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



Cancer: Prostate Message Board

  • When to start ADT?

  • Post New Thread   Closed Thread
    Thread Tools Search this Thread
    Old 12-15-2011, 01:26 AM   #1
    joshed
    Junior Member
    (male)
     
    joshed's Avatar
     
    Join Date: Dec 2011
    Location: Sydney Australia
    Posts: 11
    joshed HB User
    When to start ADT?

    Hi, I am a newbie aged 66 and had a radical Aug 2009 following biopsy Gleason 8 and PSA 11.8. Post-op Gleasons 9, negative margins. Located in Australia.
    Since then for 15 months my PSA was undetectable, then it rose to .01 then doubling every 4 months to .13 now.
    My question is when is it a good time to start ADT? I think my surgeon is going to suggest now, but lots of articles I have read say wait till PSA climbs to 10 or 20. It seems to me that if ADT has a finite effectiveness timeframe, then it would be better to wait till a 10 or 20 level which would be about 2 to 3 years assuming same doubling time.
    And do we know if the time before ADT loses it effectiveness vary with the starting PSA level, or is the timeframe the same?
    Thanks in anticipation
    Joshed
    PS Current thinking is to try diet changes for 3 months before considering ADT!

     
    Sponsors Lightbulb
       
    Old 12-15-2011, 12:12 PM   #2
    Baptista
    Veteran
    (male)
     
    Join Date: Aug 2010
    Location: Albufeira, Portugal
    Posts: 459
    Baptista HB UserBaptista HB UserBaptista HB UserBaptista HB UserBaptista HB UserBaptista HB UserBaptista HB UserBaptista HB UserBaptista HB UserBaptista HB UserBaptista HB User
    Re: When to start ADT?

    Joshed

    Welcome to the board.

    I have learned in my years with the disease that there are no fixed thresholds to start a particular treatment. Each case is judged individually because of the many variables used to get to a decision. Aggressive grades of cancer may spread faster (even with low PSA) therefore requires a quicker intervention before cancer spreads widely, becoming systemic.
    Your situation with a localized Gleason score 9 and confirmed recurrence with PSADT at 4-months is very indicative that cancer is multiplying fast and that you should start a treatment the soonest with intent to cure.

    The thresholds you refer as “waiting till a 10 or 20 level” is for cases where the “intent at cure” is diminished and control is preferred. I do not think that you are at that status at your young age.
    Your assumptions in regards to levels of PSA in 2/3 years or about the timeframe of drugs effectiveness in regards to the level of PSA are all fictitious. Guessing is typical in PCa and no two cases are equal but similar. You can compare your case with others but shouldn’t “copy” and expect the same results.

    Your choice at ADT is typical. However, the hormonal manipulations are just a palliative way for the control of the advancement of the cancer and cannot provide cure. In any case, it can hold the bandit for many years but at your young age and present status you may benefit from a salvage treatment with radiation that could provide you a chance for cure. This is the typical treatment used in recurrence cases, and in combination with hormonal (RT + ADT) have shown higher rates of success.

    I recommend you to do some researches about salvage treatments before committing to anything. You should educate yourself in the risks and side effects of the treatments because they will superimpose the ones gotten from RP.
    Second opinions are a must do thing in prostate cancer. Try to get consultations with specialists on PCa, particularly an oncologist and radiologist.

    A book that may help you to understand the diagnosis and treatments in your case, and that it also describes well about diets is;
    “Beating Prostate Cancer: Hormonal Therapy & Diet” by Dr. Charles “Snuffy” Myers. This is a famous oncologist specialized on PCa, himself a survivor of PCa. He battled the bandit with IMRT and ADT.

    Wishing you luck in your continuous journey.

    Baptista

     
    Old 12-15-2011, 02:10 PM   #3
    joshed
    Junior Member
    (male)
     
    joshed's Avatar
     
    Join Date: Dec 2011
    Location: Sydney Australia
    Posts: 11
    joshed HB User
    Re: When to start ADT?

