Testosterone Suppression After Radical Prostatectomy
Frank L
Steve Kramer
"Frank L" <frankie...@webtv.net> wrote in message news:13427-476...@storefull-3114.bay.webtv.net...I am writing for a friend so can't give you the name of the drug or very
much information but hope you can advise. My 59 year old friend had a
radical prostatectomy in March. Afterwards, he had radiation treatments
and was given an injection that lasts 6 months to suppress testosterone
and help to cure the cancer.
He had a PSA test last week and it was 0 (zero). He called his doctor
today who wants him to get another injection and my friend does not want
to do this. He wants his sex drive back and doesn't want to go another
six months like the last. Unfortunately, he didn't ask the doctor what
benefit another injection would have. Does anyone know? Is my friend
making the wrong decision? To me, if it will keep the cancer at bay,
it's worth it but he feels since his PSA count is zero, why bother. Any
insight into this would be appreciated...are injections continued for a
long period of time? What purpose do they serve?
--
PSA 16 10/17/2000 @ 46
Biopsy 11/01/2000 G7 (3+4), T2c
RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins
PSA <.1 <.1 <.1 .27 .37 .75 PSAD 0.19 years
EBRT 05-07/2002 @ 47
PSA .34 .22 .15 .21 .32 PSAD .056 years
Lupron 07/03 (1 mo) 8/03 and every 4 months there after
PSA .07 .05 .06 .09 .08 .132 .145 PSAD 1.4 years
Casodex added daily 07/06
PSA <0.04, <0.05, <0.04, <0.04 10/11/07
Non Illegitimi Carborundum
--
PSA 16 10/17/2000 @ 46
Biopsy 11/01/2000 G7 (3+4), T2c
RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins
PSA <.1 <.1 <.1 .27 .37 .75 PSAD 0.19 years
EBRT 05-07/2002 @ 47
PSA .34 .22 .15 .21 .32 PSAD .056 years
Lupron 07/03 (1 mo) 8/03 and every 4 months there after
PSA .07 .05 .06 .09 .08 .132 .145 PSAD 1.4 years
Casodex added daily 07/06
PSA <0.04, <0.05, <0.04, <0.04 10/11/07
Non Illegitimi Carborundum
Steve Jordan
on behalf of a friend:
> Your friend has a lot to learn about his cancer. Prostate cancer is
> one of those things about which one cannot make decisions in a vacuum
> and should not make decisions based purely on his doctor's
> recommendations. The treatments and side effects are highly personal.
>
And if Frank's friend wants to die with a woodie, that's his choice. As
for me, I"d prefer to be alive to enjoy the many benefits of that state,
including sex without a woodie, than to be dead.
I have to say that men who think that they cannot live without erections
are (a) mistaken and (b) childishly ignorant about the consequences of
doing nothing, which can be horrible.
I recommend that the friend (why isn't he posting for himself?) consult
a genuine cancer specialist, a medical oncologist.
Regards,
Steve J
Frank L
Steve Jordan
(snip)
> Are you saying that he needs to remain on ADT forever?
With all due respect, I say that I am saying what I said in my post.
I am not one of those who presumes to give medical advice online. Or
elsewhere.
> Does that mean
> that everyone who has undergone a RP and radiation and now is on ADT
> has to stay on it even if their PSA is as low as yours (and probably
> his...he said zero but I unedrstand what you mean regarding the
> assay).
Huh? I did not touch on that subject at all....
> He told me that no cancer is detectable now according to the
> PSA and from what I read, people only continue the ADT when there are
> remaining cancer cells. I am wondering why you say he is terminally
> ill...can't someone be cured after just the surgery and radiation,
> even without hormone therapy?
I do not understand where Frank is finding these references.
Does he think that Steve J = Steve K? Not so.
Regards,
Steve J
Frank L
I.P. Freely
> I am writing for a friend so can't give you the name of the drug or very
> much information but hope you can advise. My 59 year old friend had a
> radical prostatectomy in March. Afterwards, he had radiation treatments
> and was given an injection that lasts 6 months to suppress testosterone
> and help to cure the cancer.
