It appears you have not yet Signed Up with our community. To Sign Up for free, please click here....



Cancer: Prostate Message Board
Post New Thread   Closed Thread
LinkBack Thread Tools
Old 06-11-2010, 04:14 AM   #1
Newbie
(male)
 
Join Date: Jun 2010
Location: Bonita Springs, FL
Posts: 1
ralphlund HB User
Avodart masking/shrinking PC tumors, making detection more difficult?

Yesterday my urologist said use of Avodart known to shrink all tumors, making detection of more aggressive tumors Gleason 4 and 5) harder to detect; therefore harder to treat until at dangerous stage. He cited July 2009 work by Dr. Patrick Walsh reported in JCO. He fears that I have aggressive tumors growing and that even small increases in PSA are indicative of growing aggressive PC tumors. Stopping Avodart now will have PSA return to higher level, making PSA increases difficult to interpret for trouble. Your view? Am I likely to be at big risk of having undetected advanced PC because of Avodart?

 
Old 06-11-2010, 10:21 AM   #2
Senior Member
(male)
 
Join Date: Mar 2010
Posts: 116
Johnt1 HB UserJohnt1 HB UserJohnt1 HB UserJohnt1 HB UserJohnt1 HB UserJohnt1 HB User
Re: Avodart masking/shrinking PC tumors, making detection more difficult?

Actually Adovart shrinks the prostate making high risk tumors easier to detect not harder. Also recent studies indicate Proscar reduces the risk of getting PC up to 25%.; it is one of the most effective preventitives we have found. Once you take Adovart or Proscar you establish a new baseline and monitor psa increases from that new baseline.

 
Sponsors Lightbulb
   
Old 06-11-2010, 08:11 PM   #3
Senior Veteran
(male)
 
Join Date: Nov 2007
Location: Annandale, VA, USA
Posts: 1,730
Blog Entries: 3
IADT3since2000 HB UserIADT3since2000 HB UserIADT3since2000 HB UserIADT3since2000 HB UserIADT3since2000 HB UserIADT3since2000 HB UserIADT3since2000 HB UserIADT3since2000 HB UserIADT3since2000 HB UserIADT3since2000 HB UserIADT3since2000 HB User
Re: Avodart masking/shrinking PC tumors, making detection more difficult?

Hello Ralph,

Welcome to the board!

Johnt1's comments are right on the mark! There is even some follow-up analysis indicating that finasteride prevents about 30% of prostate cancer, though 25% is the number that is broadly accepted. You can search www.pubmed.gov for "thompson i [au] AND finasteride AND prostate cancer " to view medical research papers from one of the leaders in the field. (We can use PubMed on this board because it is Government sponsored.) One of two Avodart trials has now reported, and it prevented 23% of prostate cancer in a shorter trial. My layman's opinion is that that percentage will increase if the participants in the trial are followed for more years; my recollection is the average follow-up was about four years, in comparison with about seven years for the initial reports on the finasteride trial. I'll insert some additional comments in green.


Quote:
Originally Posted by ralphlund View Post
Yesterday my urologist said use of Avodart known to shrink all tumors, making detection of more aggressive tumors Gleason 4 and 5) harder to detect; therefore harder to treat until at dangerous stage.

Take a look at the research by Dr. Thompson and his colleagues. Another doctor who is expert in this area is Dr. Eric Klein of the Cleveland Clinic. There are many other knowledgeable doctors who agree with them and who disagree with your doctor.

He cited July 2009 work by Dr. Patrick Walsh reported in JCO.

I cannot really find fault with your doctor because of Dr. Walsh's enormous prestige. However, it's important to remember that he is expert in surgery. I'm "only" a layman, but after more than ten years of intermittent triple hormonal blockade for a challenging case, and after following what leading experts have said about hormonal blockade, I'm convinced that Dr. Walsh is not very knowledgeable about hormonal blockade, including finasteride and Avodart. The "work" to which you refer was rather an opinion piece rather than a report of research results.