    Thank you for the response, Baptista.
    Just one follow-up question - I have been to a radiation oncologist, but it seems that with negative margins and a quick doubling time the likelihood of the cancer being in the prostate region only is very small. He said that no scan is likely to show anything at this early stage (although he said they were a good idea as a "base" set).
    Please correct me if I am wrong, but salvage radiation is only for the general area around the prostate location (where it used to be)?
    Joshed

     
    Old 12-16-2011, 02:20 PM   #4
    Baptista
    Veteran
    (male)
     
    Join Date: Aug 2010
    Location: Albufeira, Portugal
    Posts: 459
    Baptista HB UserBaptista HB UserBaptista HB UserBaptista HB UserBaptista HB UserBaptista HB UserBaptista HB UserBaptista HB UserBaptista HB UserBaptista HB UserBaptista HB User
    Re: When to start ADT?

    Quote:
    Originally Posted by joshed View Post
    Thank you for the response, Baptista.
    Just one follow-up question - I have been to a radiation oncologist, but it seems that with negative margins and a quick doubling time the likelihood of the cancer being in the prostate region only is very small. He said that no scan is likely to show anything at this early stage (although he said they were a good idea as a "base" set).
    Please correct me if I am wrong, but salvage radiation is only for the general area around the prostate location (where it used to be)?
    Joshed
    Joshed

    I wonder what pathological stage has been attributed to you. Can you share the information given in the path-report?

    Negative margins indicate that the pathologists did not see any evidence of cancer in the places cut by the surgeon to free the prostate gland. However, these are tree places of dissection only; at the rectum, at the urethra and at the bladder sphincter. Other areas are also analysed and the pathologist surely looked for any extra capsular extension, involvement of cancer at the seminal vesicles and at the close lymph nodes. (all written in the path-report)
    This information is very important to decide on any possibility of a salvage treatment. Image studies such as e-MRI with resolution t3, and bone PET (c18) scan at bone are recommended to certify for close and distant metastases. Only then one can have confidence on one’s real status, and, therefore, discard a possibility of cure and instead look for a way of control.

    The radiologist may have more evidence at hands than the ones you posted here to draw to such conclusion. Otherwise his assertion is baseless. The usual place where cancer travels before becoming systemic is to the lymph nodes (at the pelvis and iliac). These are common areas for irradiation in salvage treatments. From here the cancer usually metastasises to the bone (pelvic iliac area) where it forms colonies. Once systemic it goes to other organs.
    The principle of the treatment is exactly to avoid that PCa becomes systemic, trying to catch it whole.

    Your PSA of 0.13 is still low enough to rule out distant metastases such as in bone, which tends to diagnose your case as localized. Micrometastases is a condition given to cases of voluminous cancer with low to intermediate Gleason scores, which may not apply in your case but no one real knows for sure what is occurring inside you.

    I believe that you have a chance at cure yet. You should take along all documents (path-report, etc) given to you when visiting doctors and make questions on their advices.
    You have time to research about your diagnosis. The usual recommended threshold to consider recurrence in a patient after surgery is a PSA = 0.20. At a PSA=0.4 the recommendation is for starting a salvage treatment.

    I would consider additional testing before starting any treatment. Diet and Physical fitness are important aspects in the management of prostate cancer.

    Wishing you peace of mind.

    Baptista

     
    Old 12-17-2011, 02:32 AM   #5
    joshed
    Junior Member
    (male)
     
    joshed's Avatar
     
    Join Date: Dec 2011
    Location: Sydney Australia
    Posts: 11
    joshed HB User
    Re: When to start ADT?

    Baptista, thanks again.
    As you may have inferred, I have not seen the pathology report and will get a copy asap.
    I also have just received Dr Myers book and will start to read it.
    Joshed

     
    Old 12-17-2011, 10:14 AM   #6
    Baptista
    Veteran
    (male)
     
    Join Date: Aug 2010
    Location: Albufeira, Portugal
    Posts: 459
    Baptista HB UserBaptista HB UserBaptista HB UserBaptista HB UserBaptista HB UserBaptista HB UserBaptista HB UserBaptista HB UserBaptista HB UserBaptista HB UserBaptista HB User
    Re: When to start ADT?

    Quote:
    Originally Posted by joshed View Post
    Baptista, thanks again.
    As you may have inferred, I have not seen the pathology report and will get a copy asap.
    I also have just received Dr Myers book and will start to read it.
    Joshed
    Joshed

    You are welcome.
    Please note that I have no medical enrolment. I have a keen interest and enthusiasm in anything related to prostate cancer, which took me into researching and studying the matter since 2000 when I become a survivor and continuing patient.
    Many survivors in this forum are quite educated in the matters of PCa and they too can help you in understanding the facts along your journey. At the “end” point you will always be the one to decide so that, second opinions from specialist are required.
    In my case, knowing what has/is happening to me and what I can expect, has given me peace of mind along the eleven years of fight.
    You need to educate yourself on the matter so that you can understand what doctors say and what they ask from you.
    Be confident. You will knock down the cancer again.