>
> He had a PSA test last week and it was 0 (zero). He called his doctor
> today who wants him to get another injection and my friend does not want
> to do this. He wants his sex drive back and doesn't want to go another
> six months like the last. Unfortunately, he didn't ask the doctor what
> benefit another injection would have. Does anyone know? Is my friend
> making the wrong decision? To me, if it will keep the cancer at bay,
> it's worth it but he feels since his PSA count is zero, why bother. Any
> insight into this would be appreciated...are injections continued for a
> long period of time? What purpose do they serve?
>
>
Frank, secondary (and tertiary) treatment is one of prostate cancer's
most personal, complex, and controversial issues. Some cases all but
make those decisions for us, but most of those cases are advanced,
incurable, and often symptomatic, taking some options off the table. We
don't know enough about your friend's case to make the slightest guess
about his status or treatment rationale, partly because many doctors
want to fire all barrels to maximize longevity at any quality of life cost.
ADT [Androgen (testosterone) Deprivation Therapy] is especially
controversial for many reasons including:
1. It often extracts a huge quality of life (QOL) toll. At least one
well-known oncologist with advanced (terminal) PC abandoned his ADT
because of its side effects.
2. It does not cure PC. It adds several months of heartbeat, on average,
but often just masks the cancer instead of actually treating it.
3. The biggest names in the PC world still debate when ADT is justified:
promptly after initial treatment regardless of prognosis vs only if
and when PSA climbs again vs only when symptoms appear vs when symptoms
get worse than the ADT side effects.
4. Personal priorities can and often should overrule most of those
considerations IF the patient is thoroughly educated in prostate cancer
treatment AND has carefully and thoroughly identified and evaluated his
priorities in life. At the very LEAST your friend should read a couple
of the PC books we talk about here all the time. Otherwise he's
completely at the mercy of his doctor(s), a place I'd not want to be
even if I were being treated by the world's leading PC experts, for one
simple reason: they are NOT the world's leading experts on I.P. Freely's
personal priorities.
I.P.
rosbif
wrote:
>This is a good friend of mine who does not know how to access
>this group from his system.
Fran, if your friend has a computer, he can access this group (and
post to it after a standard free registration routine) through google
*groups* which archives most of the usenet discussion groups going
back a long way. For researching those archives, the advanced group
search is best:-
http://groups.google.co.uk/advanced_search?q=&hl=en&
If that link doesn't work for you go to google/groups/advanced group
search, key alt.support.cancer.prostate into the 'group' field and
everything else should be obvious. Search words will get you into all
the relevant threads - 1000s of them!...and of course you can continue
to post specific questions here.
Steve Kramer
"Frank L" <frankie...@webtv.net> wrote in message news:20864-47...@storefull-3113.bay.webtv.net...
Are you saying that he needs to remain on ADT forever? Does that mean
that everyone who has undergone a RP and radiation and now is on ADT has
to stay on it even if their PSA is as low as yours (and probably
his...he said zero but I unedrstand what you mean regarding the assay).
He told me that no cancer is detectable now according to the PSA and
from what I read, people only continue the ADT when there are remaining
cancer cells. I am wondering why you say he is terminally ill...can't
someone be cured after just the surgery and radiation, even without
hormone therapy?
Steve Kramer
--
Steve Kramer
"Frank L" <frankie...@webtv.net> wrote in message news:18557-476...@storefull-3117.bay.webtv.net...Steve J, yes I was replying to Steve Kramer but thank you for your input
also. First let me say that I am a female (the name was random, my name
is Fran). This is a good friend of mine who does not know how to access
this group from his system. When he told me what happened when he spoke
to the doctor today, I was upset that he isn't following his advice.
I know you can lead a horse to water...I am frustrated with his lack of
research and making this most likely unwise decision of turning down
further hormonr treatment so I decided to take the initiative. He is
seeing an oncologist who is pretty well known in the large city in which
we live. A second opinion would be good but I really would like to know
the facts, not from google but from you who are experiencing this and
have done vast research. I hope Steve Kramer can clarify what I asked in
the prior post and whoever else can. I just want to understand why
continuing ADT is important is the dr. said there is no more cancer on
this particular PSA...is that just temporary sometimes? What about all
the people I know who had a radical, then some radiation and never
received ADT? They seem to be doing well and continue to have low
PSAs...isn't that a possibility?
