Baptista

In my ten years of surviving PCa, treatment protocols have become significant. I have noticed that doctors are reticent to overshadow a protocol established by the big institutions, and will not follow their own instinct or knowhow. This behavior is confusing and it made me erroneously think that such particular doctor did not know much of what he was caring for.
I have followed religiously the protocols of treatment presented to me by care providers since diagnosis in 2000, however, at the present stage of my PCa, only a small group of experts can assure me “piece of mind” when determining the best care to follow. And just like in 2000, I will be the sole responsible in the decision.

After RP in 2000, followed by AS until 2006, and then SRT, I entered into Biochemical Recurrence in May, 2009. In November of 2010 I have reached the PSA marker of 1.0, which is used as the “cutoff” trigger to start a new protocol by my uro-oncologist doctor.
I consider my case as a systemic disease because of the failure in the two previous big treatment attempts, RP and RT, done for a localized approach. What surprised me was the theory presented by my surgeon and radiotherapist (I met recently), that my cancer is still localized. Their view regards to the success of RT that brought down my PSA from 3.80 (pre-RT) to the remission level of 0.05 in 13 months. They say that the rays caught the bulk of the cancer and only few localized micro metastasis have survived
As far as I know, chemotherapy induces apoptosis of cancer cells but its protocols for use, are standard only in advanced systemic PCa where metastasis to the bone is confirmed, or when hormonal treatment has failed. They are not recommended because of their nasty side effects.

The uro-oncologist doctor suggested IADT protocol (Intermittent Androgen Deprivation Treatment), initiated on a single blockade, with LHRH agonist Eligard 45mg 6 month Depot. The Eligard is to be preceded by one month on Cyproterone Acetate (anti agonist) 2x50mg/daily, to avoid “flare”.
My preference is for a triple blockade from the beginning, however, what makes me to accept this doctor’s protocol is his approach to the pharmaceutical castration (TIP) providing some room for a change in the middle of the course.

Is there any alternative better Protocol?

Comments would be most appreciated on the above.
Baptista