    I am curious if you have done any image study at the time of diagnosis (before surgery or after)?
    Can you share info on how did you find out about PCa. Were you ever asymptomatic?

    Best regards.
    Baptista

    Last edited by Baptista; 12-17-2011 at 10:18 AM.

     
    Old 12-17-2011, 02:13 PM   #7
    Johnt1
    Senior Member
    (male)
     
    Johnt1's Avatar
     
    Join Date: Mar 2010
    Posts: 116
    Johnt1 HB UserJohnt1 HB UserJohnt1 HB UserJohnt1 HB UserJohnt1 HB UserJohnt1 HB User
    Re: When to start ADT?

    You will find a lot of disagreement on when to start HT. Some suggest waiting for psa to go to 10 or 20. All of the leading proste oncologists, Myers, Strum, Scholz all believe that the sooner you start the better for the following reasons.
    1. There is no oncological theory that supports starting any treatment later is better than starting it early. Early treatment is a tenet of oncology.
    2. Prostate caner cells are made up of mostly androgen dependent cells and a few androgen independent cells. One in a million dependent cells will mutate into independent cells. Ht will kill these before they have a chance to mutate.
    3. HT works much better when the tumor burdon is low.

    The reasons for starting HT later is that it will work for only a finite time. This is false as the less tumor cells you have and the less mutation you have the better HT works. If you wait until major matastisis to start then HT will work for a finite period.

     
    Old 12-20-2011, 10:46 PM   #8
    joshed
    Junior Member
    (male)
     
    joshed's Avatar
     
    Join Date: Dec 2011
    Location: Sydney Australia
    Posts: 11
    joshed HB User
    Re: When to start ADT?

    Hi, just an update.
    I had all the usual scans done befire RP but nothing showed up.
    Have got my post-op path report and it specifies No lymphovascular infiltration, no extraprostatic extension, no margin involvement, seminal vesicles and lymph nodes "not involved". States that 7 pelvic lymph nodes were examined and no evidence of metastatic adenocarcinoma.
    Met with my surgeon last week and he suggest doing nothing for a quarter.
    Since then I have re-talked with the Radiation oncologist I visited in November, he suggest doing MRI, CAT and bone scans - if something shows up, we can progress accordingly. But he did tell me these scans show nothing until the growth is large, normally. So any results would not seem to be conclusive! FYI we do not have ProstaScint scanning available here in Australia, as far as I can tell.
    Baptista, to answer your question PCa discovered from yearly PSA testing, and more rapid change leading to biopsy. No symptoms at all.
    So from here on, can I ask for your opinions:
    Is ProstaScint recognised as being valuable these days?

    Is there any other way of working out where any metastasis is at this early stage?Thank you Joshed

     
    Old 12-22-2011, 04:39 PM   #9
    Baptista
    Veteran
    (male)
     
    Join Date: Aug 2010
    Location: Albufeira, Portugal
    Posts: 459
    Baptista HB UserBaptista HB UserBaptista HB UserBaptista HB UserBaptista HB UserBaptista HB UserBaptista HB UserBaptista HB UserBaptista HB UserBaptista HB UserBaptista HB User
    Re: When to start ADT?

    Joshed

    I do understand the concern of your radiologist. Judging from your “clean” path-report, it seems that metastases, if any, would be difficult to find. You may be a pT2a/c pN0.
    The tests he recommends (MRI, CAT and B-scan) are typical when one is diagnosed T2 N0, but the increase in PSA is very suggestive of recurrence. In fact your case got the characteristics of micrometastases. This is considered when recurrence is confirmed by PSA and/or positive extra-capsular extension is existent, but image studies are all negative. This is difficult to treat because the colonies of cancerous cells are many and spread but very small to be detected. Radiation is not considered efficient by some doctors if targets are none existent. (One cannot send arrows in the dark and expect to hit the target)

    I confronted a similar situation after surgery (in 2000) with positive extra-capsular extension and increasing PSA, although I was a Gleason score 5 (2+3). Image studies were all negative, and I tried to get ProstaScint or PET scans but at the time these tests were not reliable, with many false positives.
    The contrast agents used in these scans are newer now and, in particular, the PET scan has shown to be better. You can inquire about the newer PET (it exists in Australia) or, if definitively you go for the MRI, then try the E-MRI with Spectroscopic Imaging (MRSI) with the Tesla 3.0 magnet for higher resolution. This should also be available in Australia. You may read about a test named USPIO which is done in a MRI machine using feraheme as contrast agent, but it may not be available in Australia.

