Battling Prostate Cancer

A large new study is challenging the common practice of recommending that elderly men forgo treatment for early prostate cancer and instead wait to see whether the malignancy progresses. Full Story
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cktirumalai

Washington, DC

#1 Dec 13, 2006
I notice that some experts in the field do not agree with the conclusions of this study and still feel that a wait-and-watch approach is suitable in many cases. I think the decision about whether to treat or not treat early prostate cancer has to be a very individual one. What sort of prostate cancer is it? How healthy is the man (this illness being gender specific)? How long can he expected to live? And other questions. What is clear is that, unfortunately, it is not rare among men over 65 and that a proportion of them do die of it. In my very limited sample no one whose prostate gland was surgically removed died of it, but the surgery led to unwanted side-effects.

Since: Jun 07

Ferndale, FL

#2 Jun 21, 2007
I was just diagnosed with prostate cancer, PSA 4.2, two spots are 6 on the Gleason scale.

I am nearly 66 and enjoying a healthy retirement and the doc says he must cut out my prostate out or burn it out with radiation. At first I agreed but after an internet search I canceled all appointments with the Doc. I want to live until I die.
Why should I give up my good health so a doc can make $20,000?

Since: Jun 07

Ferndale, FL

#3 Jun 21, 2007
cktirumalai, your link has gone bad.

Since: Jun 07

Ferndale, FL

#4 Jun 22, 2007
Scientists recently uncovered a novel component of milk thistle that may be a powerful new weapon for preventing and possibly even treating prostate cancer.

http://www.lef.org/magazine/mag2005/nov2005_r...
RJS - Miami Florida

United States

#5 Jun 27, 2007
Jim Bean wrote:
I was just diagnosed with prostate cancer, PSA 4.2, two spots are 6 on the Gleason scale.
I am nearly 66 and enjoying a healthy retirement and the doc says he must cut out my prostate out or burn it out with radiation. At first I agreed but after an internet search I canceled all appointments with the Doc. I want to live until I die.
Why should I give up my good health so a doc can make $20,000?
Get another doc who is honest in telling you ALL of your options, not just what he can perform. With a Gleason score of 6 and non-metatasized cancer you should consider Proton Beam irradiation costing $147,000 but covered by Medicare and medigap policies. IMHO your Gleason score is too high for "watchful waiting". Proton Beam irradiation does not cause ED and does not do the collateral damage to bladder and bowel which is done by conventional radiation. I tried to phone you with lots of useful info but regrettably found you have unlisted phone number. Set up and post a temporary Hotmail email address and I will get in contact with you.

Since: Jun 07

Ferndale, FL

#6 Jun 29, 2007
Hello RJS,

Thanks for the info. I will keep watch on this board for you. Jim Bean is my internet name but it makes a good drink.

Proton Beam irradiation,$147,000 Wow! I have been looking into sonic knives to remove the prostate without surgery or radiation. And maybe laser burning of the prostate.
RJS - Miami Florida

United States

#7 Jun 29, 2007
Jim,

You really need to make a totally informed decision, taking into account ALL your options. You have more options than I did in 1995. I very much would like to help you and am fully informed to do so.

Using IE7 you can right now download a message to you from ftp://65.10.70.13 to enable you to contact me directly.

Since: Jun 07

Ferndale, FL

#8 Jun 29, 2007
Hello RJS,

You can reach me at oldreb2@aim.com

Jim

Since: Jun 07

Ferndale, FL

#9 Jun 30, 2007
Hello RJS,

I got your email and I have googled proton therapy and find if very interesting but I am not going to do anything yet. I am Waiting to do a new PSA test. If I do anything I think it will be along the lines of Sonic surgery.

It looks to me that no matter what you do you still have to have neutron radiation for a clean up of stray prostate cancer cells.

Jim
RJS - Miami Florida

United States

#10 Jul 3, 2007
Jim - A new PSA test is totally worthless at the point that you already have had the biopsy and you know you have aggressive prostate cancer. There is no such thing as Sonic surgery for prostate cancer. No such thing as neutron radiation for "a clean up of stray prostate cancer cells". You can't afford this totally naive uninformed procrastination. Every day of delay reduces your chance of cure. At the rate you are going, you are headed for incurable and metastasized prostate cancer and will probably die of it. It is a particularly bad death. In all probability you can obtain a total cure and live a long and healthy life if only you will have RP, LRP, X-ray irradiation or Proton Beam irradiation quickly. You have to have one of the effective treatments before you have metastasis and become incurable. My best wishes are with you.

