A question about ADT protocol - need opinions

[Guest guest]

Hi all,

My Dad was diagnosed with advanced prostate cancer in Dec. 2005.

I've posted his history before but to briefly mention it again. He is

77, living in Western NY. Gleason scores 3+4 and 4+5. He has multiple

bone mets. PSA was 20 at time of diagnosis. He is asymptomatic except

for fatigue.

He was given a 1-month shot of Lupron plus 10 days of Flutamide

in Nov. 2005 (before his bone scan). He had a 3-month shot of Lupron

in Dec. 2005. His recent PSA was 1. We were most thankful for this

news!! I assume this means the cancer cells are not yet resistant to

the ADT. He had another 3-month shot of Lupron yesterday.

The doctor (who I have no confidence in since he never biopsied

my Dad once in a 10-year course of care despite elevated PSA - told

my Dad it was his " normal. " ) told my Dad that this would be his last

Lupron shot - that it can only be given for 6 months. He didn't say

what would come next as far as treatment and he is only checking the

PSA again in 6 months, which I thought was too long of a wait.

Any info/opinions on ADT and what might be wise to do next would

be helpful. I thought I had read somewhere that it is best to change

the ADT meds periodically and coupling them periodically is also

good, but I need to learn more about this part of the treatment so

that I can help my Dad as much as possible.

Thanks so much!

Margaret

[Guest guest]

You need to ask the doctor why he is stopping the Lupron? Is he changing

the treatment for medical reasons or because of changes in the Medicare

law. Changing the treatment because of reimbursement is unethical. Your

father should be getting the best treatment for his disease. Someone

needs to ask what the next step is. Does someone go to the doctor's

visits with your father? Two sets of ears are better than one. We all

filter what we hear. Do you have permission to talk to the doctor

directly?

Maybe it is time for your father to go to an oncologist who specializes

in PCa if the doctor is a urologist.

Kathy

A question about ADT protocol - need

opinions

Hi all,

My Dad was diagnosed with advanced prostate cancer in Dec. 2005.

I've posted his history before but to briefly mention it again. He is

77, living in Western NY. Gleason scores 3+4 and 4+5. He has multiple

bone mets. PSA was 20 at time of diagnosis. He is asymptomatic except

for fatigue.

He was given a 1-month shot of Lupron plus 10 days of Flutamide

in Nov. 2005 (before his bone scan). He had a 3-month shot of Lupron

in Dec. 2005. His recent PSA was 1. We were most thankful for this

news!! I assume this means the cancer cells are not yet resistant to

the ADT. He had another 3-month shot of Lupron yesterday.

The doctor (who I have no confidence in since he never biopsied

my Dad once in a 10-year course of care despite elevated PSA - told

my Dad it was his " normal. " ) told my Dad that this would be his last

Lupron shot - that it can only be given for 6 months. He didn't say

what would come next as far as treatment and he is only checking the

PSA again in 6 months, which I thought was too long of a wait.

Any info/opinions on ADT and what might be wise to do next would

be helpful. I thought I had read somewhere that it is best to change

the ADT meds periodically and coupling them periodically is also

good, but I need to learn more about this part of the treatment so

that I can help my Dad as much as possible.

Thanks so much!

Margaret

[Guest guest]

Hi Margaret.

My thoughts on stopping ADT after 6 months are that if high PSA levels

indicate tumor activity and low PSA indicates lack of tumor activity then

one should stay on ADT for as long as it continues to suppress the PSA

readings. If it is not broke, don't fix it.

I have been taking Lupron 4 month shots for almost two years now. At age 75

I am close to your father's age. I get a PSA test every 4 months and thus

far my Psa level is undetectable (less than .01) having fallen from a high

of 6.5 after a failed Cryosurgery. I cannot envision anything that would

make me stop taking Lupron until the treatment stops working. Some men I

have heard of have been on ADT for 10 years or more. Lupron is a little

pricey but my Medicare Advantage insurance covers all but $110 a month

coinsurance for the treatments. Treatments given in the doctors office are

covered by the medical provisions of Medicare and are not part of

prescription drug coverages as I understand it.

I am sure some of the smarter of our list members will cover your question

better than I but these are my thoughts for what they are worth.

" il faut d'abord durer " Hemingway

A question about ADT protocol - need

opinions

> Hi all,

> My Dad was diagnosed with advanced prostate cancer in Dec. 2005.

> I've posted his history before but to briefly mention it again. He is

> 77, living in Western NY. Gleason scores 3+4 and 4+5. He has multiple

> bone mets. PSA was 20 at time of diagnosis. He is asymptomatic except

> for fatigue.

> He was given a 1-month shot of Lupron plus 10 days of Flutamide

> in Nov. 2005 (before his bone scan). He had a 3-month shot of Lupron

> in Dec. 2005. His recent PSA was 1. We were most thankful for this

> news!! I assume this means the cancer cells are not yet resistant to

> the ADT. He had another 3-month shot of Lupron yesterday.

> The doctor (who I have no confidence in since he never biopsied

> my Dad once in a 10-year course of care despite elevated PSA - told

> my Dad it was his " normal. " ) told my Dad that this would be his last

> Lupron shot - that it can only be given for 6 months. He didn't say

> what would come next as far as treatment and he is only checking the

> PSA again in 6 months, which I thought was too long of a wait.

