RE: Advise please

[Guest guest]

Midge,

I hate to be the bearer of bad news, but

there are some aspects of what you post that are of concern and that may need

some action sooner rather than later. The main issue is the fact that although

your husband’s PSA dropped dramatically after the radiation and the

commencement of the chemical therapy, it did not drop as far as it should and

it has now started to rise. I say that is of concern because, although there is

sometimes a temporary rise in PSA – the so called PSA “bump” -

after radiotherapy, more often than not such a rise is associated with prostate

cancer cells that have not been killed off by the treatment and are again

becoming active.

I am not in any position to give you any

advice on how best to proceed, and there are very few men with advanced prostate

cancer who post on this List. There are

however Mailing Lists where the focus is on advanced prostate cancer and

hormone therapies and I know that the men on those sites will help you all they

can. If you have not used a Mailing List before you might find it helpful

to go to http://www.yananow.net/FAQmailinglist.htm ; if you know about Lists and Forums then you

might join http://www.prostatepointers.org/mailman/listinfo/chb

a List where men discuss hormone blockade options and http://www.groups.prostate-help.org/grsubsc.htm

where you will see that there is a specific List for men with

Advanced Disease.

Below are some links for

men with advanced disease you might find helpful

http://prostate-cancer.org/resource/advancedprostatecancerhandbook.html

This is an excellent handbook that you can order free of charge entitled Living with Advanced Prostate Cancer

When PSA Rises During Hormone Therapy

http://www.ustoo.com/Experienced_Relapse.asp

One of the US-TOO sites which also has excellent advice on pain management

http://patient.cancerconsultants.com/prostate_cancer_news.aspx?id=32365

Details of a chemotherapy treatment with Taxotere that has proved a useful

management tool

I hope this helps some. Please don’t

think that all is lost. There is a wonderful man by the name of Ric Masten who is

in his eight year of treatment following a very bad diagnosis of advanced prostate

cancer. His battle is graphically described in his website at http://www.ric-masten.net/Prostate.Series.html

All the best,

Terry Herbert in Melbourne, Australia

Diagnosed ‘96: Age

54: Stage T2b: PSA 7.2: Gleason 3+3=6: No treatment. August '06 PSA 27.4

My site is at www.yananow.net

As a

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

to prostate cancer are made with inadequate data: Dr

“Snuffy” Myers.

From: ProstateCancerSupport

[mailto:ProstateCancerSupport ] On Behalf Of miando134@...

Sent: 19 September 2006 02:45 AM

To:

ProstateCancerSupport

Subject:

Advise please

My hubby went into the hospital on May

1st with PSA of 135 approximate. A biopsy proved PCa, Gleason score of

4+4 or 8, with mets to the bones in several places. I hope I am saying

all that correctly. He underwent radiation and has an implant - Vantas -

and has a monthly IV of Zometa. His PSA in June 05 was 2.7, May 06 - 135,

June 06 - 2.1 and last week 4.02. He has been on Casodex also.

Should we be alarmed? Any questions we need to ask? Would it be

safe to wait until December when he'll have another PSA and sees the

urologist? He sees the primary doctor tomorrow.

Just as we both were feeling confident

that everything was going fine and under control, it is a big let-down

right now.

Midge

" Good friends are like stars...

You don't always see them, but you know

they are always there. "

[Guest guest]

Midge --

I agree with Terry Herbert that you want to get right on this progression given this rapid doubling time. I don't think a urologist is the kind of specialist you need at this point in your prostate cancer journey. Your husband needs to be in the care of a medical oncologist, preferably one specializing in prostate cancer. Mark Scholz, Glenn Tisman, Snuffy Myers, and a handful of others would be good choices. This is serious disease and your husband might benefit from the addition of high dose ketoconazole and hydrocortisone, or some other form of treatment that will address the androgen-independent prostate cancer that is responsible for his rising PSA. Mark Scholz often uses early chemotherapy to attack the cancer while the tumor burden is relatively small and the body relatively strong rather than waiting around for the cancer to grow and begin to take it's toll on the stamina of the patient.

You will understand the implications of androgen-independent prostate cancer better if you look into the discussion in the Primer regarding what agents have activity against androgen-dependent vs. androgen-independent prostate cancer. The Zometa is good. It has been shown to have anti-cancer activity and is the best weapon we have in our arsenal to prevent bone loss and help prevent fractures or other skeletal related incidents in men with advanced prostate cancer.

Keep us posted on your situation and get back to us with your questions as you go along, but do also look into becoming part of a list where there are more men with advanced prostate cancer who can give you the benefit of their experiences.

Donna Pogliano

Co-author of "A Primer on Prostate Cancer, The Empowered Patient's Guide"

Advise please

My hubby went into the hospital on May 1st with PSA of 135 approximate. A biopsy proved PCa, Gleason score of 4+4 or 8, with mets to the bones in several places. I hope I am saying all that correctly. He underwent radiation and has an implant - Vantas - and has a monthly IV of Zometa. His PSA in June 05 was 2.7, May 06 - 135, June 06 - 2.1 and last week 4.02. He has been on Casodex also. Should we be alarmed? Any questions we need to ask? Would it be safe to wait until December when he'll have another PSA and sees the urologist? He sees the primary doctor tomorrow.

Just as we both were feeling confident that everything was going fine and under control, it is a big let-down right now.

Midge

"Good friends are like stars...

You don't always see them, but you know they are always there."