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Old 07-18-2009, 10:46 AM   #1
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Prostate Cancer Stage and Treatment Route

As of this past week, my 73-year old dad was diagnosed as having prostate cancer.

Two weeks ago, he had an appointment with his local physican to take a DRE exam and a PSA test.

His doctor did not feel anything out of the ordinary when he administered the DRE, which led both of us to believe that everything was alright.

However, when my dad's PSA result came back, his was over 6.

This was shocking because he had taken a PSA exam almost a year-and-a half ago, and his PSA number was about 4.5.

We don't understand how it could have climbed so much in just a litte over a year!

So, the week after that, he made a consultation appointment to see a urologist; and a day later, got his biopsy.

When the technican was giving my dad his ultrasound prior to the biopsy, he did not really notice anything out of the ordinary that would really suggest that he had cancer.

The urologist told my dad that if the biopsy results looked malignant, he would schedule an appointment to see him.

Sure enough, the result came back a little less than a week showing not only did he have cancer; but, according to the Gleason scores(1 to 5 being the least aggressive), he has a rather aggressive form of prostate cancer.
Three of the 12 samples that they took from his prostate where malignant. The Gleason scores where:

7 covering 88% of the sample
6 covering 10% of the sample
9 covering 40% of the sample

Of course, its the score 9 that has us most concerned since it is near the base .

That kind of indicates that it is trying to spread from the localized area of the prostate.

Speculatively, I wander what stage of prostate cancer, from I to IV, he is in.

I was hoping he would be in Stage I so they could either treat it with the wait and see approach or radiation therapy.

That question will probably be answer next week when he takes his CT and bone scan to see if the malignancy has spreaded outside of the prostate area.

If the CT and bone scans show that it has not spreaded, his family doctor, urologist, and most friends/family are recommending that he has radical prostatectomy or prostate removal.

He has checked with M.D. Anderson, one of the most renowned treatment cancer treatment centers in America, if not the world.

They said they could set up an appointment within 7 to 10 days.

But M.D. Anderson is so far away from where we live, and they are probably going to schedule follow up appointments if he has his surgery done there.

We also considered the side effects of prostate removal such as impotence, incontinence, and intimacy which are not very pretty.

My dad will be inactive for about six weeks after the surgery to recoperate.

By the way, I'm just wandering what has been the experiences of most people on this blog who have had radical prostatectomy or have friends/loves ones that had it done.

If it has spreaded beyond the prostate, most likely they are not going to do surgery.

The oncologist will probably treat it with hormone therapy, radiation, chemotherapy(God forbid), or a combination of all three.

Hormone therapy, probably next to chemotherapy, will have the most negative side effects, which are diabetes, heart disease, and cardiac arrest. My dad has a heart condition.

Of course I don't even have to mention how bad chemotherapy is.

My dad is also due to see a radiologist on Aug 3.

My dad's sister, or my aunt, is strongly against surgery if the tumor turns out to still be localized in the prostate.

She is a dyed-in-the-wool Seventh Day Adventist naturalist who believes that being on a strict, natural vegetarian diet can maybe help cure cancer.

My aunt has a strong distrust of doctors and drug companies. She thinks that they are out to rip people off and their side effects are sometimes worse than the cure.

She recently sent us a DVD about this doctor who went to a place called Times Of Refreshing Ministries in Georgia, which is a presumingly Seventh Day Adventist facility that specializes in bringing advanced cancer patients into remission whom others have written off as terminal.

They do this through a strict natural herbal diet.

This doctor happens to be a prostate cancer patient. His PSA was over 1000.

At first, he ignored the early signs of cancer by taking vitamins and other supplements.

Then, the tumor metastasis from the prostate and spreaded to his kidney. As a result, he suffered kidney failure and had to go on dialysis.

But, since he went to Times of Refreshing Ministries, he has gotten alot better without surgery/radiation/chemo. He is off of dialysis and his PSA level has dropped from over 1000 to 13.

I don't know what their diet consists of; but, apparently it worked in this guy's case.

I am skeptical of this alternative treatment ministry called Times of Refreshing Ministries. Sure, it worked for this doctor; but, who is to say that it will work for my dad?

He recently talked to the minister who is the head of Times of Refreshing Ministries. The minister did not really go into detail as to what exactly what this herbal or vegaterian diet consist of.

It also consists of getting enough sleep, exercise, water, etc.

At first, my dad seemed really enthusiastic about the program.

Now, he is having second thoughts.

So, we are really debating on where we want to go from here; but, everything depends on the CT and bone scan results this coming week.

 
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Old 07-18-2009, 01:21 PM   #2
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Re: Prostate Cancer Stage and Treatment Route

Look into Proton Beam Therapy at Loma Linda.