    Another useful test is a colour Doppler which if done by experts can identify the existence of newer blood vessels at the proximities of cancer colonies, therefore locating the bandit. You definitively should search about these tests and discuss with your radiologist. In any event, you have enough time to research and consider what to do.
    PET scans with newer contrast agents (C11 or F18) are more sensitive to find cancer in bone than the traditional scintigraphy scan with gamma machines.

    Our cases cannot be compared. I would recommend you to get the best and decide from there. Just for your information, my doctor’s threshold as the trigger to start ADT is a PSA=1.00 ng/ml, in cases of PSADT lower than 6 month. You should inquire with an oncologist but not wait for apparent metastases.

    Wishing you find that peace of mind for the holiday season.

    Merry Christmas and a Happy New Year.

    Baptista

    Last edited by Baptista; 12-22-2011 at 04:49 PM.

     
    Old 12-24-2011, 02:45 PM   #10
    joshed
    Junior Member
    (male)
     
    joshed's Avatar
     
    Join Date: Dec 2011
    Location: Sydney Australia
    Posts: 11
    joshed HB User
    Re: When to start ADT?

    Thanks again, Baptista, I will research the scan options.
    And may I wish you and yours a Merry Xmas - it is already Christmas Day here!
    Cheers Joshed

     
    Old 12-25-2011, 09:57 AM   #11
    Johnt1
    Senior Member
    (male)
     
    Johnt1's Avatar
     
    Join Date: Mar 2010
    Posts: 116
    Johnt1 HB UserJohnt1 HB UserJohnt1 HB UserJohnt1 HB UserJohnt1 HB UserJohnt1 HB User
    Re: When to start ADT?

    Joshed,
    The John Hopkins web site has a program that you plug in your pre op and post op numbers and it gives a probability of salvage radiation working. This may be helpful in your decision of having SRT.
    JohnT

     
    Old 12-28-2011, 07:06 PM   #12
    IADT3since2000
    Senior Veteran
    (male)
     
    Join Date: Nov 2007
    Location: Fountain Valley, CA, USA
    Posts: 3,152
    IADT3since2000 HB UserIADT3since2000 HB UserIADT3since2000 HB UserIADT3since2000 HB UserIADT3since2000 HB UserIADT3since2000 HB UserIADT3since2000 HB UserIADT3since2000 HB UserIADT3since2000 HB UserIADT3since2000 HB UserIADT3since2000 HB User
    Re: When to start ADT?

    Hi Joshed and welcome to the Board!

    You have already had some replies with great information. I'll add some points in green, taking off from your update a few days ago.


    Quote:
    Originally Posted by joshed View Post
    Hi, just an update.
    I had all the usual scans done befire RP but nothing showed up.
    Unfortunately, the usual CT and bone scans are not very sensitive, so it's common that they are negative. There are much better scans, but they are more expensive. It often does not make sense to use scans at the outset after diagnosis unless the case is extreme because there are so few results that show metastases.

    Quote:
    Have got my post-op path report and it specifies No lymphovascular infiltration, no extraprostatic extension, no margin involvement, seminal vesicles and lymph nodes "not involved". States that 7 pelvic lymph nodes were examined and no evidence of metastatic adenocarcinoma.
    Of course all that is good. The shortcoming for the lymph node exam is that there are many other lymph nodes that might be involved. The good news is that there is now a scan (Feraheme USPIO) that can detect very small mets in nodes anywhere in the body, similar to the Combidex/Sinerem USPIO scan that is no longer available. However, that scan is currently only available in one place in the US in a clinical setting (Orlando, Florida area), and even then under restrictions, from what I've learned. The plan is to publish research on patients who have had the scan, with some going on to radiation that targets mets with intent to cure. Initial publication is expected within months. Apparently any imaging center powered with 3 Tesla magnetic field equipment will simply be able to install software, obtain the Feraheme contrast agent, and do the scan, once the research results are published; in other words, no large investment in new equipment will be required, which is great. On the other hand, there is often great resistance to change in the medical world, so we will have to wait and see.

