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Cancer: Prostate Message Board

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This is a joyful update to my previous thread:

"Ready for vacation from triple blockade - mostly good test results, but a concern too", started 4/9/1010 at 10:38 AM.

I am now two months in to my third "vacation" (off-therapy period - no heavy duty drugs, specifically the Lupron period ran out two months ago and stopped bicalutamide (generic Casodex) at that point. I am at the 10 1/2 year point since diagnosis for a challenging case. After nineteen months of a third round of triple blockade (Lupron, bicalutamide, finasteride with Boniva in support), my PSA had stabilized in April at 0.04, a little higher than I was aiming for, but below the key level of 0.05. I had blood taken for an ultrasensitive PSA test last week on 6/15.

This morning I got the result: 0.02, a [SIZE="4"][B][I][U]decline[/U][/I][/B][/SIZE] of 50% from the previous 0.04! :eek: :jester: :D :angel: Not that I'm excited about that or anything! :cool: ;)

While I honestly had a hunch that this might happen instead of the increase that one would expect, but I was mostly prepared for an increase, or at least a repeat at 0.04, and that decrease came as a welcome surprise. The one thing that gave me an extra dose of optimism is that I had started taking a certain brand of curcumin with a potent absorption agent over the past two months, based on recent enthusiastic reports from Dr. Charles "Snuffy" Myers, MD, an eminent medical oncologist specializing in prostate cancer.

The curcumin is one of a few changes in my program since that last PSA test in April. I also stopped the monthly Boniva (vacation from that too, now that my bone density has returned to normal and that I'd stopped the Lupron). I have also slightly decreased the calcium I'm taking. However, I doubt that either of those changes would account for the decline. Personally, I'm betting on the curcumin.

I've updated my previous update from April in this fresh thread. The updated information is in green, and the rest is in black.

Here's how I have done from the last time I decided to resume full therapy. (This updates and includes some of the same information from my thread started 3/27/09, "Still so far so good - 3rd PSA test (6 months) third round, tenth year IADT3.)" My earliest thread on this board about my case was "Eighth year anniversary as a survivor - challenging case, today", started back on 12/7/2007.

September 3, 2008 PSA 9.53 (Last test before returning to triple therapy)
November 2008......PSA---2.27
January 16, 2009....PSA---0.86
March 18, 2009.......PSA---0.46
May 4, 2009............PSA---0.28
July 2.....................PSA---0.15
August 28...............PSA---0.07
October 28..............PSA---0.05
December 24...........PSA---0.04
March 2, 2009.........PSA---0.03
April 2, 2009...........PSA---0.04
[COLOR="darkgreen"]June 15, 2010.........PSA---0.02[/COLOR]

September 3, 2008 PSA 9.53 (testosterone 631)

Decided to end vacation from major drugs and go back on triple hormonal blockade (continuing finasteride, 2 X 5 mg daily on vacation and on full therapy).

September 17 - last thalidomide, used to prolong vacation

September 18 - first Casodex, 50 mg

September 26 - first Lupron shot (getting four month shots)

November 2008 PSA 2.27

January 16, 2009 PSA .86

March 18, 2009 PSA .46
March 18, 2009 28 testosterone (too high)
March 18, 2009 75 vitamin D (nice!)

May 4, 2009 PSA .28
May 4, 2009 DHT <3 (That's fine - the lower limit of the test.)

July 2 PSA 0.15
July 2 DHT <3

Cholesterol results are important for hormonal therapy patients too, and I was reassured by these fine results from my internal medicine doctor that my countermeasures were doing the job:

July 6 Total Cholesterol 198 (Once was in the 250s [before simvastatin]. )
July 6 HDL 87 (My internal medicine doc was clearly awed by this one! )
July 6 Ratio 2.3
July 6 LDL 101
July 6 Trigs 49

