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Cancer: Prostate Message Board


Cancer: Prostate Board Index


[QUOTE=IADT3since2000;3358252]Hi again Herb,

You are surely having a tough time, but I'm glad hospice has been able to help. My experiences involving relatives with them have been great. :angel:

On the other hand, some patients decide they would rather recover and take an extended vacation from hospice. Art Buchwald comes to mind. He had some excellent time between his first and last sessions with hospice.

You mentioned that you would be seeing a urologist. If you want to take a shot at the more complete hormonal blockade I mentioned, you have a much better chance being understood by a medical oncologist than a urologist. Most of the urologists I have known or found out about are just not very expert or understanding about hormonal blockade; that includes some who were outstanding surgeons. An oncologist is much more likely to be savvy enough to manage you on the other drugs. (Drug delivery is easy - pills in your case, but finding a willing doctor is sometimes hard.) However, hormonal blockade usually works most effectively when cases are not so advanced.

There's another drug that you might want to consider. It's known as Leukine, and it is delivered by daily injection, usually by the patient himself or a family member or friend. Apparently about 50% of patients have a good response, and it has worked wonders for some late stage patients. It is also expensive, but most of the patients on it that I have known have had the expenses well covered by insurance. It is not chemo therapy but rather an immune system booster. It is one of the first immunotherapy drugs that was substantially helpful for prostate cancer. It is also possible to combine Leukine with hormonal blockade.

I realize that you may be tired of the battle and just want to rest. You seem at peace with your life, and that's wonderful. :angel: I just wanted you to know there are some options that might still give you more good quality time if you wanted to try them.

Take care,

Jim[/QUOTE]


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. The insurance company compiled a list of 10 serious diseases and offered a chance for a sort of second (or third, or fourth) opinion for anyone suffering from one of these diseases. There is no charge for this program. In looking over the list, I have TWO of the diseases listed...Parkinson's and cancer, so I considered myself a excellent candidate. They agreed.

Because the cancer is probably the more life-threatening of the two, I decided to go forward with that one.

What was involved was my signing multiple releases authorizing Best Doctors to gather all my medical history from all my doctors, hospitals, labs, etc. When they had gotten it all (about two months later) 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. I don't know if I should give his name on this board.

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.

Again, I can't thank you enough for your interest and advice. These boards are amazing, aren't they?

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

Best wishes for the season.

Herb





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