    Quote:
    Met with my surgeon last week and he suggest doing nothing for a quarter.
    Since then I have re-talked with the Radiation oncologist I visited in November, he suggest doing MRI, CAT and bone scans - if something shows up, we can progress accordingly. But he did tell me these scans show nothing until the growth is large, normally. So any results would not seem to be conclusive!
    As far as I know, that is true except for certain advanced technologies that are not yet widely available. However, I've just posted about the Na 18F PET/CT bone scan (not the FDG PET scan which is useless for most of us prostate cancer patients) I just had, which is quite sensitive and specific; in other words it finds cancer in the bone if it is there but has few false alarms. That scan technology has been around for a while, but few nuclear imaging facilities seem to offer it. As noted just above, the Feraheme USPIO scan appears to be ideal for picking up mets in lymph nodes, even mets as small as 2 or 3 mm.

    Quote:
    FYI we do not have ProstaScint scanning available here in Australia, as far as I can tell.
    The fusion ProstaScint approach is likely the best ProstaScint technology, but it appears the Feraheme scan, as well as at least one other scan mentioned by Baptista, are substantially better. If you are able to wait for a year or more, it's likely available technology will be much improved.

    Quote:
    ....
    Is ProstaScint recognised as being valuable these days?
    I've heard a leading researcher behind another new imaging system state that ProstaScint was worthless, but I thought the speaker was biased and exaggerating. My personal layman's view is that it is valuable but very likely not as good as the emerging technologies. I had a ProstaScint myself, and it helped my decision making and morale, but that was back in early 2000.

    Quote:
    Is there any other way of working out where any metastasis is at this early stage?Thank you Joshed
    Yes, as noted above and in other posts, provided the PSA is higher; at your current PSA level the cancer is still so small that the signal may not be detected even by a very sensitive scan. For instance, my impression is that the Feraheme scan can sometimes work if the PSA is below 2 but that it works reliably if the PSA is at least 2.

    However, it may not be wise to try such scans yet even if you can get access to them. While your recurrence does appear fairly aggressive, you may be one of the patients who has a great response to lifestyle tactics, such as those mentioned in the Myers book. Quality pomegranate juice or quality pomegranate extract capsules have greatly extended PSA doubling time in small but promising studies. In one study, recurring men with a PSADT of about 15 months extended their average PSADT to about 54 months when measured two years after consuming eight ounces of juice daily. Quality vitamin D3 has been known to help, as have other dietary tactics. By the way, in the original edition Dr. Myers was against curcumin on the basis that there was inadequate human research. Based on more research, he now favors it, provided it is a version with an effective agent to aid absorption, which is a key problem with curcumin. These tactics are worth trying, and they may be supportive even if they do not do all that we want. I myself still use the nutritional tactics even though I haven't seen clear results for my challenging case, in contrast to clear benefits that I do see from medications.

    You wonder how long hormonal blockade can be effective. Baptista and Johnt1 both emphasized that accounts of short average effectiveness were not true, and I'll join them. For many of us, the intermittent triple hormonal blockade approach appears to work for either about ten years or indefinitely long. Using myself as an example, I'm now starting my thirteenth year with intermittent triple therapy as my sole main therapy - no surgery or radiation. (However, based on fresh hope for a cure due to new technology and my improvement, I'm looking into radiation for my challenging case.) Moreover, after "first line" hormonal therapy fails, second line therapy often works for additional years. It's important to realize that during this time a patient has success controlling cancer with hormonal therapy, technology is sure to improve in major ways. We are fortunate that so much research and so many advances happen in prostate cancer every year. Successful hormonal therapy helps us gain time for technology to improve!

    You asked in post #3 if salvage radiation was only done right around the prostate. It depends on the patient's case. Radiation in a broad pelvic area is often done. Some experts, aided by advanced imaging, can specifically target distant lymph nodes and bone sites, provided there are only a few (known as "oligometastatic cancer").

    I hope this helps.

    Take care,

    Jim

     
    The Following User Says Thank You to IADT3since2000 For This Useful Post:
    joshed (01-02-2012)
    Old 01-01-2012, 04:43 PM   #13
    joshed
    Junior Member
    (male)
     
    joshed's Avatar
     
    Join Date: Dec 2011
    Location: Sydney Australia
    Posts: 11
    joshed HB User
    Re: When to start ADT?

