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On Sunday, March 10, 2013 5:45:51 PM UTC-5, Edward Dolan wrote:
> wrote in message
> How is that androgen deprivation therapy working out for you I wonder? I
> had a friend who was on that for many years and it never seemed to bother
> him in the least. I had just one shot prior to my radiation treatments and
> it just about drove me crazy. I had almost continuous hot flashes night
> and
> day for 4 months. I knew I would never get used to it, but many of the
> guys
> at the VA were so scared of cancer that they wanted to continue to get
> those
> shots even after their initial treatments.
>
> By the way, those shots are expensive. I think you could probably get them
> at the VA for not much cost.
>> I don't want to be bothered with the VA. Too much bureaucracy and
>> inconvenient location/travel. My medicare and medicare supplement
>> completely cover costs of all medical treatments and yes they are ALL
>> quite expensive,
Yes, if you have got the cost covered then you are doing it right. The VA is
fine once the initial bureaucratic measures are taken care of. After that it
is smooth sailing.
>> My cancer is not organ (prostate) confined and metastatic and is
>> considered high-risk with poor prognosis. The first line of defense for
>> advanced, metastatic prostate cancer is systemic treatment in the form of
>> androgen ablation, or what is commonly referred to as androgen
>> deprivation therapy (ADT). Hormonal manipulation is the mainstream
>> medicine standard of care and is essential in the management of advanced
>> prostate cancer. Lupron (leuprolide acetate) is a
>> Luteinizing-Hormone-Releasing hormone (LHRH) agonist (substance that
>> initiates a physiological response when combined with a receptor) that
>> shuts down testosterone production. Bicalutamide (Casodex) is an
>> anti-androgen that inhibits testosterone from binding to prostate cancer
>> cell�s androgen receptors. Adrenal glands produce a testosterone
You have a doctor�s knowledge of what is transpiring and of how to treat it.
Most folks never want to know that much about their disease, no matter what
it is. They figure that is what they are paying the doctor for. What you say
above makes me wonder if older men should ever be taking any testosterone to
boost their sexual performance. Those ads on TV disgust me!
>> Ed, you were given a Lupron injection prior to radiation to kill of as
>> many cancer cells as possible and reduce prostate volume to improve
>> radiation treatment targeting. Once a Lupron injection is given, they are
>> generally given continuously. That is standard of care. To answer your
>> specific question regarding Lupon injections, ADT does have its downside.
>> Treatment induced menopausal side effects include anemia, hair loss, dry
>> eyes, dry skin, hot flashes, erectile dysfunction, abdominal fat deposit,
>> weight gain, breast pain and/or enlargement, decreased size of testes and
>> penis, emotional changes (anxiety, depression, and mood swings), fatigue,
>> loss of libido, sleep disturbance, myalgia (muscle pain), nausea,
>> increased urinary frequency, discomfort or obstruction, and changes in
>> bowel function, including diarrhea and rectal incontinence. More serious
>> side effects include peripheral edema (swelling of hands, feet, ankles,
>> and lower legs), decreased muscle mass, loss of bone mass
>> (osteopenia/osteoporosis), elevated serum glucose, Type-II diabetes,
>> hypertension, cardiovascular disease (heart attack and stroke), elevated
>> cholesterol and triglycerides, decreased HDL cholesterol, memory
>> impairment, cognitive decline, abnormal liver function, increased risk of
>> SREs (skeletal-related events � pathological fractures, spinal cord
>> compression, and severe joint and bone pain), and excess serum cortisol.
>> Some anti-aging experts refer to cortisol as the �death hormone� due to
>> multiple degenerative effects that cortisol produces including immune
>> dysfunction, brain cell injury, and arterial wall damage. As daunting as
>> the side effects are, I had only two alternatives. I could allow the
>> disease to rapidly progress unabated, or I could opt for ADT to survive
>> longer with the distinct possibility of a compromised quality of life.
>> Neither are appealing alternatives, but I opted for ADT. Unfortunately,
>> that is an option that I realized would most likely reduce me to a shade
>> of my former self.
Yes, I am sure I just had the Lupron shot. It was suppose to be good for 3
months, but it lasted 4 months in my case. The hot flashes were the worst
side effect for me. Frankly, I would not want to be on that treatment for
long. The business about the erectile dysfunction is funny since the Lupron
shot also completely takes away libido. Sex apparently is just chemistry. It
is not exclusively in the mind as I once thought.
If I were in your shoes the hardest thing for me to overcome would be
depression. I tend to dwell on every unpleasantness that comes down the
pike. I do not take ill health well. I have always thought that a modicum of
good health is priceless for which we should be ever thankful. I am always
amazed at what some folks are able to put up with. I can see now that you do
not have it easy at all. Everyone I have ever known who had prostate cancer
apparently caught it early enough so as to avoid your extreme treatments.
>> To be more specific, I have experienced dry skin, hot flashes,
>> depression, and decreased muscle mass. I have just deliberately opted to
>> begin intermittent androgen deprivation therapy well aware that it is no
>> standard of care. I determined to do so because the American Society of
>> Clinical Oncologists recently issued a report specifying that
>> intermittent ADT is almost as effective as continuous ADT but without its
>> associated side effects. With some degree of apprehension, I decided to
>> remove my safety net. Although unconfirmed in clinical trials, it is my
>> conjecture that with intermittent ADT, tumor cells are forced into normal
>> pathways due to testosterone rebound with the subsequent probability of
>> an increased duration of treatment efficacy and delay in progression to
>> castrate resistant (hormone refractory) disease. When my PSA begins to
>> rise again, androgen dependent tumor cells should be responsive to the
>> next cycle of hormone therapy. In the interim, I continue to take
>> dutasteride (Avodart) as maintenance therapy to inhibit conversion of
>> testosterone into the more dangerous metabolite dihydrotestosterone.
You are most likely on the cutting edge of treatment. If knowledge alone
could save you, you would be saved. But one also needs some luck. All your
efforts deserve some of that too.
>> Well, that is far more than you probably expected to hear back in the way
>> of a response, however since you are being reasonable (you are capable
>> when you want to be), I took the time to be very thorough in my reply.
I could follow your explanation of all the complications and treatments as
long as I read slowly. On the other hand, I never wanted to be a doctor. I
learned that when I was a Hospital Corpsman in the Navy for 4 years. I
mostly can�t bear to even think much about my own ailments. I think you are
one tough guy to be able to cope as well as you are. Maybe cycling is good
for us after all if it makes us tough when we need to be.