Since: Jun 07

Ferndale, FL

#11 Jul 3, 2007
Hello RJS,

You are the uninformed one. There are two types of sonic surgery, HIFU,(High Intensity Focused Ultrasound and Sonablade.
They are used in Europe, Canada and Mexico, and trials are running in the USA.

It burns the prostate out without surgery or radiation and it is done as an outpatient.

The anal probe has a c shape that sends sonic waves from the top to the bottom of the "C" and the waves enter the body without harm but at the point where all the waves meet the temperature of that point destroys the prostate flesh.

I prefer the slow growing cancer to radiation, freezing, laser burning or major surgery. Now I have another choice, Sonic surgery.
Dale

Sacramento, CA

#12 Jul 4, 2007
Hello, there your topic is indeed interesting..my Father was just diagnosed with Prostate Cancer Yesterday..i'm crush upon hearing the news..I need your opinions on how to battle this problem.which is the best method to battle it up.
RJS Miami Florida

United States

#13 Jul 4, 2007
Dale, The most important factors are:(1) Is the cancer still confined to the prostate gland?(2) What is the Gleason score on a scale of 2 to 9? For a prostate cancer which has not metastasized the Gleason score is the the most important predictor of the outcome. Beware that many of the doctors offer as treatment options only what they are prepared to do, not the best that is available to the patient nationwide or worldwide. That is shameful. As I stated before to "Jim" the current best current day treatments (approved by the FDA and known effective) for non-metastasized prostate cancer are Proton Beam Irradiation and Laproscopic Prostatectomy (may be robot assisted). X-ray radiation will work, but the collateral damage to bowel and colon will give problems down the pike. I would recommend staying away from cryo and seeding. My own options in 1995 were X-ray radiation and the rough old open incision retropubic radical prostatectomy. When diagnosed I moved quickly and elected the latter. The cancer is totally gone. BPH symptoms (urinary blockage) are also totally cured. There is no problem with incontinence, but, as expected, I am left with ED. Proton Beam irradiation would likely not have the ED side effect. I have friends who have had RP and X-ray radiation, with total cures. Another recently had LRP in Houston. We will not know for some time if he is totally cured. Another friend let things go, now has metastasized cancer and is on Cassodex to extend his life. Two other friends died of metastasized prostate cancer. Another with very low Gleason score has done nothing and the cancer seems to be so slow growing that he may never have it treated. I have one friend with high Gleason score headed to Shands Hospital in Jacksonville for Proton Beam irradiation. He should come out of treatment cured and with little or no bad side effects. If you want to communicate in detail, you will have to provide at least a temporary Hotmail email address.

Since: Jun 07

Ferndale, FL

#14 Jul 4, 2007
Here are some articles I gleaned from the internet.

The Partin tables are the best nomogram for predicting prostate cancer spread and prognosis.
Men with PSA levels less than 10 ng/mL and low- or moderate-grade histology (Gleason score <7) with no findings or minimal findings upon physical examination may proceed to surgery or brachytherapy without further studies. Men with PSA levels greater than 10 ng/mL, high-grade histology (Gleason score >7), or physical findings suggesting stage T3 disease should probably undergo a staging CT scan and bone scan. The CT scan is the one modality with evidence-based guidelines. The CT scan can evaluate extension into the bladder and lymph nodes to help stage the patient's cancer or to consider lymph node sampling prior to treatment. TRUS (transrectal ultrasound (TRUS)) is no better than DRE, and positron emission tomography scans are not proven effective.
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Treatment Options Continue to Evolve
"The landscape around management options continues to evolve," said Dr. See. Take for example brachytherapy. Brachytherapy involves physically placing radioactive pellets inside the prostate to treat the cancer without surgery. "The trend in the past decade for greater use of seed implantation is seeing a reversal, driven by the recognition that seed implantation is over the long haul not nearly as benign as initially perceived and that it's not as effective an option for cure as was initially hoped.
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Using the National Cancer Institute's Surveillance, Epidemiology and End Results (SEER) database of 60,269 men diagnosed with localized prostate cancer between 1998 and 2002, Tward and colleagues assessed the rate of death due to prostate cancer or any cause after a median of 46 months.
Outcomes of brachytherapy, removal of the prostate (prostatectomy) or no definitive treatment were assessed for men less than 60 years of age at diagnosis and those aged 60 years and older.
Prostate cancer-specific mortality rates at 10 years for the younger age group were 1.3 percent with surgery, 0.5 percent with brachytherapy and 3.7 percent with no definitive therapy.
For older men, corresponding mortality rates were 3.8 percent with surgery, 5.3 percent with brachytherapy and 8.4 percent with no definitive therapy.
SOURCE: Cancer, November 15, 2006.
http://www.prostatecancerfoundation.org/site/...
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Prostate Radiation May Raise Rectal Cancer Risk
Pay Careful Attention to Colorectal Screening, Experts Say
Article date: 2005/04/07
Men who get radiation treatment for prostate cancer are 70% more likely to develop rectal cancer than those who are treated with surgery only, according to a new study in the journal Gastroenterology (Vol. 128, No. 4:819-824).
Men who have been irradiated need to be particularly careful that they are getting screened for colorectal cancer,
http://www.cancer.org/docroot/NWS/content/NWS...
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Rectal polyps were most closely related to patient age and percent positive biopsies, whereas sigmoid/colon polyps were best predicted by patient age, planning volume, and supplemental XRT. Conclusions: Colorectal cancer was diagnosed with equal frequency before and after brachytherapy with comparable geographic distributions. In addition, the vast majority of postbrachytherapy colorectal polyps were located beyond the confines of the rectum.
http://cat.inist.fr/...
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The research suggests that a PSA velocity of more than 2ng/ml/year strongly suggests aggressive disease, according to study leader Dr. Anthony D'Amico, of Boston's Brigham and Women's Hospital.
Dale