 
Old 07-18-2009, 02:12 PM   #3
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Re: Prostate Cancer Stage and Treatment Route

Sorry to read about the relatively high Gleason scores, but that doesn't mean successful treatment cannot be done. While you mention the side effects from hormone treatment, that, coupled with radiation, might be a course to consider. Everyone has to make up his own mind, but surgery for a 73 year old given all you've reported would not seem to be the path to take. Surgeons will probably disagree.

You didn't say what part of the country you are from. The previous poster suggested you look into proton beam therapy at Loma Linda in California. I'm on the east coast and chose proton beam therapy at Univ of Florida Proton Therapy Institute in Jacksonville. I did a tremendous amount of research before selecting that method of treatment, which is a highly targeted form of radiation with lower side effects than a lot of other treatment forms. (I initially was scheduled for surgery.)

I might suggest an endorectal MRI with spectroscopy, as this can be very helpful in showing whether the cancer is contained within the prostate capsule. It's more accurate than the standard MRI. One of the benefits of radiation is that the treatment coverage area can be adapted to cover a little more area at the edge of the prostate.

I know that the Jacksonville facility often recommended hormone therapy for a 6 to 12 month period following the radiation treatment for higher risk patients (generally a Gleason score of 8 or 9). While there can be side effects from the hormones, these generally are over once that period ends. I think they do the same thing at Loma Linda, only the hormone treatment may precede the course of radiation treatment. If you have interest in learning more, I'd suggest you contact one or both of those centers. They can send you some detailed information. There's a great book discussing the benefits of proton written by Robert Marckini- You Can Beat Prostate Cancer. That's become one of the most read books in the prostate cancer subject area
(I think the second largest seller for one of the largest online book resellers).

I'm not a medical professional, and there are many things to consider, so it's good you are talking to others. Please write again, as I know you're just beginning to look into the alternatives.

I'm adding a couple more thoughts-- I don't think there is a "wait and see" option, and herbal treatments might be right for some, but that's a personal choice, and it wouldn't be anything I'd consider now given the facts of this case.

An area to consider might be only hormonal therapy. There are a lot of posts by IADT3since2000 that you can read. Jim was diagnosed with a very advanced case, and was unable to do radiation or surgery-- but he's successfully treated the cancer by a triple hormone therapy program. One of the books that talks about this is "A Primer on Prostate Cancer - The Empowered Patient's Guide," Strum & Pogliano. Hopefully you'll get Jim's thoughts when he sees your post. There's no one more knowledgeable on this board, in my opinion, that he is.

Last edited by daff; 07-18-2009 at 02:25 PM. Reason: added some information after submitting the initial post

 
Old 07-18-2009, 05:08 PM   #4
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Re: Prostate Cancer Stage and Treatment Route

Prostate Cancer Stage and Treatment Route

Welcome jawhik,

I realize this is one board you would rather have nothing to do with, but we are a band of fine layman (virtually all of us) colleagues who are here to help each other, and I believe you will enjoy the fellowship of the board. Your dad is fortunate to have you working to help him, and it is clear from your post that the family is rallying around him. This is one of those times when families can play such an important role.

Just so you know where I am coming from, I am now a survivor of nearly ten years of a challenging case of prostate cancer with an initial survival prediction of five years from two leading centers (my story with updates is on the board). My only therapy has been hormonal blockade, supported with bisphosphonate drugs and supplements for the bones and a lifestyle program of nutrition/supplements/diet, exercise and stress reduction that is tailored to prostate cancer. (My initial stats in 1999/early 2000: PSA 113.6, Stage 3, Gleason 4+3=7, all cores positive, most 100% cancer, but scans negative - CT, bone, ProstaScint.) I am in my third round of intermittent triple hormonal blockade at age 66, and I was able to drive my PSA down to less than (<) 0.01 at the end of the previous two rounds of full triple therapy (for me, Lupron + 50 mg Casodex + 10 mg finasteride daily, plus Fosamax or Boniva for bone protection). My PSA has been falling about 25% per month (slow for most men, but normal for me), and is now at 0.15. I'm in good shape, benefiting much from known countermeasures for the side effects of hormonal blockade, and busy replanking and refurbishing my deck with 15'9" pressure treated lumber.

I'll insert some thoughts in green. Jim


Quote:
Originally Posted by jawhik View Post
As of this past week, my 73-year old dad was diagnosed as having prostate cancer.

...His doctor did not feel anything out of the ordinary when he administered the DRE, which led both of us to believe that everything was alright.

That's actually a very good sign if the doctor's DRE was well done. It means the stage is considered 1 at this time, and I'll add a question about the urologist and his DRE below.