Steve Kramer
"I.P. Freely" <fuhghed...@noway.nohow> wrote in message
news:pdFaj.2042$e56...@newsfe06.lga...
> 2. It does not cure PC. It adds several months of heartbeat, on average,
> but often just masks the cancer instead of actually treating it.
As usually, I agree with I.P. except on this one issue. Actually,
statistically it may be fairly accurate, but it should be qualified, IMHO,
to include that sometimes it might add years!
During July 2003, my PSA was doubling every 6+ months. At that rate, it
would today be in the thousands (and I'd be dead, likely). Instead, I went
on ADT and it has been undetectable for 1½ years. I work full time in a
physically active job, I take care of my family, help my sons and
sons-in-law with moving and digging and building and remodeling, and the
hardest of all (and most fun), sometimes watch my grandchildren. My QOL is
just fine, thank you, with and because of ADT.
cmdrdata
> I am writing for a friend so can't give you the name of the drug or very
> much information but hope you can advise. My 59 year old friend had a
> radical prostatectomy in March. Afterwards, he had radiation treatments
> and was given an injection that lasts 6 months to suppress testosterone
> and help to cure the cancer.
>
> He had a PSA test last week and it was 0 (zero). He called his doctor
> today who wants him to get another injection and my friend does not want
> to do this. He wants his sex drive back and doesn't want to go another
> six months like the last. Unfortunately, he didn't ask the doctor what
> benefit another injection would have. Does anyone know? Is my friend
> making the wrong decision? To me, if it will keep the cancer at bay,
> it's worth it but he feels since his PSA count is zero, why bother. Any
> insight into this would be appreciated...are injections continued for a
> long period of time? What purpose do they serve?
>
>
Fran,
I've been following this thread and the "expert opinions" given so far
are
good information, but let me try to explain what I hope you are
looking for:
Your friend has PC and was treated with 1) RP then 2) radiation and 3)
drugs.
This is NOT the normal treatment path for men with early PC diagnosis
(low
PSA, T1 staging, post surgery tissue indicated negative margins
outside
the prostate). The fact that he was treated with all 3 seemed to me
that he
had an aggressive PC that has spread (metastazized) outside the
prostate.
In that case, then drugs is the only way (currently) to manage the
spread until
one day the cancer will manifest elsewhere (I know this from my own
two family
members that have died from it). The drugs will prolong his life, and
there will
be a point where Side Effects will override Quality Of Life. So, the
decision is really
his own. BTW, QOL is also an individual thing, and each person has to
decide
what that is. It could be sex, or be alive to enjoy your children and
grandchildren
until the trade off with SEs balanced the other way.
BH
As you've already heard from several people, the decision on whether
to undergo (continue, in this case) ADT is not easy one. In the
final analysys, it comes down to a very personal level. Your friend's
statement that he "doesn't want to go another six months like the
last" is the most important point in your post.
If he doesn't want to continue the ADT, it's up to him to stop.
Whether loss of sex drive is the "right" criterion for making this
decision is totally up to him. (Not all of us here would make the
same decision based on that criterion, but, it's his decision.) Based
on my experience, there are probably a lot of other side effects that
contribute to his feelings about ADT and loss of sex drive may
actually rank low in importance even though it's frequently at the
forefront of our awareness.
As others have said, I agree that your friend does need to become
better informed about what ADT might, and might not, do for him over
time before he makes his decision on stopping ADT. Statistically, ADT
might add a few months to a person's life. Empirically, there's our
fellow member of this group Steve Kramer, who gives a good measure of
credit to ADT for about 4 1/2 years of "additional time". Steve is
obviously able to tolerate the side effects acceptably. I stopped ADT
after about 10 months because I wasn't willing to trade off QOL for
what might be a few months of extra life if I was going to feel
terrible for the entire remainder of my life. Steve and I may be near
the opposite ends of the spectrum. As long as a person is comfortable
with his decision, it's "right".
Please continue to help your friend become better informed. And tell
him I think that having a friend like you who will help him get
through this is about the best Christmas present he could hope to get!
