What is the latest information on cancer research?
R L
prostate cancer that has metastasized?
~Ralph
Alan Meyer
I know of a few things that are relatively new and appear to be
promising.
1. Docetaxel.
This has been used for some years now with useful but limited
success. However there are a number of trials underway using it
earlier, before the cancer has gone too far. Gourd Dancer had it
that way and has had good results.
2. Revlimid.
This is a compound related to thalidomide. I think it might be
an anti-angiogenic agent, which means it would retard the
formation of new blood vessels, something that growing tumors
need. It is approved for patients with some other cancers and is
in clinical trials for PCa. Some patients have apparently
experienced excellent results.
3. Radioisotopes delivered directly to bones.
This works by binding a radioactive isotope to a molecule that is
taken up by bones. I don't know exactly how it works, but I
think you get an infusion of the stuff which then circulates
through your body, collecting in bone cells - where the radiation
is slowly released. It provides a whole body attack on bone
metastases and so would appear to be very useful for advanced
cases where the cancer has spread to many bones. It's most
intended for pain relief, but some are reporting some life
extension as well.
4. Vaccine therapies.
The purpose of vaccine therapy is to sensitize the patient's
cancer cells to attacks from his own immune system.
There was something of a setback in this field when the FDA
required the makers of Provenge to go back to clinical trials for
another couple of years, but at least some patients have had good
results.
5. Pomegranate? Capsaicin?
Some supplements are getting good reports. Someone posted a
message here recently citing a study of capsaicin (the hot part
of jalapeno peppers) reducing tumors by 80%.
6. Others?
There are a lot of clinical trials underway. Go to:
http://www.cancer.gov/search/ResultsClinicalTrials.aspx?protocolsearchid=4280451
to see a list of 334 current trials. Only some of these are for
new treatments. Some are diagnostic or screening trials, or
other things, and many are minor refinements of existing
treatments. But it's apparent that there is a fair amount of
research activity.
Of course I'm not a doctor and not qualified to advise people,
but my personal opinion is that different patients will be
sensitive to different treatments. I suspect that a patient will
have the best chance of extending his life if he has a medical
oncologist who is willing to really work with him - try different
treatments and watch closely to see how they work. If they're
not working, try something else.
The older we get, the less chance we have for life extension.
After all, something will get us. But for younger patients
especially, I think that at least some of the ones who battle
their disease, and have a doctor who will help them do it, may
get some extra years.
In the long term, I think that the scientists are going to beat
this completely. But I don't think we're there yet. When the
old director of the NCI (Dr. von Eschenbach) said we would have
cancer under control by 2015, I think he was grossly
exaggerating. But maybe our sons, and very likely our grandsons,
will have much better treatments than we do.
Alan
R L
very much.
I have one additional question that has bothered my wife. She is
concerned that the urologist (who was treating me at the time) changed
me to Eligard when Lupron had done so well in shrinking the nodules in
my lungs and also lowering my psa to undetectable levels. (Since last
fall the nodules have reappeared and my psa started creeping up. I was
referred to a medical ocologist who put me o Casadex in additon to the
Eligard shot that the urologist had given me. The nodules stabalized at
last report (had not shrunk though). The PSA reduced somewhat....last
reading was 1.0
She tends to think the Lupron was better than Eligard. The urologist
had told me they were the same chemical compound.
Thanks again,
Ralph
Alan Meyer
> ...
> I have one additional question that has bothered my wife. She
> is concerned that the urologist (who was treating me at the
> time) changed me to Eligard when Lupron had done so well in
> shrinking the nodules in my lungs and also lowering my psa to
> undetectable levels.
I'm no expert, but I had thought that the urologist is right. I
believe that Lupron and Eligard are not exactly identical, but
they work the same way. They both work by stimulating the
production of a hormone which in turn stimulates the testes to
produce more testosterone. The testes actually do that for about
two weeks (the "testosterone flare" associated with hormone
therapy), after which they become overloaded and shut down.
If that theory is right, I would think the results should be the
same.
> (Since last fall the nodules have reappeared and my psa started
> creeping up. I was referred to a medical ocologist who put me
> o Casadex in additon to the Eligard shot that the urologist had
> given me. The nodules stabalized at last report (had not
> shrunk though). The PSA reduced somewhat....last reading was
> 1.0
>
> She tends to think the Lupron was better than Eligard. The
> urologist had told me they were the same chemical compound.
> Thanks again, Ralph
The medical oncologist will know more about this than I do. When
you say "she" are you referring to the medical oncologist? Does
she plan to put you back on Lupron?
If the doctors have been taking testosterone readings they should
be able to tell if the Lupron and Eligard are working equally
well. The testosterone reading should be below 50, or maybe
below 20 (depending on who you talk to). But in any case, I
would think that if the testosterone reading under Eligard is
higher than under Lupron, then it's not working as well. If it's
the same, then it is working as well.
