Discussions that mention simvastatin

Cancer: Prostate board


I am delighted to be celebrating today my eighth anniversary as a survivor of a challenging case of prostate cancer, incurable but hopefully still controlable, with an excellent quality of life. :cool:

I posted general details of my story on November 20, but I thought some participants would like to see more detail and an update from tests on November 30.

I am now at the one year mark for my second off-therapy period, feeling fine and with a great quality of life, :) probably nearing the point where I will go back on triple blockade or more likely use low-dose thalidomide plus vitamin B6to extend my off therapy period. For the first time since the diagnosis I can say that my bone density has returned to the healthy range. (I am aware of the DEXA versus qCT issue, but in my particular circumstances the DEXA seems to be valid. At the 2005 national conference, in a personal discussion, a doctor who is a strong advocate for qCT and a leader in the national conference series, concurred that it was better in my circumstances, with a track record for DEXA, to continue with DEXA.)

I am doing this in part because there are not many long-term histories on the web of patients with challenging cases who are on intermittent triple androgen deprivation therapy with finasteride (or Avodart) maintenance. I am glad to say there are more such histories now than there were a few years ago, and that will help patients who are thinking about blockade.


12/4/2007 -- Calcium blood test to check for hypercalcemia in view of D3 result: pending.
Prior tests for Ca have always been fine.


11/30/2007 -- PSA: 4.68 Immulite 2000, 3rd generation ultrasensitive (for consistency)
PSADT based on this and previous tests: 3.09 months, velocity 0.89/month.
Testosterone: 572
Vitamin D3 calcidiol (25-hydroxyvitamin D - my first calcidiol test): 144

I had called my oncologist to switch to the calcidiol test after re-reading Dr. Myers' new book
and reading posts on another board. I learned that my doctor had recently decided to switch to calcidiol
himself for all his patients. He said my calcidiol result was the highest he had seen. He and I are
generally pleased and confident, but we are checking for hypercalcemia to be on the safe side.
I am also knocking off vitamin D3 supplementation for now to let that calcidiol level drop below
100. I hope to do a separate post about all this.
Blood: fine

11/19/2007 -- Added 30 mg Co-Q-10 as I'm on a statin drug, following an expert doctor's advice for those who take statins.


10/16/2007 -- PSA: 3.36 Immulite 2000, 3rd generation ultrasensitive (for consistency)
Testosterone: 770
DHT: 15
Vitamin D3 (1,25-Dihydroxy): 35.2
Blood: fine


9/12/2007 -- DEXA BMD scan: both spine and hip normal; details below.


8/16/2007 -- PSA: 2.49 Immulite 2000, 3rd generation ultrasensitive (for consistency)
Testosterone: 585
DHT: 43
Blood: fine

8/1/2007 -- Total cholesterol 175 (Triglyceride 88, HDL 66, LDL 91, Chol./HDL ratio: 2.7)
Simvastatin worked to lower my cholesterol, and hopefully support my PC program.


7/27/2007 -- Last hot flash. They had been mild and infrequent for several months.
I plan to do a separate post about how the hot flashes tailed off, which I tracked.


6/21/2007 -- PSA: 1.61 Immulite 2000, 3rd generation ultrasensitive (for consistency)
(PSADT now 0.73 months, velocity .41/month, as mostly normal prostate continues to regrow.)
Testosterone: 549
DHT: 6
Vitamin D3 (1,25-Dihydroxy): 47
Blood: fine


6/7/2007 -- Started simvastatin to lower total cholesterol and support my prostate cancer program.


4/12/2007 -- PSA: .28 Immulite 2000, 3rd generation ultrasensitive (for consistency)
(Clearly increasing faster than during my previous (first) off-therapy period.)
At this point my PSADT was 0.42 months with a velocity of 0.19/month, in context of an intact,
unradiated prostate. That PSADT will surely lengthen.
Testosterone: 417
DHT: 13
Vitamin D3 (1,25-Dihydroxy): 61
Blood work: fine


3/14/2007 -- Labs for annual physical all okay except for cholesterol. Low risk for heart trouble due to good ratio and all other indicators; not diabetic.


3/2007 -- Hot flashes are mild and becoming infrequent.


2/20/2007 -- First tests during second IADT3 off-therapy period
Drugs for maintenance: finasteride 5 mg X2/day; Boniva 1/month
PSA -- 0.03 (Ultrasensitive DPC Immulite 2000)
Testosterone -- 144
Dihydrotestosterone -- 6Vitamin D,1,25-Dihydroxy (D3) -- 38


The following results include tests at the end of my second period on full therapy, results during this off-therapy period, and DEXA results.

12/5/2006 -- PSA <0.01, the lower practical clinical limit of the Immulite
Third Generation ultrasensitive test, matching my best scores during the first
cycle of blockade, and indicating no sign of development of Androgen
Independent Prostate Cancer.
Vitamin D (calcitriol) 46 (looking for above 40, so okay),
Testosterone 22 (a little higher than the 20 or below I was shooting for, but the other numbers are great, so all is fine);
DHT 3 (my lowest score; excellent Did it with just Proscar, not Avodart.)

12/12/2006 -- Took final Casodex. Lupron due to run out today (4 X 28 day
months).

12/13/2006 -- Began second off-therapy period. Hoping for and expecting
fairly rapid of testosterone, again, and for reversal of side effects,
particularly loss of bone mineral density.


(DEXA BMD (Bone Mineral Density) recap - summary T score September 2007: healthy. Seven of eight spinal and hip readings are now in the healthy range, with one that has improved to the osteopenia range. My hip density measurements have always been in the normal range.) I have been on either Fosamax or Boniva, with calcium and vitamin D3 supplements in support, continuously since 9/16/00.


9/11/00 T score: -2.0


9/16/00 Started Fosamax with calcium + vitamin D3 supplements in support


9/18/01 T score: -1.9


9/19/02 T score: -1.6 (Went off therapy 7/17/2002, gradually recovering testosterone, helping BMD.) Continued Fosamax and supplements.


9/24/03 T score: -1.5


9/01/05 T score: -1.3 (Back on full therapy including Lupron 5/15/2005, decreasing testosterone abruptly, not helping BMD)


9/08/06 T score: -1.6 for spine, osteopenia (hip fine). However, the average hides the bad news and good; for the first time one vertebra, L4, is well into the osteoporosis range at T= -3.6; on the other hand, for the first time all other measurements are in the good range - no longer showing osteopenia. I've been going to the gym and working on strength exercise as well as aerobic exercise all year.)


10/23/06 Switched, for convenience, to monthly Boniva from weekly 70 mg Fosamax


9/12/07 T score: -0.8, healthy, for spine overall, with vertebra L4 improved to the osteopenia
range and the other three in the healthy range (hip fine at 0.5). This is the
first time since my first DEXA scan in 2007 that both spine and hip have been
considered healthy.


Low PSAs to all,

Jim