Best wishes,
Burney
On Thu, 20 Dec 2007 18:22:55 -0500, frankie...@webtv.net (Frank L)
wrote:
>I am writing for a friend so can't give you the name of the drug or very
>much information but hope you can advise. My 59 year old friend had a
>radical prostatectomy in March. Afterwards, he had radiation treatments
>and was given an injection that lasts 6 months to suppress testosterone
>and help to cure the cancer.
>
>He had a PSA test last week and it was 0 (zero). He called his doctor
>today who wants him to get another injection and my friend does not want
>to do this. He wants his sex drive back and doesn't want to go another
>six months like the last. Unfortunately, he didn't ask the doctor what
>benefit another injection would have. Does anyone know? Is my friend
>making the wrong decision? To me, if it will keep the cancer at bay,
>it's worth it but he feels since his PSA count is zero, why bother. Any
>insight into this would be appreciated...are injections continued for a
>long period of time? What purpose do they serve?
RP in 1995 (age 52)
RT in 2000
ADT (Casodex) 10/06 - 8/07
burney dot huff at mindspring dot com
I.P. Freely
> If he doesn't want to continue the ADT, it's up to him to stop.
> Whether loss of sex drive is the "right" criterion for making this
> decision is totally up to him.
Besides, which is better ... having no sex drive (via ADT) or having a
sex drive but limited capacity for following through on it (not uncommon
with RP)? Does your friend know how his equipment is working post-op but
without ADT?
> Empirically, there's our
> fellow member of this group Steve Kramer, who gives a good measure of
> credit to ADT for about 4 1/2 years of "additional time".
I could credit the string on my finger with my having seen no pink
elephants for the last 5 years, but maybe, just MAYBE, the reason is the
dearth of pink elephants in the Pacific Northwest. But even if Steve is
right and his longevity really is due to ADT, you and your friend need
to be reminded that anecdotal evidence is a classic oxymoron, that the
flip side of his experience includes people who died "right on schedule"
or even earlier than expected despite ADT, and that for his ADT to work
that well would require that his cancer was of a specific type
susceptible to ADT intervention. ADT's 6-8 months (up to a year under
certain case-specific constraints) median heartbeat extension is nothing
more than a statistic.
I.P.
Steve Jordan
(su-nip)
> ADT's 6-8 months (up to a year under certain case-specific
> constraints) median heartbeat extension is nothing more than a
> statistic.
And, if it can be so dignified, so is Mike's allegation.
Regards,
Steve J
"Facts are stubborn things; and whatever may be our wishes, our
inclination, or the dictates of our passions, they cannot alter the
state of facts and evidence."
--John Adams
Frank L
Shirley ann
Last month his urologist called him to have another hormone shot.
Hubby said No and they said they would see him next year.
His PSA was ,04. 6 months after the radiation.
He started to have these hormone shots before his seed implant and was
told they would shrink his gland and it will not enlarge or will up
anymore.
He is 77.
shirleyann
Steve Kramer
> BH wrote:
>> Empirically, there's our
>> fellow member of this group Steve Kramer, who gives a good measure of
>> credit to ADT for about 4 1/2 years of "additional time".
>
> I could credit the string on my finger with my having seen no pink
> elephants for the last 5 years,
Really? I do not mean this to be insulting, but you were a scientist. Can
you really equate my history of RPP, PASD, EBRT, PSAD, ADT1, PSAD, ADT2,
straight line undetectable for 1½ years to a heard of light red pacoderms?
Surely, further thought would, even to you, render this argument weak.
> you and your friend need to be reminded that anecdotal evidence is a
> classic oxymoron
At the risk of repeating myself (but, since you have repeated yourself), in
some cases anecdotal evidence is of no use. If I were cured of cancer
during my surgery as a pink Dumbo balloon passed by the hospital in a
parade, it would be the heighth of stupidity to assume that everytime that
Dumbo passes, an operation is successful. Conversely, when a clearly
established case of out-of-control PSA is presented and suddenly stunted for
a long term, it is pissing into the wind to say that ADT only adds 6-8
months. Anecdotal evidence ranges from no value to incontrovertible,
depending on whether a single occurence is all that is necessary to disprove
a theory.