If they don't have readings from before, they can still take a
reading now, under Eligard, and get a good idea about whether
it's doing what it should be doing.
So I don't think it should be necessary to guess about that.
If the docs take a testosterone reading, then there is a direct
way to find out if the Eligard is doing what it's supposed to do.
It is possible that the Eligard is working fine, that your
testosterone is at "castrate level", but you are becoming hormone
refractory. Unfortunately, that eventually happens to most men.
The addition of Casodex at this point sounds pretty standard as
the next thing that doctors do. It may help for a short time, or
for a long time. There's really no way to tell. Different
individuals have different responses.
One thing I didn't mention in my posting on advanced treatments
is "second line" hormone therapy. It isn't really very new, but
it does work for many patients. Some of the drugs used include
Estradiol patches (an estrogen compound) and ketoconazole. Some
men get a few months of lowered PSA from those treatments, some
get years, and some have nasty side effects that cause them to
give them up. The medical oncologist should know about these
treatments.
Best of luck.
Alan
R L
are essentially the same. The eligard shot is still being billed as
"Lupron Depot" at the business office.
I will see the oncologist Monday to get a
three week evaluation. I will ask him if I get the opportunity.
He seemed to be pleased three weeks ago when my MRI showed no mets in
the spine. The prostate nodules in the lungs had not grown any more
since taking the Casodex.
~Ralph
Steve Jordan
> I'm no expert, but I had thought that the urologist is right. I
> believe that Lupron and Eligard are not exactly identical, but
> they work the same way.
I'm certainly no chemist, but I looked up both drugs on www.rxlist.com
and found that the chemical formulae are exactly the same:
5-oxo-L-prolyl-L-histidyl-L-tryptophyl-L-seryl-L-tyrosyl-D-leucyl-L-leucyl-L-arginyl-N-ethyl-L-prolinamide
acetate (salt)
However, FWIW, Lupron is a product of TAP Pharmaceuticals; Eligard is a
product of Sanofi Aventis.
I wouldn't be surprised to learn that there is a price difference.
Regards,
Steve J
Lud
Ralph
Before you get to the chemotherapies and after Lupron/Eligard have
failed, the is transdermal estradiol therapy (Ref Ockrim studies),
Ketoconazole (low dose at 200 mg TID anf high dose at 400 mg TID) with
hydrocortisone (see studies by Trachtenberg and Strum), DES an old
drug available from compounding pharmacies and the anti-androgen
Anandron. All more tolerable then Taxotere.
Lud
Gourd Dancer
take the Lupron when I do not want to wait for the Eligaard to be ordered
up. Eligard needs to be refrigerated as the shelve life is quite a bit less
than Lupron. Small needle and given in arm rather than the buttocks.
However, stings like hell 20 seconds after administered. Because of the
smaller gauge needle it is used mostly often on bony men who do not have a
lot of meat.....
Still, my experience is less hot flashes with Eligard.
Gourd Dancer
"R L" <wa5...@webtv.net> wrote in message
news:2989-47D...@storefull-3277.bay.webtv.net...
Gourd Dancer
with a Phase II clinical trial. There are promising trials taking place
everywhere. I suggest that you look toward research facilities first. In
other words, non-FDA approved drugs rather than standard fare.
Good luck,
Gourd Dancer
"R L" <wa5...@webtv.net> wrote in message
news:23439-47D...@storefull-3276.bay.webtv.net...
Joe Price
"Gourd Dancer" <!!!msheets!!!@!!!sbcglobal!!!.net> wrote in message
news:i6JAj.15065$0o7...@newssvr13.news.prodigy.net...
>I have had both for 46 months and frankly, prefer Eligard over Lupron. I
>take the Lupron when I do not want to wait for the Eligaard to be ordered
>up. Eligard needs to be refrigerated as the shelve life is quite a bit less
>than Lupron. Small needle and given in arm rather than the buttocks.
>However, stings like hell 20 seconds after administered. Because of the
>smaller gauge needle it is used mostly often on bony men who do not have a
>lot of meat.....
>
> Still, my experience is less hot flashes with Eligard.
>
> Gourd Dancer
>
I was switched from Eligard to Lupron when I moved from one Canadian
province to another. In my new location there is a requirement that all
needles incorporate a safety device to cap the needle after use to prevent
needle stick injuries to the doctor/nurse administering the drug. Lupron is
available in that format, Eligard isn't.
I have not noticed any difference in side-effects and both drugs reduced my
PSA to undetectable levels.
I liked that Eligard is available in a 6-month dose - Lupron is available in
doses lasting up to 4 months. I travel a fair bit and the less tied I am to
the injection clinic the better.
Lupron is injected in the muscle, Eligard is subcutaneous; in my case it was
injected above the belt line in my abdomen. In that respect, I prefer
Lupron.
Bottom line - very little difference/personal preference.
JP