventing conversion of T to DHT.> If this is the case, then there is> the possibility that the cancer may be very much diminished or

even> disappear!Maybe......> If the biopsy shows otherwise, then treatment will be> necessary. If, for instance brachytherapy is chosen, then the need to> have to use ADT (like Lupron), with all of its undesirable side effects,> to shrink the prostate will have been avoided.Maybe.....As with life itself, there is no certainty when trying to cope with PCa.Sorry to rain on the parade.I have two recommendations:(1) Objective, encyclopedic and reliable information is available on the website of the Prostate Cancer Research Institute (PCRI) at:http://www.prostate-cancer.org/pcricms/Including two excellent articles on how to cope with SEs of ADT.(2) _A Primer on Prostate Cancer_ 2nd ed., subtitled "The Empowered Patient's Guide" by medical oncologist and PCa specialist B. Strum, MD and PCa warrior Donna Pogliano. It is available

from the PCRI website and the like, as well as Amazon (30+ five-star reviews), & Noble, and bookstores. A lifesaver, as I very well know.Regards,Steve J------------------------------------There are just two rules for this group 1 No Spam 2 Be kind to othersPlease recognise that Prostate Cancerhas different guises and needs different levels of treatment and in some cases no treatment at all. Some men even with all options offered chose radical options that you would not choose. We only ask that people be informed before choice is made, we cannot and should not tell other members what to do, other than look at other options. Try to delete old material that is no longer applying when clicking replyTry to change the title if the content requires it