However, if I die between next year and 2010 (8-10 years), I'll stop arguing
with you about it.
Incontrovertible evidence to follow:
Steve Kramer
"Frank L" <frankie...@webtv.net> wrote in message news:10423-476...@storefull-3115.bay.webtv.net...In answer to one question (IP)...he started the ADT very shortly after
the surgery<< That is very odd. I wonder if they found cancer in his seminal vesicles (Stage T3c) and attacked it fast and furious with radiation and ADT.He also said that his penis got smaller.<< Doctors say this does not happend. But, it did to me an many others here.I don't know what his PSA was then nor his Gleason score, any of the
numbers you all are posting so I feel a bit foolish going on like this.<< It is foolish to feel foolish. You are not responsible for his numbers. If you don't know them, we just can't be as accurate as we or you might like. It's not a 'foolish' issue.
What I do know is that he is having another PSA in 3 months and says
that if it's still zero (he said the paper says 0.0, not even 0.1 but
Steve K., I know you doubt this<< It's not a doubt. But, it's not important either. I remember Bev, a very learned wife of a patient, got the same reading on a piece of paper. It caused concern the first time and confusion the 2nd time. Maybe it's just a limitation of a field on a computer. 0.0 is very nice, indeed. At worst, it means < 0.1 which is "undetectible" but the old standard. That's a good thing.
I.P. Freely
> Really? I do not mean this to be insulting, but you were a scientist. Can
> you really equate my history of RPP, PASD, EBRT, PSAD, ADT1, PSAD, ADT2,
> straight line undetectable for 1½ years to a heard of light red pacoderms?
> Surely, further thought would, even to you, render this argument weak.
I'm simply observing that concurrence does not prove causality, and
voicing the self-evident observation that if your ADT did add years to
your life, your cancer was primarily androgen dependent.
> Conversely, when a clearly
> established case of out-of-control PSA is presented and suddenly stunted for
> a long term
How many cases of cancer or other disease have inexplicably gone into
remission?
> it is pissing into the wind to say that ADT only adds 6-8 months.
Tell it to the researchers whose work reached that conclusion we've all
seen and discussed many times; I'm just the messenger (and you omitted
the "median" part). I've never seen anyone claim ADT cannot add years
... nor have I seen anyone here cite references disputing that 6-8 month
median figure except as noted for certain lower-grade cases which may
average a little over a year.
> Anecdotal evidence ranges from no value to incontrovertible,
> depending on whether a single occurence is all that is necessary to disprove
> a theory. Incontrovertible evidence to follow:
This is awfully old stuff. I don't have the time to rehash it. I can't
think of anything to add to the forum archives on it.
I.P.
Steve Kramer
> Steve Kramer wrote:
> I'm simply observing that concurrence does not prove causality, and
> voicing the self-evident observation that if your ADT did add years to
> your life, your cancer was primarily androgen dependent.
Wow! That didn't come across to me. I guess I could not see for all the
large pink mammals. However, I can concur with both of these points.
> How many cases of cancer or other disease have inexplicably gone into
> remission?
I have no idea. To be honest, I don't know what the medical definition of
"remission" is. ... or whether it is applicable to prostate cancer. If it
is just a touchy feely thing, then I suppose several of us are going through
remission. But, I envision cancer doing it's work, just at a level lower
than what can currently be detected by modern medicine. Is that remission
or ADT doing it's thing?
> Tell it to the researchers whose work reached that conclusion we've all
> seen and discussed many times; I'm just the messenger (and you omitted the
> "median" part). I've never seen anyone claim ADT cannot add years ... nor
> have I seen anyone here cite references disputing that 6-8 month median
> figure except as noted for certain lower-grade cases which may average a
> little over a year.
Well, to be honest, I'm not fluent in that median, mode, and average thing.
But, aware I may be treading on Steve Jordan territory, I have not seen
citations asserting the figure either -- or at least not that I am aware of
any long cognizant of.
> This is awfully old stuff. I don't have the time to rehash it. I can't
> think of anything to add to the forum archives on it.
I did warn that it was a repeat response. I'm considering saving it and
just cutting and pasting it in the future. ;-)
BH
wrote:
Hi Fran.