    Jim, I really appreciate your advice and that of Johnt1 and Baptista.

    I am doing a 3-month dietary trial Jan-Mar, with little or no meat, very little dairy, reduced fruits, lots of vegetables, pomegranate juice, and supplemented by Vit D3, Vit C, Vit E, selenium, resveratrol and Fish Oil Omega-3. We grow our own beans, tomatoes, lettuce and cucumbers and they are in season now so my wife uses these a lot, and cooks a wide variety of dishes with regular soy and cruciferous vegetables.

    I am not going to do one of the way out diets eg Gersen as I think they are over the top!

    Just one query if I may? Do you think juicing the vegetables through a masticating juicer is worth the effort?

    Thanks Mike (Joshed is derived from grandsons names)

     
    Old 01-02-2012, 09:17 AM   #14
    IADT3since2000
    Senior Veteran
    (male)
     
    Join Date: Nov 2007
    Location: Fountain Valley, CA, USA
    Posts: 3,152
    IADT3since2000 HB UserIADT3since2000 HB UserIADT3since2000 HB UserIADT3since2000 HB UserIADT3since2000 HB UserIADT3since2000 HB UserIADT3since2000 HB UserIADT3since2000 HB UserIADT3since2000 HB UserIADT3since2000 HB UserIADT3since2000 HB User
    Re: When to start ADT?

    Hi again Mike,

    Here are a few more thoughts in response to your latest post, #13. You wrote in part:


    Quote:
    ... I am doing a 3-month dietary trial Jan-Mar, with little or no meat, very little dairy,
    For me, diet has not been enough, though I believe it has helped, perhaps by making it harder or impossible for the cancer to metastasize. A three month trial is worth trying. I eat no red meat, but I do eat poultry, mainly chicken, and a lot of fish. I consume almost no dairy products; the exceptions are about a teaspoon of milk/cream in coffee about once a week and a small amount of butter that my wife sometimes uses in cooking. Ideally, I would use a substitute for the coffee and the butter. Soy milk is fine, and I use that on cereal.

    Quote:
    reduced fruits,
    Reducing fruit may be helpful for you, though the evidence is that it is not helpful for most of us. That's because prostate cancer does not use sugar for energy unless it is very aggressive; instead, it uses fat as the energy source, unlike many other cancers. If you have some cancer left that is in the Gleason 8-10 range of aggressiveness, it may be that it is getting some energy from sugar metabolism. That short PSA doubling time indicates a possible aggressive cancer. On the other hand, fruits have many desirable elements for health generally.

    Quote:
    lots of vegetables, pomegranate juice,
    Pomegranate juice has an amount of sugar that is typical for fruit drinks - a fair amount. The juice used in one of the two published trials is regarded as high quality. (The other trial used an extract tablet - no sugar - from the same manufacturer.) Among other points, it is a brand that is refrigerated until consumption, which, I've read, preserves potency that is otherwise decreased. Are you aware of the trials? There are a number of posts on this board about pomegranate juice and extracts to help control prostate cancer. Research is continuing. I'm impressed by the research results, though both studies were rather small, and both were sponsored by a juice manufacturer.

    Quote:
    and supplemented by Vit D3,
    D3 appears to be a very beneficial supplement for us, but some of the D3 supplements that are sold apparently are ineffective.

    Quote:
    Vit C, Vit E,
    The evidence on vitamin E is confusing. Apparently the wrong kind (alpha tocopherol) and dose (400 IU) of vitamin E was used in the large SELECT trial, where no benefit and possible harm (bleeding risk, mainly) were found. I still take vitamin E, but it is a form that is high in gamma tocopherol, and the dose is about 200 mg/day.

    Quote:
    selenium,
    The evidence on selenium is also mixed. I'm still taking it, but not the form that did not appear effective in the SELECT trial. A team led by Dr. Kantoff, a well-known physician/researcher in the US, has found early evidence that it may be necessary to have certain genes (specifically a certain "SNIP") to benefit from selenium, with no benefit seen in the team's research otherwise. There is no commercially available genetic test for this at this time.

    Quote:
    resveratrol and Fish Oil Omega-3.
    I'm taking both of those too. It's amazing how beneficial fish oil is for reducing the risk of sudden death from a heart attack, and for improving other cardiovascular and health factors.