August 28 PSA 0.07
August 28 Testosterone <10 (Goal: <20; so that's fine.)
August 28 DHT <3 [In the current Prostate Forum newsletter, Dr. Charles Myers, one of our leading experts in hormonal therapy, said he likes this result to be below 10.]
August 28 25 hydroxy vitamin D: 53 (Would like it higher; but it's toward the lower end of the acceptable range of 50 - 80, or even 100, recommended as ideal for us by the experts I trust.) [In the latest Prostate Forum newsletter, Dr. Myers said he likes to see this value between 60 and 100. I've added an additional 1,000 IU of vitamin D3 per day, and my oncologist and I will be checking how I do with the 25-hydroxy vitamin D test. I once way overshot my target, hitting around 141, near what is called "vitamin D intoxication." I've been more cautious since then!]

October 28 PSA 0.05

December 24 PSA 0.04

March 2, 2010 PSA 0.03
Vitamin D 54

March 25 DEXA: "Normal", improved from osteopenia, remarkable after 19 months of hormonal blockade therapy

April 2,2010 PSA 0.04 Vitamin D 62 (I had increased the dose of Vitamin D3 by 1000 IU; would like to get the 25-hydroxy vitamin D level in the 80 to 100 range.)

[COLOR="DarkGreen"]June 15, 2010 PSA 0.02, Vitamin D 66[/COLOR]

My triple hormonal blockade consists of Lupron (four month shot for me, = 30 mg), Casodex (50 mg/day for me), and finasteride (2 X 5 mg/day). Intermittent triple hormonal blockade is also known as Intermittent Androgen Deprivation Therapy 3; it's abbreviated as IADT3.

This is following up on the thread I started on January 22, 2009 entitled "So far so good, 2nd PSA, third round, tenth year IADT3," and a previous thread, November 27, 2008, entitled "So far so good - first PSA, third round/ninth year IADT." (I was also on Boniva for bone density until April 2010, simvastatin to lower the risk of lethal prostate cancer plus heart health benefit, and a supportive program of diet/nutrition/supplements, exercise, and stress reduction.)

My goal was to stay on blockade for at least a year (done)and to get that PSA below 0.05 (done), but based on what Dr. Charles "Snuffy" Myers has been saying and writing lately, I would really like to have seen the PSA again drop to below 0.01. (I think that 0.05 goal was established when we lacked ultrasensitive PSA tests that could reliably report PSA to as low as less than (<) 0.01.) Unlike many patients who get below 0.05 within a few months on triple blockade, it has taken me many months on the two previous cycles. But my PSA has declined to below 0.05 twice before (in fact, to <0.01 twice before), and that's most important. The unusually long time to get there is not surprising considering my highly challenging case.

I'm still really happy that IADT3 is still working for me at this time. Quite a few men run into a hitch at this point - around ten to eleven years, and have to switch to another line of defense. Our fellow prostate cancer survivor and highly respected medical oncologist Dr. Charles "Snuffy" Myers, MD, said recently again that the patients he knows who are doing very well despite challenging cases are the ones who are diligent about their supportive care, including diet/nutrition/supplements, exercise, and stress reduction; I'm in that group. (Many of the men in his practice, which is specialized in prostate cancer, have challenging cases, and he also repeated this year that most of these men who die earlier than other men with similar challenging circumstances are men who ignore supportive care lessons, eating whatever they want, being careless about exercise, and so on. )

I'm extremely grateful that I'm responding well to intermittent androgen deprivation therapy at the ten and one half year point since my diagnosis in December 1999. Back then I talked to several of the experts in hormonal blockade, and even they were doubtful that I would enjoy prolonged success. Now quite a number of their patients with extra challenging cases similar to mine are also doing extraordinarily well, and all that I know in that group are diligent about supportive care (nutrition, exercise, etc.). Many of us are also spiritual and active church members who pray and invite prayer support. We don't talk about that much on the board, but I'm convinced that spiritual life and support also is key.

I think we will be hearing a lot more about curcumin. The brand I take is Life Extension's Super Bio Curcumin, and I have been taking two capsules in the morning, and two at lunch time.

Take care everyone,

Jim :wave:

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