Is my PSA OK? I wish I could give you a "yes", but the answer is not
that easy. About five years after salvage radiation therapy, my PSA
started rising again. We watched it for a while to get a feel for how
quickly it was rising. Then I started taking Casodex. (By the way,
that's a pill taken daily, rather than an injection. But, that's not
really important. There are different types and forms of ADT; but,
they are all "chemical castration" and can result in similar side
effects.) After being on Casodex for about 10 months, my PSA dropped
to 0.13. So, the ADT did work for me "as advertised" in terms of
causing my PSA to drop. I was just no longer willing to continue
taking the medicine because of the side effects, so I stopped. For
me, 0.13 is a "good" PSA level in that it's lower than it was. I'm
due to get another psa at the end of January. The results of that
test will help me decide what to do next.
I do not plan to go back onto ADT on a long-term basis. I will
probably consider trying an intermittent treatment plan to see if that
helps keep the PSA down with a tolerable level of undesirable side
effects. So, for right now, my PSA level is "OK". Is it going to
stay there? Probably not. What next? Who knows? I'll just manage
my life in the best way possible. I hope that helps.
On another note, you have already noticed that your friend apparently
has some pretty serious mental/emotional issues about his situation.
That is very common! It sometimes takes a while for a man to get
through those enough to be able to rationally manage his own
treatment. Keep doing what you are doing and sooner or later you'll
probably see some improvement in his attitude.
Burney
>BH, I am curious to know if your PSA is fine now since you stopped the
>injections. Thanks for your kind words also. I care about my friends
>deeply but it is frustrating when they don't seem to care enough to do
>their own research. This is so important for him to know, I just wish he
>would take the time to learn the things I read here and all the material
>on the web and in the books you recommend (I've been lurking here since
>March).
>
>Again, thanks, both Steves and everyone else who replied. This is an
>amazing group and my holiday wish for all of you is that you get as well
>as you can and stay around for a very long time.
Frank L
Leonard Evens
> I am writing for a friend so can't give you the name of the drug or very
> much information but hope you can advise. My 59 year old friend had a
> radical prostatectomy in March. Afterwards, he had radiation treatments
> and was given an injection that lasts 6 months to suppress testosterone
> and help to cure the cancer.
>
> He had a PSA test last week and it was 0 (zero). He called his doctor
> today who wants him to get another injection and my friend does not want
> to do this. He wants his sex drive back and doesn't want to go another
> six months like the last. Unfortunately, he didn't ask the doctor what
> benefit another injection would have. Does anyone know? Is my friend
> making the wrong decision? To me, if it will keep the cancer at bay,
> it's worth it but he feels since his PSA count is zero, why bother. Any
> insight into this would be appreciated...are injections continued for a
> long period of time? What purpose do they serve?
I haven't read all the responses, so what I have to add may be superfluous.
As Steve Kramer pointed out, radical prostatectomy can cure prostate
cancer. In your friend's case, his doctor presumably found indications
that the surgery had not done that. That could be result of the
pathology report on the tissue excised by the surgeon, or it could be a
PSA that didn't return to undetectable levels within a month or two
after surgery. In that case, doctors often suggest salvage radiation
which may, if the cancer is localized to the area of the prostate, still
cure it. But the cancer cells don't die immediately; it takes up to two
years. In some cases radiation is supplemented with the use of hormone
suppressing drugs such as that your friend got. The idea is that those
drugs make the cancer cells more susceptible to destruction by
radiation. The physician has to use his judgement to decide which
drugs to use and how long to administer them. But, in such cases, the
drugs will not be continued indefinitely if PSA levels drop to a low
level and stay there. The final possibility is that the radiation,
supplemented or not, doesn't work and PSA starts rising. In that case,
hormone therapy is the established treatment. As Steve Kramer said, it
doesn't cure but in many cases it keeps the patient alive for quite a
long time. Unfortunately, even in those cases, oncologists differ
about how long to wait to administer these drugs, which drugs to use,
and how to space the doses. Also, a lot can depend on the specific
patient. If your friend is in that situation, and doesn't like what his
doctor is suggesting, he should seek other opinions from qualified
oncologists who specialize in prostate cancer.