He fears that I have aggressive tumors growing and that even small increases in PSA are indicative of growing aggressive PC tumors.

Would you mind providing details of your case? That would enable board participants to provide better leads to pertinent information.

Stopping Avodart now will have PSA return to higher level, making PSA increases difficult to interpret for trouble.

That could well be, as you will have to establish a new baseline. Dr. Ian Thompson, Dr. Klein, and other leaders like Avodart and finasteride in part because they decrease the "noise" in the PSA "signal", making the signal more meaningful as an indicator of cancer.

Your view? Am I likely to be at big risk of having undetected advanced PC because of Avodart?

Please remember that I, like almost all of our board participants, am a layman with no enrolled medical education. That said, I believe that you are at lower risk of having undetected advanced PC because of the Avodart. Take a look at the research by Thompson and others and see what you think.

Take care and good luck,

Jim

 
Old 06-12-2010, 02:57 PM   #4
Senior Member
(male)
 
Join Date: Dec 2008
Location: Saratoga,c
Posts: 130
viperfred HB User
Re: Avodart masking/shrinking PC tumors, making detection more difficult?

Hi Ralph,

PCa is a scary thought for many, and scarier when diagnosed with PCa.

I feel the best path to reduce anxiety and maximize care is to be very well informed about your specific case and the options comparing risk and benefit. There are may on this site with experience of localized to more advances cases that can help those looking for information.

Good Luck!

 
Old 06-13-2010, 10:30 AM   #5
Senior Member
(male)
 
Join Date: Jun 2005
Posts: 102
inspectormoe HB User
Re: Avodart masking/shrinking PC tumors, making detection more difficult?

Recently I posted about a biopsy that resulted in "atypical cells" which I have learned is cells in transition. I just had a visit at the urologist who did the biopsies and asked what I could do for slowing things, thinking I'd be proactive after reading replies about Avodart etc. He said there was nothing I can do and the "atypical" means nothing! I was flabbergasted. I was prepared to go on a regiment of Avodart to slow down progression but this was not expected. I'm not trying to hijack the thread but rather felt it was in line with the Avodart discussion, thanks.

 
Old 06-13-2010, 02:37 PM   #6
Senior Veteran
(male)
 
Join Date: Nov 2007
Location: Annandale, VA, USA
Posts: 1,730
Blog Entries: 3
IADT3since2000 HB UserIADT3since2000 HB UserIADT3since2000 HB UserIADT3since2000 HB UserIADT3since2000 HB UserIADT3since2000 HB UserIADT3since2000 HB UserIADT3since2000 HB UserIADT3since2000 HB UserIADT3since2000 HB UserIADT3since2000 HB User
Re: Avodart masking/shrinking PC tumors, making detection more difficult?

Hi inspectormoe,

Please remember that I have had no enrolled medical education, unlike your urologist who has an M.D. degree. That means that I'm just passing on my layman's understanding rather than anything authoritative. However, I can say that I have read and seen/heard firsthand physicians who specialize in prostate cancer express extremely different conclusions than those expressed by your urologist. I'll insert some comments in green.


Quote:
Originally Posted by inspectormoe View Post
Recently I posted about a biopsy that resulted in "atypical cells" which I have learned is cells in transition.

I don't believe I've read that post yet. I'm trying to juggle a number of projects, some involving prostate cancer, and it's a challenge to keep current with the board. I'll give a brief response here about your concer with "atypical" cells.

I just had a visit at the urologist who did the biopsies and asked what I could do for slowing things, thinking I'd be proactive after reading replies about Avodart etc. He said there was nothing I can do and the "atypical" means nothing! I was flabbergasted.