    Quote:
    We grow our own beans, tomatoes, lettuce and cucumbers and they are in season now so my wife uses these a lot, and cooks a wide variety of dishes with regular soy and cruciferous vegetables.
    There's nothing so good as fresh vegetables straight from the garden! I like tomatoes uncooked in salads and other dishes, but cooking or processing both tomatoes and cruciferous vegetables apparently makes the nutrients we want more available.

    Quote:
    I am not going to do one of the way out diets eg Gersen as I think they are over the top!
    I see it the same way. The Gerson approach just has not done well when put to the test; there is one medical paper about that by an author associated with the prestigious Memorial Sloan-Kettering Institute in New York City. The only person I know of who was following the Gerson approach in our support group passed on.

    Quote:
    Just one query if I may? Do you think juicing the vegetables through a masticating juicer is worth the effort?
    I don't know much about it, but I do not do it myself. Now and then I look at the evidence and recommendations by doctors I consider experts, and I just have not been impressed with juicing. I have not done a thorough review of pros, cons and evidence.

    Quote:
    Thanks Mike (Joshed is derived from grandsons names)
    Grandkids are great, aren't they?

    I hope your three month trial is successful. You might have just the right genes to allow the nutritional tactics to put the brakes on the growth of the cancer. You will also gain time to learn more about ADT.

    Take care and good luck,

    Jim

     
    Old 01-02-2012, 04:24 PM   #15
    harpman
    Inactive
    (male)
     
    Join Date: Mar 2011
    Location: Kamloops, BC, Canada
    Posts: 190
    harpman HB Userharpman HB Userharpman HB Userharpman HB Userharpman HB Userharpman HB Userharpman HB User
    Re: When to start ADT?

    joshed,
    You may want to have your Surgical Pathology slides read for a second opinion by the most experience person you can find at a leading Cancer hospital in Australia or even abroad. There is a very good chance that your cancer is close to the original site still so that you should consider radiation therapy soon especially with a Gleason 9. My case was similar in that I also had a failed RP PSA 3.95 Gleason 7 (4+3) I think but with positive margins although they told me that it was close but that they thought they got it all. In my case the prostate came out clean and they didn't remove the seminal vesicles. Did the remove your seminal vesicles? I eventually went the the United States for salvage treatment with Proton Beam Therapy at Loma Linda University Medical Center in California. They targeted an area 12mm outside my surgical staples and as of now, two years post treatment, I believe that I am cured. There were a couple of Australian fellows receiving treatment also while I was there. If you contact a Loma Linda Proton support group you may be able to get in touch with them. My opinion as a patient is to move to salvage treatment quickly but there are no guarantees but your chance of a cure is better the sooner you act. Just because they can not definitely identify the recurrence doesn't mean that they can't wipe it out if it's in the local area. Sometimes they use a combination Proton and Photon.
    Be aggressive and Good luck,
    Bob

     
    Closed Thread

    Related Topics
    Thread Thread Starter Board Replies Last Post
    When a PSA rise from 9.76 to 10.97 is a good thing IADT3since2000 Cancer: Prostate 6 08-23-2011 12:49 PM
    when a psa is high and the biopsy is normal beoria08 Cancer: Prostate 21 06-02-2011 02:46 PM
    Catheter out after Da Vinci,when does the pee stop Brute290 Cancer: Prostate 29 11-29-2010 01:14 PM
    Husband had robotic surgery Nov. 10 what will happen when catheter removed? CM63 Cancer: Prostate 1 11-22-2009 09:45 PM
    when you have a psa level of 600 what does that mean maarie Cancer: Prostate 3 04-27-2009 03:59 PM
    when it comes back toyofan Cancer: Prostate 8 01-22-2008 05:15 PM
    when are hormone shots necessary in the treatment of prostate cancer butch121 Cancer: Prostate 7 01-17-2008 08:47 AM




    Thread Tools Search this Thread
    Search this Thread:

    Advanced Search

    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




    Sign Up Today!

    Ask our community of thousands of members your health questions, and learn from others experiences. Join the conversation!

    I want my free account

    All times are GMT -7. The time now is 12:19 AM.





    © 2022 MH Sub I, LLC dba Internet Brands. All rights reserved.
    Do not copy or redistribute in any form!