>
>
>
> ------------------------------------------------------------------------
>
Leonard Evens
> Thank you for all of your responses. My friend is the stubborn sort and
> for some reason does not want to get on this group from his home. I am a
> detail oriented person and need to know exactly what's going on with my
> own health, never leave a drs. office without a copy of my bloodwork,
> MRI, etc. I know some people are not like that. I am amazed at the vast
> knowledge of the people in this group, the added benefit of posting your
> scores and dates.
>
> In answer to one question (IP)...he started the ADT very shortly after
> know that the injection (wish I knew the name, he doesn't know) is about
> to wear off now and he has been able to have an orgasm (he has no
> girlfriend or wife at this time) but he says it takes a half hour. He
> says he feels no sex drive at all and has to force it just to prove that
> he can have an orgasm. He also said that his penis got smaller. He is
> pretty down about all of this but opted for the RP because he was afraid
> he would die if he had just chosen radiation. He now regrets his
> decision.
>
> I don't know what his PSA was then nor his Gleason score, any of the
> numbers you all are posting so I feel a bit foolish going on like this.
> that if it's still zero (he said the paper says 0.0, not even 0.1 but
> he doesn't know about on the sheet), he won't take the injection and as
> I said, he is refusing it now.
>
> I am still not clear, despite a few hours on google, what role ADT plays
> if no further cancer has been found in either the prostate or elsewhere
> and with a low PSA. Is it a preventatve?
> BH, I am curious to know if your PSA is fine now since you stopped the
> injections. Thanks for your kind words also. I care about my friends
> deeply but it is frustrating when they don't seem to care enough to do
> their own research. This is so important for him to know, I just wish he
> would take the time to learn the things I read here and all the material
> on the web and in the books you recommend (I've been lurking here since
> March).
>
> Again, thanks, both Steves and everyone else who replied. This is an
> amazing group and my holiday wish for all of you is that you get as well
> as you can and stay around for a very long time.
It seems to me one crucial point may have gotten lost here. I mentioned
it in my previous response. If your friend was put on hormone therapy
to enhance the radiation and his doctor wants to continue it just for
that reason, then if the approach is successful, he will be able to stop
sometime pretty soon. He, and you, should be clear about whether or
not that is what the doctor is trying to accomplish.
If, on the other hand, it has become clear that the radiation failed,
then he has to decide on the basis of the best information when to begin
HT and how to go about it. It is pretty clear that eventually he will
need it. Unfortunately, the research on the subject is rather murky.
No one knows for sure what the best time to start HT is. Also, it can
depend a lot on the specifics of the case. In the end it will have to
be a personal choice, but one presumably based on good medical advice,
not anything that can be found by surfing the net.
>
>
>
> ------------------------------------------------------------------------
>
Steve Kramer
"Frank L" <frankie...@webtv.net> wrote in message news:10423-476...@storefull-3115.bay.webtv.net...
Burney, thanks for the very informative and insightful post. Time will
tell and he will have to see the light himself as he gets periodically
tested. It will upset me if his count goes way up and it gets past the
point of being helped much. I suppose waiting until March is no big
deal. I just wish he were more open to reading. He is a very intelligent
guy who reads all day but is avoiding this. I don't get it but I guess
it's in the area of denial. I read everything, maybe too much, when I
get a health condition so it's hard for me to watch someone on the other
end of the spectrum doing nothing! Have a great holiday, and same to
everyone else reading this. You all have been so helpful.
Frank L
Steve Jordan
> The last time he spoke to thr dr. was just on the phone when he was
> advised to take anoher injection. The doctor told him he wants to see
> him in person. My friend didn't want to bother going in, he felt the
> dr. just wants to get paid for another visit. I told him first of
> all, that's not necessarily true, he just wants to sit and explain
> this in person...anyway, the co-pay on his plan is only $20 so it
> isn't that.
No, I suspect that what it is is that he simply cannot bring himself to
face facts.
No one can do it for him.
Drop it. Soon enough, he will discover through his agony the nature and
extent of his error.
