RE: PSA testing on hormone treatment

[Guest guest]

Mark

Everyone is welcome to their own views but I find this one a little unusual. I accept that other tests ned to be done from time to time but PSA has always been the main marker for all treatment in the UK. My experience has been that men on intermittent hormone manipulation depend on a low or negligable PSA - usually for a year at least - before pausing the treatment.

The other thing about 's test is that so far he has had only one rise. This could have been down to the lab staff having an off day etc. This is why I suggested he had another in a month before getting too concerned. Whilst I am happy to discuss the pros and cons of treatment options this group is about bringing hope and support.

-----Original Message-----From: Mark L. Sent: 26 July 2004 03:50To: ProstateCancerSupport Subject: Re: You should be concerned. Taking a PSA of a person on hormone blockingmakes no sense whatsoever. It's a ridiculous waste of resources. You'llnever get a clear picture of what's really going on that way. I didn'thave a PSA test until I was half a year away from Zoladex. This is somescary stuff though, eh? A mushroom growing in one's groin that doesn'thave the sense to not kill its host.

[Guest guest]

Mark

Having had some years on Casodex - Bicultamide - I have seen the ups and downs of PSA - I'll chat with my specialist about it!

Re: >> You should be concerned. Taking a PSA of a person on hormone> blocking> makes no sense whatsoever. It's a ridiculous waste of> resources. You'll> never get a clear picture of what's really going on that> way. I didn't> have a PSA test until I was half a year away from Zoladex.> This is some> scary stuff though, eh? A mushroom growing in one's groin> that doesn't> have the sense to not kill its host.>>>>

[Guest guest]

Not to offend, , but how does it make sense to take a PSA reading

from someone on andro blocking? How can that possibly be beneficial? I'm

not trying to be anything less than supportive here, but just logical. A

PSA reading from a guy on andro blocking? The Yankee expression " put

some lipstick on that pig " comes to mind.

Metcalf wrote:

> Mark Everyone is welcome to their own views but I find this one a

> little unusual. I accept that other tests ned to be done from time to

> time but PSA has always been the main marker for all treatment in the

> UK. My experience has been that men on intermittent hormone

> manipulation depend on a low or negligable PSA - usually for a year at

> least - before pausing the treatment.The other thing about 's

> test is that so far he has had only one rise. This could have been

> down to the lab staff having an off day etc. This is why I suggested

> he had another in a month before getting too concerned. Whilst I am

> happy to discuss the pros and cons of treatment options this group is

> about bringing hope and support.

>

> Re:

>

> You should be concerned. Taking a PSA of a person on hormone

> blocking

> makes no sense whatsoever. It's a ridiculous waste of

> resources. You'll

> never get a clear picture of what's really going on that

> way. I didn't

> have a PSA test until I was half a year away from Zoladex.

> This is some

> scary stuff though, eh? A mushroom growing in one's groin

> that doesn't

> have the sense to not kill its host.

>

>

>

>

[Guest guest]

My first and second urologists both told me they wouldn't draw blood to

check for PSA while I was on andro blocking.... Said there was no point.

sammy_bates wrote:

> is quite right Mark. Although I see your point, there is a

> different

> argument here. In my paper I call the PSA's obtained on

> LHRH-testicular-suppression " the castration basement " . Those of you

> who have

> read the paper will find a reference to it along with the biphasic

> diagrams.

>

> As long as PSA remains in the castration basement there is no worry

> and

> theoretically no need to measure constantly. [ Hence Mark is

> theoretically

> correct.] However, PC cells adapt to an androgen free environment and

> PSA

> starts to creep out of the basement eventually and so it is in

> practice

> necessary to watch out for changes in PSA level in the basement..