> Any info/opinions on ADT and what might be wise to do next would

> be helpful. I thought I had read somewhere that it is best to change

> the ADT meds periodically and coupling them periodically is also

> good, but I need to learn more about this part of the treatment so

> that I can help my Dad as much as possible.

> Thanks so much!

> Margaret

>

>

>

>

>

>

>

>

[Guest guest]

with some med it best to rotate it, and usually your doctor could tell when it's that time by the reading receive from your blood test. is there any reason you would like another biopsy. this would be my 3 year after my first treatment, another biopsy has not been needed my meds has been changed and added to several time, not by my request but by my test results and symptions.Kathy Meade wrote: You need to ask the doctor why he is stopping the Lupron? Is he changingthe treatment for medical reasons or because of changes in the Medicarelaw. Changing the treatment because of reimbursement is unethical. Yourfather should be getting the best treatment for his disease. Someoneneeds to ask what the next step is. Does someone go to the doctor'svisits with your father? Two sets of ears are better than one. We

allfilter what we hear. Do you have permission to talk to the doctordirectly?Maybe it is time for your father to go to an oncologist who specializesin PCa if the doctor is a urologist.Kathy-----Original Message-----From: ProstateCancerSupport [mailto:ProstateCancerSupport ] On Behalf OftheherbalnookSent: Saturday, March 18, 2006 8:02 AMTo: ProstateCancerSupport Subject: A question about ADT protocol - needopinionsHi all,My Dad was diagnosed with advanced prostate cancer in Dec. 2005. I've posted his history before but to briefly mention it again. He is 77, living in Western NY. Gleason scores 3+4 and 4+5. He has multiple bone mets. PSA was 20 at time of diagnosis. He is asymptomatic except for fatigue.He was given a 1-month shot of Lupron plus 10 days of Flutamide in Nov. 2005 (before his bone scan). He had a 3-month

shot of Lupron in Dec. 2005. His recent PSA was 1. We were most thankful for this news!! I assume this means the cancer cells are not yet resistant to the ADT. He had another 3-month shot of Lupron yesterday. The doctor (who I have no confidence in since he never biopsied my Dad once in a 10-year course of care despite elevated PSA - told my Dad it was his "normal.") told my Dad that this would be his last Lupron shot - that it can only be given for 6 months. He didn't say what would come next as far as treatment and he is only checking the PSA again in 6 months, which I thought was too long of a wait.Any info/opinions on ADT and what might be wise to do next would be helpful. I thought I had read somewhere that it is best to change the ADT meds periodically and coupling them periodically is also good, but I need to learn more about this part of the treatment so that I can help my Dad as much as possible. Thanks so

much!Margaret

[Guest guest]

Hi Margaret.

My thoughts on stopping ADT after 6 months are that if high PSA levels

indicate tumor activity and low PSA indicates lack of tumor activity then

one should stay on ADT for as long as it continues to suppress the PSA

readings. If it is not broke, don't fix it.

I have been taking Lupron 4 month shots for almost two years now. At age 75

I am close to your father's age. I get a PSA test every 4 months and thus

far my Psa level is undetectable (less than .01) having fallen from a high

of 6.5 after a failed Cryosurgery. I cannot envision anything that would

make me stop taking Lupron until the treatment stops working. Some men I

have heard of have been on ADT for 10 years or more. Lupron is a little

pricey but my Medicare Advantage insurance covers all but $110 a month

coinsurance for the treatments. Treatments given in the doctors office are

covered by the medical provisions of Medicare and are not part of

prescription drug coverages as I understand it.

I am sure some of the smarter of our list members will cover your question

better than I but these are my thoughts for what they are worth.

" il faut d'abord durer " Hemingway

A question about ADT protocol - need

opinions

> Hi all,

> My Dad was diagnosed with advanced prostate cancer in Dec. 2005.

> I've posted his history before but to briefly mention it again. He is

> 77, living in Western NY. Gleason scores 3+4 and 4+5. He has multiple

> bone mets. PSA was 20 at time of diagnosis. He is asymptomatic except

> for fatigue.

> He was given a 1-month shot of Lupron plus 10 days of Flutamide

> in Nov. 2005 (before his bone scan). He had a 3-month shot of Lupron

> in Dec. 2005. His recent PSA was 1. We were most thankful for this

> news!! I assume this means the cancer cells are not yet resistant to

> the ADT. He had another 3-month shot of Lupron yesterday.

> The doctor (who I have no confidence in since he never biopsied

> my Dad once in a 10-year course of care despite elevated PSA - told

> my Dad it was his " normal. " ) told my Dad that this would be his last

> Lupron shot - that it can only be given for 6 months. He didn't say

> what would come next as far as treatment and he is only checking the

> PSA again in 6 months, which I thought was too long of a wait.

> Any info/opinions on ADT and what might be wise to do next would

> be helpful. I thought I had read somewhere that it is best to change

> the ADT meds periodically and coupling them periodically is also

> good, but I need to learn more about this part of the treatment so

> that I can help my Dad as much as possible.

> Thanks so much!

> Margaret

>

>

>

>

>

>

>

>