RE: [NewDx] Reprise: Things That Puzzle Me About PCa # 14 in an unlimited series

[Guest guest]

I've never seen a good explanation of how ADT actually works. I

have read that most, but not all, tumor cells depend on receiving

androgens from outside the cell to signal them to replicate, but

I haven't seen an explanation of exactly what happens to cells

that don't receive the androgens. I presume they die. But how

many of them die, which ones die, why they die, and why some of

them don't die? I don't know. There seems to be a huge amount

of research in these areas but progress is slow. Our knowledge

is very incomplete.

As so often happens in medicine, we have empirical evidence that

a treatment works, but the explanation has to wait for much

further research. I believe, for example, that aspirin was

discovered a hundred years before anyone knew how it worked.

Without an explanation for how it works, and without an

explanation for why it would work for local disease but not

metastatic disease, and without a randomized clinical trial to

establish that it really does work, and without knowing how much

and how long ADT is required, and knowing that it does have

significant side effects, I'd be very hesitant to try or to

recommend ADT when surgery or radiation are available as curative

treatments.

There are people who doubt the efficacy of surgery and radiation

- claiming that they only cure people who would not die of the

disease anyway. However I think there really is good evidence

that they work for many patients.

Alan

[Guest guest]

I feel pretty certain, Alan, that there are likely several papers that explain just what occurs with the administration of androgen deprivation medications, but likely in a medical form of what we call “Greek” that we wouldn’t have a clue on how to decipher and understand. (grin) Chuck Always as close as the other end of your computer to help address any prostate cancer concerns. " What you leave behind is not what is engraved in stone monuments, but what is woven into the lives of others. " (Chuck) Maack/Prostate Cancer Advocate/Counsel Wichita, Kansas Chapter, Us TOOEmail: maack1@... PCa Help: " Observations " : http://www.ustoowichita.org/observations.cfm From: ProstateCancerSupport [mailto:ProstateCancerSupport ] On Behalf Of Alan MeyerSent: Monday, September 12, 2011 2:46 PMTo: ProstateCancerSupport Subject: Re: RE: [NewDx] Reprise: Things That Puzzle Me About PCa # 14 in an unlimited series I've never seen a good explanation of how ADT actually works. Ihave read that most, but not all, tumor cells depend on receivingandrogens from outside the cell to signal them to replicate, butI haven't seen an explanation of exactly what happens to cellsthat don't receive the androgens. I presume they die. But howmany of them die, which ones die, why they die, and why some ofthem don't die? I don't know. There seems to be a huge amountof research in these areas but progress is slow. Our knowledgeis very incomplete.As so often happens in medicine, we have empirical evidence thata treatment works, but the explanation has to wait for muchfurther research. I believe, for example, that aspirin wasdiscovered a hundred years before anyone knew how it worked.Without an explanation for how it works, and without anexplanation for why it would work for local disease but notmetastatic disease, and without a randomized clinical trial toestablish that it really does work, and without knowing how muchand how long ADT is required, and knowing that it does havesignificant side effects, I'd be very hesitant to try or torecommend ADT when surgery or radiation are available as curativetreatments.There are people who doubt the efficacy of surgery and radiation- claiming that they only cure people who would not die of thedisease anyway. However I think there really is good evidencethat they work for many patients.Alan

[Guest guest]

> I feel pretty certain, Alan, that there are likely several

> papers that explain just what occurs with the administration of

> androgen deprivation medications, but likely in a medical form

> of what we call “Greek†that we wouldn’t have a clue on how to

> decipher and understand. (grin)

Chuck,

If you come across something let me know. The problem with

searching Pubmed is that you get abstracts of narrow and specific

current research, not overviews of the whole subject.

Although I'm not a scientist I've read some basic textbooks in

biochemistry and molecular biology and would be willing to take a

shot at reading the Greek.

Alan