Yuba City, CA

#15 Jul 4, 2007
To RJS,

my e-mail alvindale_myself@yahoo.com..as of now i don't have the Gleason score.i'm still waiting for my sister to call.The only feedback I got is the Radiation therapy which will be scheduled as long as my Dad's fever will subside..i'm not sure as well about the stage,as long as i got it i'll share it here..
Dale

Yuba City, CA

#16 Jul 4, 2007
To RJS,
my temporary hotmail...alvindale_myself@hot mail.com
Dale

Antelope, CA

#17 Jul 7, 2007
Does anyone Know the Generic name of Cassodex or Lupron?
RJS Miami Florida

United States

#18 Jul 8, 2007
Dale,
http://www.coloradourologists.com/documents/p... shows the chemical name of Cassodex (elsewhere spelled Casodex) to be Bicalutamide and or Lupron to be Luprolide (elsewhere spelled Leuprolide). Lupron/Luprolide is manufactured by Abbott and is probably still on patent. Bicalutamide 50 mg is available in the generic from CanadaMedicineShop.com today at $420.00 #90 (vs branded price of $599). That is probably your best buy. I do not readily find a generic of Lupron. BTW, I purchase all the high ticket non-generic meds for our family from CanadaPharmacy.com at a saving of about 50% compared to purchasing in the U.S. They meet the price of all Canadian competitors in B.C. and are a great source. The generics are generally cheaper locally in the U.S. Your dad can likely get his best buy on Lupron or Cassodex at home in the Phillipines.
virginian

Waynesboro, VA

#19 Jul 9, 2007
I am a 44 year old male who has been diagnosed with stage 4 prostate cancer [metatisized to hip and sacrum],gleason scores 7-8 or all 9's depending on 2 different interpretations.My psa was intitially 128 but had droped to 84 before i started any treatment on diet alone [no milk no diary, flax seed oil, promogranite juice,green tea and lots of soy and fish] I have started lupron about 2 weeks ago but is still to early to know if it is working well yet..mdanderson took the strategic approach of doing just the hormones and waiting to see what happened keeping all my options for clinical trials open 2-5 years down the road when technology has improved.My questions are these 2: 1] does anuyone have any advise on clinical trials or something where i could be more aggressive. 2] my hip metatisis is not getting any better and was wondering if anyone had any advise ? thanks Rob

Since: Jun 07

Ferndale, FL

#20 Jul 9, 2007
Hello Virginan,

Here is some info on a immunothearpy.

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by DAN CHILDS
ABC News Medical Unit
March 30, 2007

A Food and Drug Administration (FDA) advisory panel announced Thursday that a new treatment designed to turn the body's own immune system against deadly prostate cancer tumors is both safe and effective.

The 17-member panel voted unanimously that the drug is safe, and 13-4 that substantial evidence exists suggesting that it is effective in treating prostate cancer.

http://abcnews.go.com/Health/CancerPrevention...

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