My father just came back from The Mayo Clinic. He failed RP/SR and had the choline 11
pet scan. Based on test results underwent cryo + radiation + 12 months ADT....PSA .3 24 months out...just had evaluation...doc said even with all the new drugs if he lives long enough he will die of PC...hell...I could have told him that and I am not an MD
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gusgold
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Just thinking out loud here - the PET only located malignant prostate tissue, which, hopefully is now gone. Is it not possible that he could still have some benign prostate tissue left, and that accounts for the PSA?
Mayo found the PCa in both SV remnants that were left behind from original RP plus 2 LN...at the time of the choline 11 scan psa had risen to 2, which is where Dr. Kwon wanted it. Since he had previous SRT they used cryo in the pelvic area...a 4 hour procedure...then radiation to all LN not radiated previously and some that were and 12 months of ADT. PSA remained <.1 for 18 months..then .1 and latest .3..so the whole damn procedure was a complete failure...One Doc told me once the PCa is in the SV it travels throughout the whole body and a cure is not possible. After all this bs he is now on DES 1 mg. I know about supplements and had him on everything that ever showed promise + celebrex....my opinion is supplements are are complete waste of money..the best treatment for PCa if you can obtain it is DES 1mg per day for 3 months then cycle off and wait until PSA reaches 1 then do another 3 month cycle of DES...read the literatue...guys have done this for 18 years and not developed CRPC.
Sorry to hear about the troubles that your dad are experiencing. Admittedly I do not know much about Estrogen Therapy except that if one has heart problems, it usually is not an option. So I looked it up.
"Estrogen Therapy
Another form of hormone therapy involves administering a female hormone such as estrogen. Female hormones reduce the production of testosterone by the testicles.
The most commonly used estrogen in prostate cancer is diethylstilbestrol or DES. Hormone therapy with estrogen has limited use and is generally considered only for patients who cannot have surgery or to relieve pain in patients with prostate cancer that is progressing. Estrogens were once considered standard treatment for prostate cancer, but this is not the case today. Other drugs with fewer side effects have replaced DES.
Advantages:
Estrogen therapy is simple and only involves taking a pill. Estrogen therapy preserves the testicles, and its effects are usually reversible.
Disadvantages:
Estrogen therapy produces various side effects of its own. Estrogens can cause water retention, breast growth and tenderness, and symptoms such as stomach upset, nausea, and vomiting. In addition, even low doses of estrogen may significantly increase the risk of heart and blood vessel problems."
I have a question that has no right or wrong answer. Why not chemotherapy? As one who was diagnosed with Stage 4 metastatic prostate cancer, I am curious.
My surgical pathology showed seminal vesicle involvement and I assumed I had systemic disease so did not have SRT when I recurred. Last Nov. had similar C11 Acetate in KC and found 2 spots in prostate bed. After 14 years I just had SRT and am hoping that was all there was. I'd think that in your case 1 of/and 2 things happened: they just flat missed the mets, or the PET failed to show all there was. I'd be curious to see a post salvage Tx recurrent Pt get a PET and see what shows.
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