However, when my dad's PSA result came back, his was over 6.

Would you mind telling us exactly what it was and the dates of the 4.5 PSA and the latest one? That information actually is quite useful, as in the past few years researchers have demonstrated that a rise at a rate of 2.0 or under per year in the year prior to diagnosis suggests a milder case than would otherwise be expected, while a rise at a rate of more than 2.0 suggests a more challenging case than otherwise. There's a thread on the board on this entitled "PSA Velocity >2 and assessing seriousness of prostate cancer - AUA endorsement" started 5/31/2009, which ties in with "Psa velocity >2.0 and assessing seriousness of prostate cancer", started 12/15/2007. Those threads will lead you to underlying research which you can access on www.pubmed.gov, a site we can use on this board because it is Government sponsored. (Our US tax dollars doing some highly useful work! )

However, it would be wise to get another PSA at least two to six weeks after the biopsy, to allow the prostate to recover with more time preferable, but before commencing any treatment, using the same version of PSA test done by the same lab. It's possible your dad's PSA was just fine up to several months ago, but then commenced a rapid climb. Hope not.


This was shocking because he had taken a PSA exam almost a year-and-a half ago, and his PSA number was about 4.5.

We don't understand how it could have climbed so much in just a litte over a year!

Cancer can do that (so can infection, even more so), but as noted above, the rise you indicate appears to be below that threshold of >2.0.

So, the week after that, he made a consultation appointment to see a urologist; and a day later, got his biopsy.

The urologist would almost surely have done his own DRE, and urologists are much more expert at doing them and interpreting results. It really is important to nail down that stage, which in prostate cancer hinges primarily on the DRE at this point; it is a strong but not perfect indicator whether the cancer is confined to within the prostate capsule.

...

A dark area can suggest a greater likelihood of cancer, but ultrasound is usually not that helpful. It does provide some hints as to places to take biopsy cores.

...Sure enough, the result came back a little less than a week showing ...he has a rather aggressive form of prostate cancer.
Three of the 12 samples that they took from his prostate where malignant. The Gleason scores where:

7 covering 88% of the sample
6 covering 10% of the sample
9 covering 40% of the sample

Of course, its the score 9 that has us most concerned since it is near the base .

That biopsy result clearly rules out an Active Surveillance approach, even in a man your dad's age with a heart condition, in my now-savvy layman's opinion, but with no enrolled medical education. It looks like you and your dad already appreciate this.

It is actually better that the Gleason 9 core is near the base, as the prostate capsule is thicker there, making it harder for the cancer to grow through the capsule.


...Speculatively, I wander what stage of prostate cancer, from I to IV, he is in.

As noted above, based on the DRE from the first doctor, it's probably stage 1; but check with the urologist and get a copy of his notes if you can. You should be able to get his DRE evaluation results.

I was hoping he would be in Stage I so they could either treat it with the wait and see approach or radiation therapy.

As noted, "wait and see", which is a weaker form of Active Surveillance, is almost surely not a wise approach for your dad. However, radiation can be used all the way up to Stage 4, though it is much more likely to be curative in Stages 1, 2 and 3. Radiation could be a good option for your dad, even with his heart condition.

...next week when he takes his CT and bone scan to see if the malignancy has spreaded outside ...

These scans, so often useless, inadvisable (per the American Urological Association), needlessly provoking anxiety, and a waste of money in low risk men, are a wise step for patients like your dad, mainly based on his Gleason results. However, they are extremely likely to be negative. Neither scan is very sensitive, especially the CT scan. In other words, it takes a fair amount of cancer to enlarge lymph nodes enough so that they will suggest cancer on the scan. Similarly, though bone scans are more sensitive, it still takes about 10% of cancer involvement with a location in the bone before it will suggest cancer. What this means, in short, is that even with negative scans you can still have cancer in the lymph nodes and bones, just not a lot. These days, with men caught fairly early like your dad, it's very likely that the cancer is not yet in the nodes, elsewhere, or in bones, but even if it is, it is unlikely to show up.

If the CT and bone scans show that it has not spreaded, his family doctor, urologist, and most friends/family are recommending that he has radical prostatectomy or prostate removal.

I am absolutely confounded and upset that the urologist would recommend that for a 73 year old man with a known heart condition!!! I can understand friends thinking an RP would be appropriate (the idea of "just getting it out!" has great appeal even if uninformed, and many family doctors are not very knowledgeable about prostate cancer, even if they are diligent about screening as your dad's doc appears to be. I'll give both the friends and the family doctor a pass. But that urologist should know better! In the first place, expert surgeons do not like to operate on men over 69 out of conviction that the likely side effects outweigh the likely benefits, unless the man is in great health with a long life expectancy. But in the second place, having a heart condition makes surgery for prostate cancer questionable at any age! Here's just one fairly likely and dangerous complication: blood clots. They occur in almost all RPs per research, but usually are too small to even be noticed, let alone causing any problems. But it's different for men with heart conditions; clots are a much bigger issue!