>

> Strum uses ultrasensitive PSA to 'catch' when a tumour begins to fail

> LHRH

> and that point serves as a kick-off for chemotherapy. Over on this

> side of

> the water our docs do not like chemo as a first resort so ultraPSA

> 'detection' is not really a serious issue. The issue becomes serious

> when a

> guy on LHRH has a PSAin the 10 or 20's because that means no matter

> what you

> do with the LHRH you are not going to get a durable response. Removal

> of

> Casodex ( take note) may achieve a temporary anti-androgen

> withdrawal response. It is worth a try. However, if it were me I would

> also

> remove the LHRH and move on to TRT ala Leibowitz without the

> thalidomide

> (maybe artemisia annua instead) or if that is not an option than DES.

> [

> Personally I would probably opt for death than go for DES, but that is

> just

> me. I know other guys who have personally opted for a continuation of

> LHRH

> and added DES and then died too. At this level it becomes a personal

> choice

> and one would hope there are decent doctors who will facilitate the

> 'non-choices' we have at our disposal when we reach a certain stage of

>

> advancement.

>

> Can I just remind folks that as long ago as the 50's and 60's doctors

> like

> Pearson and Prout were able to demonstrate a durable response with

> testosterone patches. In the days prior to PSA, subjective symptoms

> were

> often what was relied on. However in this day and age it is a crime

> not to

> investigate the androgen angle in a proper humanistic and scientific

> context.

>

> Sammy.

>

>

> Re:

> >

> >

> > You should be concerned. Taking a PSA of a person on hormone

> blocking

> > makes no sense whatsoever. It's a ridiculous waste of resources.

> You'll

> > never get a clear picture of what's really going on that way. I

> didn't

> > have a PSA test until I was half a year away from Zoladex. This is

> some

> > scary stuff though, eh? A mushroom growing in one's groin that

> doesn't

> > have the sense to not kill its host.

> >

> >

>

>

>

[Guest guest]

is quite right Mark. Although I see your point, there is a different

argument here. In my paper I call the PSA's obtained on

LHRH-testicular-suppression " the castration basement " . Those of you who have

read the paper will find a reference to it along with the biphasic diagrams.

As long as PSA remains in the castration basement there is no worry and

theoretically no need to measure constantly. [ Hence Mark is theoretically

correct.] However, PC cells adapt to an androgen free environment and PSA

starts to creep out of the basement eventually and so it is in practice

necessary to watch out for changes in PSA level in the basement..

Strum uses ultrasensitive PSA to 'catch' when a tumour begins to fail LHRH

and that point serves as a kick-off for chemotherapy. Over on this side of

the water our docs do not like chemo as a first resort so ultraPSA

'detection' is not really a serious issue. The issue becomes serious when a

guy on LHRH has a PSAin the 10 or 20's because that means no matter what you

do with the LHRH you are not going to get a durable response. Removal of

Casodex ( take note) may achieve a temporary anti-androgen

withdrawal response. It is worth a try. However, if it were me I would also

remove the LHRH and move on to TRT ala Leibowitz without the thalidomide

(maybe artemisia annua instead) or if that is not an option than DES. [

Personally I would probably opt for death than go for DES, but that is just

me. I know other guys who have personally opted for a continuation of LHRH

and added DES and then died too. At this level it becomes a personal choice

and one would hope there are decent doctors who will facilitate the

'non-choices' we have at our disposal when we reach a certain stage of

advancement.

Can I just remind folks that as long ago as the 50's and 60's doctors like

Pearson and Prout were able to demonstrate a durable response with

testosterone patches. In the days prior to PSA, subjective symptoms were

often what was relied on. However in this day and age it is a crime not to

investigate the androgen angle in a proper humanistic and scientific

context.

Sammy.

Re:

>

>

> You should be concerned. Taking a PSA of a person on hormone blocking

> makes no sense whatsoever. It's a ridiculous waste of resources. You'll

> never get a clear picture of what's really going on that way. I didn't

> have a PSA test until I was half a year away from Zoladex. This is some

> scary stuff though, eh? A mushroom growing in one's groin that doesn't

> have the sense to not kill its host.

>

>