Discussions that mention zometa

Cancer: Prostate board


[QUOTE=Mr Herb;3359517]Thanks so very much. You have piqued my interest a great deal and my wife and I are trying to sort out a course of action to get more information.

Just FYI, I have excellent health insurance and one of the more recent benefits they have offered is something called Best Doctors. ... they submitted the package to their expert physician, the Chief of Urologic Oncology at the Fox Chase Cancer Center. He's also a Professor of Urology at Temple University School of Medicine....

Anyway, this week I received his InterConsultation Report (along with his biography). Most interestingly, he suggests exactly what you have mentioned. He says I should begin by obtaining a testosterone level as a baseline and then immediately start an anti-androgen to deal with potential impact of adrenal androgen "feeding" the cancer despite my orchiectomy. Oral Casodex is mentioned as being usually well-tolerated. Based on the rapid PSA velocity, it should be rapidly apparent if this will be a succcessful treatment in slowing down the progression of the cancer. He then goes on to mention several other options. He does note that all of the options are indeed palliative and at this point there is no intent to offer a curative option.

So....as I said we are planning a course of action. We have decided to begin with our internist, a brilliant young woman, and get her advice on whom to contact.

...I see you are in Annandale. We used to live in Reston before we retired to South Carolina.

Best wishes for the season.

Herb

Good morning Herb,

We do get to Reston now and then. In fact, the Army manages the Prostate Cancer Research Program for the Congressionally Directed Medical Research Program, giving out $80 million for the PCRP this year, and I've been one of the survivor representatives on panels of researchers that judge research proposals, going to Reston for the panel meetings in 2006 and 2007. Our "International Conference on Prostate Cancer 2006" was also held in Reston. Bet you didn't know it was such a hotbed of prostate cancer activity! (I didn't either before attending. It's probably because it is close to Dulles Airport and has good meeting and conference facilities.)

I'm so glad to hear you are getting good advice. :) Fox Chase is a highly regarded institution, as you no doubt know, and it sure helps to have a sharp internal medicine doctor on board. By the way, when the doctor says "palliative," he is emphasizing that it is not curative, as you noted. But these approaches have a lot of potential to add months, probably years of good quality life, not just avoid pain and suffering. To me, that is more than palliative, or maybe Palliative with a capital P. :)

I mentioned getting a bone mineral density scan in an earlier post. A clear majority of prostate cancer patients have reduced density (below our age peers), and it is especially an issue for those of us on hormonal blockade. Zometa is probably the bisphosphonate drug of choice for someone in your situation. It is expensive, but I'm confident it would be well covered by a good insurance policy. It is infused.

There is a rare side effect that seems to be partly due to Zometa, osteonecrosis of the jaw, that is associated with very frequent and long duration (years usually) dosing. :( Patients trying to reverse bone mets are often put on an every three to four week schedule, but patients without bone mets don't need such frequent dosing from what I have heard. Also, one prominent practice well-known for its expertise in hormonal blockade has had no cases of ONJ with the every three months dosing schedule it uses. :)Also, some patients get strong flu-like symptoms for a few days after administration, especially after the first one. That is known as an "acute phase response," and the good news is it can be prevented or markedly reduced by lenghtening the time of the infusion and reducing the first dose, from what I've heard. :) Patients need to supplement with calcium and vitamin D3 when they are taking any bisphosphonate. I can give you leads if you need them, but by searching the web you can probably dig up some of this fairly easily.

When you see the doctors, be sure to ask about Zometa and Leukine.

I'm so glad you have found some solid help. What a great Christmas present! :angel:

Take care,

Jim