You can play a vital role in educating your family and your dad's friend's about this. It's really important.


He has checked with M.D. Anderson, one of the most renowned treatment cancer treatment centers in America, if not the world.

It is truly one of the best centers, and I'll be very surprised if the consulting doctor does not throw a bathtub full of ice cold water on the notion of surgery as an option for your dad.

...But M.D. Anderson is so far away from where we live, ...

Where does your dad live? There might be a major resource that is more convenient, but it strikes me that getting a "second opinion" consult at M.D. Anderson is highly advisable, especially in view of the advice and urging from friends that he is getting. As I said, surgery is almost surely not appropriate, but external beam radiation could require a couple of months near the treating location. On the other hand, hormonal blockade, and chemo if deemed advisable, can be done at many locations throughout the country.

We also considered the side effects of prostate removal such as impotence, incontinence, and intimacy which are not very pretty.

Those side effects are especially likely, much more than average, in men your dad's age, but it's the more serious complications that are the true threats. There is published medical research that documents this.

My dad will be inactive for about six weeks after the surgery to recoperate.

I deeply hope he does not go that route! People just don't understand that prostate cancer cases vary dramatically in seriousness and in their basic natures. Therapy needs to be tailored to the patient's circumstances. This is one disease where "one size definitely does NOT fit all!"

... I'm just wandering what has been the experiences of most people on this blog who have had radical prostatectomy ...

I have a fairly young friend who had an RP and had unusual blod clot complications that sent him to the emergency room near death. He survived, but not by much. It's often useful to kind of kick the tires, as we do when buying a used car, when comparing treatments by finding out how others have fared, but with a non-routine case like your dad's, that is simply not adequate. If you are going to check outcomes, you really need to find out about men older than 69 who have serious health conditions, ideally a heart condition like your dad. We have one man who often contributes, Bob, shs50, who had an RP when he was close to your dad's age, and he has done fine. But he was healthy! I believe that Bob will join me in urging your dad not to have an RP.

...

The oncologist will probably treat it with hormone therapy, radiation, chemotherapy(God forbid), or a combination of all three.



Hormone therapy, probably next to chemotherapy, will have the most negative side effects, which are diabetes, heart disease, and cardiac arrest. My dad has a heart condition.

How did you learn about the negative side effects of hormonal blockade? I'm betting it was the urologist, and I'm thinking he was trying to turn your dad away from that therapy. Please forgive me if I am overly suspicious.

Yes, "diabetes, heart disease, and cardiac" complications, I'll avoid the term cardiac arrest as that is more in the long-term uncountered category, are potential side effects of hormonal blockade therapy. I'm a little surprised whoever briefed your dad did not include, to overstate the case as is fairly typical, loss of bone density, muscle weakness, muscle and joint pains, anemia, emotional ups and downs, high cholesterol, breast enlargement and tenderness, pain, loss of libido and ED, and hot flashes. All of these are potential side effects of hormonal blockade therapy.

However, few of us experience many of those, and most that we do experience are only to a relative degree, some very slight and a minor nuisance. Moreover, there are fairly to highly effective countermeasures for each of these side effects. For instance, cholesterol lowering medication is usually quite effective in countering cardiac effects, and bone density preserving medication (bisphosphonate drugs) is highly effective in preserving bone density. Drs. Mark Scholz and Richard Lam have volunteered information about countermeasures based on their highly experienced practice, and the Prostate Cancer Research Institute has also published an article along the same lines in their free newsletter "PCRI Insights" (author: Brad Guess). Breast tenderness and enlargement is common under one form of hormonal therapy, but can be countered by a short course of pre-emptive radiation, but is not common under other forms. Hot flashes, if severe enough to warrant medical intervention, can be very effectively countered by drugs like Megace or Depot Provera. Exercise, especially resistance exercise, and nutrition are excellent for avoiding or minimizing fatigue, weight gain, and mood swings. And so on.

I'm thinking that oncologists would tend to try the easier approaches first, such as hormonal therapy alone, or hormonal therapy with radiation, rather than adding chemotherapy, though that is emerging as a legitimate approach. Hormonal therapy can be highly effective at controlling the cancer for years (not just two or three years as is often mistakenly asserted!, which could be all your dad needs.


Of course I don't even have to mention how bad chemotherapy is.