I too would have been flabbergasted, both by his comment that there is nothing you can do and also by his remark that "atypical" means nothing. As you probably know, cancer usually develops gradually. Normal cells have a few mutations and become atypical but not cancerous; they lack the key characteristics of cancer cells. Then those atypical cells have mutations and become "pre-cancerous" - still lacking the full, key set of characteristics of cancer cells. After more mutations, those pre-cancerous cells become fully fledged cancer cells, but often they are still not very aggressive. Additional mutations can make them aggressive, spreading locally by invasion and perhaps putting out cells into the blood and lymphatic systems that are potential seeds for distant spread as metastases. The long and short of this is that "atypical" cells indicate that the cancer train is starting.

I was prepared to go on a regiment of Avodart to slow down progression but this was not expected. I'm not trying to hijack the thread but rather felt it was in line with the Avodart discussion, thanks.

You are running into the reality that it takes medical practice many years to change! Regarding this specific issue, some of the older leaders in prostate cancer, especially surgery, Drs. Walsh and Catalona in particular, have clearly not kept up with the state of the art regarding hormonal blockade in general and Avodart and finasteride in particular. (They aren't so hot on radiation either, in my layman's opinion.)

That said, I remain so grateful for their immense contributions to understanding prostate cancer. However, their heroic stature has a negative side for some of their colleagues who look to them for guidance. My layman's opinion is that surgeons are less able to rise above their own field than medical oncologists, as a rule, with many notable exceptions. (I believe that both Ian Thompson and Eric Klein, both leaders in using Avodart and finasteride, are urologists.)

It may be best for you to find out what medical oncologists near you are thought well of by prostate cancer patients who are active in nearby prostate cancer education/support groups (such as Us Too International, and Man-To-Man). It's also possible that you may be able to find a broader minded urologist.

If you want to research this on your own, www.pubmed.gov has abstracts for an abundance of studies in this area.

Are you using the diet/nutrition/supplement, exercise and stress reduction tactics as well?

Take care,

Jim


 
Old 06-13-2010, 04:45 PM   #7
Senior Member
(male)
 
Join Date: Jun 2005
Posts: 102
inspectormoe HB User
Re: Avodart masking/shrinking PC tumors, making detection more difficult?

Jim thank you for the thorough and informative reply. I realize the limitations of this site but also the vast amount of cutting edge information submitted by fellow contributors. I believe members have a vested interest in the best treatments of their condition thereby motivating them to seek the latest research. I doubt the physicians can stay abreast of the latest trials or research even if they wanted to just due to their time invested in their practice.

I for one believe there are preventative measures to halt or at least slow the advancement of prostate cancer with appropriate drugs, nutritional changes etc. I can't believe I have to just sit there waiting the inevitable course of events.

I plan to see an alternative urologist for a second and need be third opinion.

I thank you for all of your posts that provide a wealth of information that we most likely would not hear from our doctors.

Steve

 
Closed Thread

Similar Threads
Thread Thread Starter Board Replies Last Post
LMP Ovarian Tumors, Total Hysterectomy, AGC found on pap claybricks94 Hysterectomy 14 09-30-2009 06:43 PM
How long does a person have to use AVODART? Alex24 Urology 0 11-11-2008 08:18 PM
Testosterone/estrogen/thyroid results and avodart + severe bloating Poastingefficac Men's Health 1 10-18-2008 08:47 PM
avodart mikey15 Cancer: Prostate 3 06-11-2008 06:14 AM
Brain tumors, hereditary? TheMamaLisa Brain Tumors 4 07-30-2006 07:49 PM




Thread Tools

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is Off
HTML code is Off
Trackbacks are Off
Pingbacks are Off
Refbacks are Off




Join Our Newsletter

Stay healthy through tips curated by our health experts.

Whoops,

There was a problem adding your email Try again

Thank You

Your email has been added




Top 10 Drugs Discussed on this Board.
(Go to DrugTalk.com for complete list)
Casodex
Cialis
Cipro
Flomax
Levaquin
  Levitra
Morphine
Proscar
Tylenol
Viagra







All times are GMT -7. The time now is 01:51 PM.



Site owned and operated by HealthBoards.comô
Terms of Use © 1998-2014 HealthBoards.comô All rights reserved.
Do not copy or redistribute in any form!