Gentlemen, I can't tell you how much your encouragement and advice have meant to me. This site has truly helped me get through the struggles after my initial diagnosis and now I need your help again. I had my RP on 1/26 and now I need to make a treatment choice. As you all know, this is not like picking out a color to paint a room. I'm stage VI and my life literally depends on the choices I make going forward. This doesn't just impact me, it impacts my whole family. Anyhow, I've got two possible avenues to choose from.
The first one is a clinical trial at John Hopkins with Dr. Pienta. The trial is for men who have metastatic disease and who have had an RP. The treatment would be 2 years of Lupron injections every 3 months. Chemotherapy would start at the same time and would consist of IV infusions of Taxotere every 3 weeks for 4 to 6 cycles with daily oral administrations of Casodex. Six to eight weeks after chemo ends, radiotherapy would begin. Dr. Pienta said this should eradicate the disease. The only con is that I have to wait until I can get an 8-week post-op PSA and if that PSA is .2 or less then I cannot be in the trial. A couple of other things - 1) the trial is not free and I do not know yet if insurance will cover it. 2) even if I do get in, my treatment would not start until March 26th - almost two months from now.
The second option is Dr. Amato in Houston. This is the doctor who treated gourd_dancer (Mike?) who was diagnosed with stage IV 14 years ago and now has an undetectable PSA, normal testosterone levels, and has been off all medications for the last 7 years. Dr. Amato responded to my email same day and is wanting me to come this week or first of next week to see him. The treatment he used on Mike, and I'm assuming it would be the same, is Lupron injections every 3 months for 2 years with Casodex starting after chemo. Chemo would be Ketoconazole and Doxorubicin for weeks 1, 3, and 5 and Estramustine and Docetaxel for weeks 2, 4, and 6. No treatments during weeks 7 and 8. Not sure if radiotherapy is included or not.
There is my conundrum. I'm at a fork in the road and I don't know which way to go. I'm leaning toward Dr. Amato though because with him there are no precluding factors that would keep him from treating me and the treatments would start much sooner.