Are you aware that chemo for prostate cancer is considerably more tolerable than for some other cancers? It's still no cake walk, but, for instance, nausea and vomiting are quite controllable with medication. Most often chemo is not used until after hormonal therapies, first line and if needed second or third line, have failed to control the cancer.

My dad is also due to see a radiologist on Aug 3.

It's an excellent idea to get an opinion from a radiologist who is not connected with the surgeon your dad talked to.

My dad's sister, or my aunt, is ... a dyed-in-the-wool Seventh Day Adventist naturalist who believes that being on a strict, natural vegetarian diet can maybe help cure cancer.

That may be true, especially for low-risk cases of prostate cancer. But it is very likely not true for a case like your dad's. My own program is fairly vegetarian - no red meat, no pork, low in saturated fat, but including frequent fish, other seafood, and poultry, as well as an abundance of fruits and vegetables. I'm convinced it helps, and, while not conclusive for prostate cancer, research is accumulating that is fairly persuasive in favor of that kind of supportive program. It's great for support, but your dad most likely will need some heavy artillery too.

My aunt has a strong distrust of doctors and drug companies. She thinks that they are out to rip people off and their side effects are sometimes worse than the cure.

That can be true, but it appears your aunt takes a black versus white view of the medical world, and that is too bad. There's a lot of good and helpful medicine out ther.

She recently sent us a DVD about this doctor who went to a place called Times Of Refreshing Ministries in Georgia, which is a presumingly Seventh Day Adventist facility that specializes in bringing advanced cancer patients into remission whom others have written off as terminal.

They do this through a strict natural herbal diet.

I believe in God, Jesus, the Holy Spirit, and prayer, and you'll find me in church and Sunday School nearly every Sunday, but I'm deeply suspicious of places like you describe, in general, though I'm not aware of this particular facility.


This doctor happens to be a prostate cancer patient. His PSA was over 1000.

At first, he ignored the early signs of cancer by taking vitamins and other supplements.

Then, the tumor metastasis from the prostate and spreaded to his kidney. As a result, he suffered kidney failure and had to go on dialysis.

But, since he went to Times of Refreshing Ministries, he has gotten alot better without surgery/radiation/chemo. He is off of dialysis and his PSA level has dropped from over 1000 to 13.

This story is in the nature of an unsupported claim, an anecdote. You can easily find an abundance of that, including anecdotes from many enthusiastic MDs who really don't know what they are talking about or don't care what they are saying. Now on the other hand, if his case has been reported in a reputable, peer reviewed medical journal, I'll be impressed.

I don't know what their diet consists of; but, apparently it worked in this guy's case.

I am skeptical of this alternative treatment ministry called Times of Refreshing Ministries. Sure, it worked for this doctor;

That may not be the case; probably not. He's probably not being informed, truthful, or both.

but, who is to say that it will work for my dad?

Amen!

He recently talked to the minister who is the head of Times of Refreshing Ministries. The minister did not really go into detail as to what exactly what this herbal or vegaterian diet consist of.

I hate to be cynical, but I'm not surprised.

It also consists of getting enough sleep, exercise, water, etc.

Those are all fine things and truly important to us cancer patients. But they are not heavy artillery. If you want an overview of lifestyle tactics that are supported by much medical research (though not yet conclusive), check this thread: "Nutrition & lifestyle tactics - books, resources, and a quick summary," started 3/6/2008.

At first, my dad seemed really enthusiastic about the program.

Now, he is having second thoughts.

So, we are really debating on where we want to go from here; but, everything depends on the CT and bone scan results this coming week.
Actually, not so much depends on those results, as discussed above. But there is a lot more to learn. Keep learning and supporting your dad. Your questions and thoughts make me believe that you and he will be successful.

Please feel free to ask any of us follow-up questions.

Good luck and take care,

Jim

 
Old 06-27-2010, 05:24 AM   #5
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Re: Prostate Cancer Stage and Treatment Route

Quote:
Originally Posted by jawhik View Post
As of this past week, my 73-year old dad was diagnosed as having prostate cancer.

Two weeks ago, he had an appointment with his local physican to take a DRE exam and a PSA test.

His doctor did not feel anything out of the ordinary when he administered the DRE, which led both of us to believe that everything was alright.

However, when my dad's PSA result came back, his was over 6.

This was shocking because he had taken a PSA exam almost a year-and-a half ago, and his PSA number was about 4.5.

We don't understand how it could have climbed so much in just a litte over a year!

So, the week after that, he made a consultation appointment to see a urologist; and a day later, got his biopsy.

When the technican was giving my dad his ultrasound prior to the biopsy, he did not really notice anything out of the ordinary that would really suggest that he had cancer.

The urologist told my dad that if the biopsy results looked malignant, he would schedule an appointment to see him.