Regards,
Steve J
Alone after the cord is cut we slip
into this world to start our search
for a place of belonging. Every inch
of skin exposed, stung by thin air,
we long to be nestled in cupped palms,
safe, surrounded, warm. There are times
we settle for anyone who’ll have us, yet
all the while we're vigilant for
a better match, the right fit, alert
for threads to knit together. And when
at last we’ve woven a web, a gossamer web
of connectedness, we’ll sit content until
blind and nearly deaf, we feel, one
by one, the outer threads begin to snap,
those minute tugs that signal us
we’ll leave as we entered, alone.
--Ted McMahon, MD
Seattle, Washington
I.P. Freely
> In the end [when to begin ADT] will have to
Necessarily supplemented, I submit, by extensive introspection to define
one's priorities. My prioritization of ADT's couple of dozen efects was
invaluable to me and surprising to my oncs. They presumed, for example,
that my top three priorities would include erections, continence, and
longevity in one sequence or the other, with everything else a distant
4th through 25th. All the medical facts and statistics are almost
meaningless until evaluated in light of one's priorities.
> not anything that can be found by surfing the net.
I found the internet a strong adjunct to the books in identifying ADT's
good and bad effects, guesstimating their likelihoods, determining and
evaluating any additional meds they may entail, and preparing and
defending my questions, findings, and treatment protocol changes to my
oncs. Not everyone can or would want to propose their own treatment
protocol, but, *damn*, it reinforced my preferences, vetted my research,
and gave me confidence in my choices when a whole and widely varied team
of oncs concurred with my results, heavily based on the time I spent
sitting right here.
Of course, that presumes one can reject the BS, discard the unsupported
anomalies, and make defensible sense of the remaining inconsistencies. I
didn't feel comfortable making the most important, complex, and
challenging decision of my like without that level of involvement.
Others are far more comfortable punting, tossing a coin, trusting their
future to a carefully chosen great oncologist or just finding a doctor
with good vibes, or having one of whatever Uncle Joe had for HIS
prostate cancer ... whatever floats one's boat (without extensive
second-guessing).
I.P.
Frank L
Steve Kramer
"Frank L" <frankie...@webtv.net> wrote in message news:13427-477...@storefull-3114.bay.webtv.net...He's my ex boyfriend from some years ago and we're just buddies now but
he sees things in black and white and is very hard headed (ergo...my
ex!)<< He was lucky to have found you and stupid to lose you.Merry Christmas, Fran!
Leonard Evens
> Len, thanks for your posts. The last time he spoke to thr dr. was just
> on the phone when he was advised to take anoher injection. The doctor
> told him he wants to see him in person. My friend didn't want to bother
> going in, he felt the dr. just wants to get paid for another visit. I
> told him first of all, that's not necessarily true, he just wants to sit
> and explain this in person...anyway, the co-pay on his plan is only $20
> so it isn't that.
Doctors often want a patient to come in to dicuss something that may be
complicated. They prefer not to give advice or explanations of such
matters over the phone. Your friend really should go to see the doctor
despite the $20 copay. Depending on how his insurance works, the
doctor may not even make much money on the deal.
It is really important that he understand the purpose of the tretment.
>
> He should have taken the time to see the dr. At this point, being that I
> am not his "significant other", wife, etc., I feel I should butt out.
> He's my ex boyfriend from some years ago and we're just buddies now but
> he sees things in black and white and is very hard headed (ergo...my
> ex!) It's just too frustrating to talk to someone who wants to put their
> head in the sand or make what he thinks are logical conclusions without
> discussing them with their doctor and with so little knowledge. I am
> still going to lurk here, maybe ask questions and let you all know what
> happens in March when he gets his next PSA.
>
> As a woman, I can't know exactly what this must feel like from a
> psychological standpoint but I have had to have mammograms repeated and
> thought what would it be like with no breasts anymore, how it would
> affect my identity, how much of my femininity is tied to my body image.
> Yet, women don't need breasts to perform a sexual act so it isn't quite
> the same.
>
> Steve K, I understand what you're saying and I just wish my friend would
> get some support from other men, somehow, a group, something. We're in
> NYC where every imaginable kind of help is available. Anyway, I am going
> on and on here...thanks to everyone who has posted to me. This is such a
> cohesive group and I'm glad I found you.
>
>
>
> ------------------------------------------------------------------------
>