Sure enough, the result came back a little less than a week showing not only did he have cancer; but, according to the Gleason scores(1 to 5 being the least aggressive), he has a rather aggressive form of prostate cancer.
Three of the 12 samples that they took from his prostate where malignant. The Gleason scores where:

7 covering 88% of the sample
6 covering 10% of the sample
9 covering 40% of the sample

Of course, its the score 9 that has us most concerned since it is near the base .

That kind of indicates that it is trying to spread from the localized area of the prostate.

Speculatively, I wander what stage of prostate cancer, from I to IV, he is in.

I was hoping he would be in Stage I so they could either treat it with the wait and see approach or radiation therapy.

That question will probably be answer next week when he takes his CT and bone scan to see if the malignancy has spreaded outside of the prostate area.

If the CT and bone scans show that it has not spreaded, his family doctor, urologist, and most friends/family are recommending that he has radical prostatectomy or prostate removal.

He has checked with M.D. Anderson, one of the most renowned treatment cancer treatment centers in America, if not the world.

They said they could set up an appointment within 7 to 10 days.

But M.D. Anderson is so far away from where we live, and they are probably going to schedule follow up appointments if he has his surgery done there.

We also considered the side effects of prostate removal such as impotence, incontinence, and intimacy which are not very pretty.

My dad will be inactive for about six weeks after the surgery to recoperate.

By the way, I'm just wandering what has been the experiences of most people on this blog who have had radical prostatectomy or have friends/loves ones that had it done.

If it has spreaded beyond the prostate, most likely they are not going to do surgery.

The oncologist will probably treat it with hormone therapy, radiation, chemotherapy(God forbid), or a combination of all three.

Hormone therapy, probably next to chemotherapy, will have the most negative side effects, which are diabetes, heart disease, and cardiac arrest. My dad has a heart condition.

Of course I don't even have to mention how bad chemotherapy is.

My dad is also due to see a radiologist on Aug 3.

My dad's sister, or my aunt, is strongly against surgery if the tumor turns out to still be localized in the prostate.

She is a dyed-in-the-wool Seventh Day Adventist naturalist who believes that being on a strict, natural vegetarian diet can maybe help cure cancer.

My aunt has a strong distrust of doctors and drug companies. She thinks that they are out to rip people off and their side effects are sometimes worse than the cure.

She recently sent us a DVD about this doctor who went to a place called Times Of Refreshing Ministries in Georgia, which is a presumingly Seventh Day Adventist facility that specializes in bringing advanced cancer patients into remission whom others have written off as terminal.

They do this through a strict natural herbal diet.

This doctor happens to be a prostate cancer patient. His PSA was over 1000.

At first, he ignored the early signs of cancer by taking vitamins and other supplements.

Then, the tumor metastasis from the prostate and spreaded to his kidney. As a result, he suffered kidney failure and had to go on dialysis.

But, since he went to Times of Refreshing Ministries, he has gotten alot better without surgery/radiation/chemo. He is off of dialysis and his PSA level has dropped from over 1000 to 13.

I don't know what their diet consists of; but, apparently it worked in this guy's case.

I am skeptical of this alternative treatment ministry called Times of Refreshing Ministries. Sure, it worked for this doctor; but, who is to say that it will work for my dad?

He recently talked to the minister who is the head of Times of Refreshing Ministries. The minister did not really go into detail as to what exactly what this herbal or vegaterian diet consist of.

It also consists of getting enough sleep, exercise, water, etc.

At first, my dad seemed really enthusiastic about the program.

Now, he is having second thoughts.

So, we are really debating on where we want to go from here; but, everything depends on the CT and bone scan results this coming week.
I am sorry I didn't find this site sooner and am wondering and hoping that my info will help your dad. My husband was a nuclear physicist during his career and when he took the radiation treatments he got radiation sickness, because radiation never leaves the body and no one checked up on that before the radiation treatments, which he had to stop halfway through. Radiation sickness acts just like a stroke.

Since changing doctors he is on Bicalutamide (generic name), a little pill once a day, and his PSA is now low normal. I wanted to do a short message and not go into all the stuff he went through because of incompetent and thoughtless doctors. The Bicalutamide is key for your dad.

Last edited by Shiralee74; 06-27-2010 at 05:27 AM. Reason: left out a word

 
Old 06-27-2010, 05:25 PM   #6
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Re: Prostate Cancer Stage and Treatment Route

Hi Shiralee,

It's sad that your dad had to suffer from that oversight about previous doses of radiation. I'll insert a few comments in green.


Quote:
Originally Posted by Shiralee74 View Post
I am sorry I didn't find this site sooner and am wondering and hoping that my info will help your dad. My husband was a nuclear physicist during his career and when he took the radiation treatments he got radiation sickness, because radiation never leaves the body and no one checked up on that before the radiation treatments, which he had to stop halfway through. Radiation sickness acts just like a stroke.

I thought it would be helpful to add a comment for board participants who are not familiar with radiation therapy. Modern radiation therapy for prostate cancer delivers external doses that do not last in the body, or doses from "seeds" that decay with a known half life, becoming virtually non-radioactive in a certain set time.

Since changing doctors he is on Bicalutamide (generic name), a little pill once a day, and his PSA is now low normal. I wanted to do a short message and not go into all the stuff he went through because of incompetent and thoughtless doctors. The Bicalutamide is key for your dad.

Bicalutamide is one of my main drugs intermittently through ten plus years for a challenging case. However, research on bicalutamide as the only drug to combat the cancer indicates it is not as promising as the heavier duty class of drug (LHRH agonists) or combination therapy. That said, bicalutamide is said to deliver about (rule of thumb, quite rough) 80% of the effectiveness for 20% of the side effects. It is okay where cancer control is not paramount but minimizing side effects of therapy is deemed very important. I just wanted to make sure you were aware of that. I can provide more detail if you wish.

A low normal PSA, which you mention above, is not ideal for a prostate cancer patient. Fully effective hormonal blockade should bring the PSA down to <0.05, or even to <0.01 (testing with an ultrasensitive PSA test). Is your dad determined to minimize side effects?

Take care,

Jim

 
Old 06-27-2010, 06:37 PM   #7
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Re: Prostate Cancer Stage and Treatment Route

Couple of month ago at age 56 I was diagnosed with T1C prostate cancer. PSA 4.5, Gleason score 6. Somebody recommended Dr. Jeffrey Demanes in UCLA, Los Angeles. He specialized in HDR brachytherapy. Did anybody have experience with HDR? Does anybody know anything about this doctor?

 
Old 11-30-2010, 03:05 PM   #8
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Re: Prostate Cancer Stage and Treatment Route

I have only just found this useful website. I have to say that I have learnt more about my condition from posts made by 'JIM' than from any other source.

I was diagnosed with Prostate Cancer in May 2010. After about 4 years of frequent bathroom visiting every night I decided to seek help and eventually ended up in front on an Oncologist . That was following a biopsy which showed a Gleason score of 9. PSA was given as 37. I was 72 in November.

The oncologist gave me immediate Hormones in the form of Casodex , for four weeks and then I had a Zoladex injection. During the period that I was taking Casodex, I had the most terrible Diarrhoea. It lasted for 3 weeks and during that time my weight fell from 227 lbs. to 200 lbs. I went to my GP but no real assistance was offered. I took in a stool sample but no infection was present. When I ceased to Casodex, the illness stopped. This was before I had the Zoladex pellet injection.

In late August I commenced a series of 39 Radiation treatments. These caused a slight fatigue, some small amount of rectal bleeding and an increase in the passing of Urine frequency and more frequent excretions. Sometimes I was up 6 times each night. However this treatment was not as bad as I had expected and I would not hesitate to go through it again, if needed.

Since then, the symptoms have gone and indeed I seemed to have improved in my peeing habits, only going once or twice per night. Mind you, even during the daytime I sometimes only just make it to the bathroom and I cannot think about leaving home for a couple of hours without first making a visit !

I am quite active physically and I play golf 3 times per week.

I see the oncologist again on 14th December, and, until then, when presumably I will have another CAT scan and a PSA test, I have no idea of how I stand. I have not had any sort of pain associated with the cancer.

Should I also take Finasteride or Avodart. I do tale 1500 mg lucosamine, 1100 mg Omega 3 oil and a multivit which includes 50 um Selenium and B6 Complex.

I would appreciate any other advice

 
Old 11-30-2010, 03:08 PM   #9
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Thumbs up Re: Prostate Cancer Stage and Treatment Route

Quote:
Originally Posted by IADT3since2000 View Post
Prostate Cancer Stage and Treatment Route

Welcome jawhik,

I realize this is one board you would rather have nothing to do with, but we are a band of fine layman (virtually all of us) colleagues who are here to help each other, and I believe you will enjoy the fellowship of the board. Your dad is fortunate to have you working to help him, and it is clear from your post that the family is rallying around him. This is one of those times when families can play such an important role.

Just so you know where I am coming from, I am now a survivor of nearly ten years of a challenging case of prostate cancer with an initial survival prediction of five years from two leading centers (my story with updates is on the board). My only therapy has been hormonal blockade, supported with bisphosphonate drugs and supplements for the bones and a lifestyle program of nutrition/supplements/diet, exercise and stress reduction that is tailored to prostate cancer. (My initial stats in 1999/early 2000: PSA 113.6, Stage 3, Gleason 4+3=7, all cores positive, most 100% cancer, but scans negative - CT, bone, ProstaScint.) I am in my third round of intermittent triple hormonal blockade at age 66, and I was able to drive my PSA down to less than (<) 0.01 at the end of the previous two rounds of full triple therapy (for me, Lupron + 50 mg Casodex + 10 mg finasteride daily, plus Fosamax or Boniva for bone protection). My PSA has been falling about 25% per month (slow for most men, but normal for me), and is now at 0.15. I'm in good shape, benefiting much from known countermeasures for the side effects of hormonal blockade, and busy replanking and refurbishing my deck with 15'9" pressure treated lumber.

I'll insert some thoughts in green. Jim




Actually, not so much depends on those results, as discussed above. But there is a lot more to learn. Keep learning and supporting your dad. Your questions and thoughts make me believe that you and he will be successful.

Please feel free to ask any of us follow-up questions.

Good luck and take care,

Jim
I have only just found this useful website. I have to say that I have learnt more about my condition from posts made by 'JIM' than from any other source.

I was diagnosed with Prostate Cancer in May 2010. After about 4 years of frequent bathroom visiting every night I decided to seek help and eventually ended up in front on an Oncologist . That was following a biopsy which showed a Gleason score of 9. PSA was given as 37. I was 72 in November.

The oncologist gave me immediate Hormones in the form of Casodex , for four weeks and then I had a Zoladex injection. During the period that I was taking Casodex, I had the most terrible Diarrhoea. It lasted for 3 weeks and during that time my weight fell from 227 lbs. to 200 lbs. I went to my GP but no real assistance was offered. I took in a stool sample but no infection was present. When I ceased to Casodex, the illness stopped. This was before I had the Zoladex pellet injection.

In late August I commenced a series of 39 Radiation treatments. These caused a slight fatigue, some small amount of rectal bleeding and an increase in the passing of Urine frequency and more frequent excretions. Sometimes I was up 6 times each night. However this treatment was not as bad as I had expected and I would not hesitate to go through it again, if needed.

Since then, the symptoms have gone and indeed I seemed to have improved in my peeing habits, only going once or twice per night. Mind you, even during the daytime I sometimes only just make it to the bathroom and I cannot think about leaving home for a couple of hours without first making a visit !

I am quite active physically and I play golf 3 times per week.

I see the oncologist again on 14th December, and, until then, when presumably I will have another CAT scan and a PSA test, I have no idea of how I stand. I have not had any sort of pain associated with the cancer.

Should I also take Finasteride or Avodart. I do tale 1500 mg lucosamine, 1100 mg Omega 3 oil and a multivit which includes 50 um Selenium and B6 Complex.

I would appreciate any other advice

 
Old 11-30-2010, 04:03 PM   #10
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Re: Prostate Cancer Stage and Treatment Route

Hi Teddy

Like you I have just discovered this very useful site. My history is similar to yours except I have yet to have the injection having been on two hormone courses - Bicalutamide for 4 weeks - no side effects at all psa down to 11 from 23, and Flutamide for 4 weeks - minor side effects psa down to 6. My urolisist wants me to have the Lupron injection to speed up the process but I wouldnt mind trying another 4 weeks of bicalutimide to see if I can get down to below 3 which appears to be a magic number.

I play tennis 3 times a week and work as a self employed designer and would rather use an option that lets me maximise my activity levels.

 
Old 12-01-2010, 10:16 AM   #11
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Johnt1 HB UserJohnt1 HB UserJohnt1 HB UserJohnt1 HB UserJohnt1 HB UserJohnt1 HB User
Re: Prostate Cancer Stage and Treatment Route

First of all you cannot depend on the CT and bone scans as they will only detect cancer that is very advanced and usually with a psa that exceeds 40. for any psa under 40 the scans are about as good as a coin flip. With a Gleason 9 you dad has to be treated as this indicates an agressive cancer that will spread if not treated. Surgery for anyone over 70 is risky and many top doctors will not operate on anyone over 70, this should tell you something. With a Gleason 9 some type of hormone therapy is recommended is recommended along with a conventional treatment of radiation or surgery for the best chance of a cure and or increased survival time. Diet will not cure prostate cancer, but there is some indication that it will slow progression. I would see a good medical oncologist that specializes in Prostate Cancer for the best recommendations of how to treat it at this stage. The side affects of hormone therapy that you mentioned are due to the weight gain caused by the hormones and not the therapy itself. If he follows a good diet and excercise program and keeps weight off he won't experience those other health issues.
JohnT

 
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