Having just attended a seminar where dose reduction was discussed by Dr. Snuffy Myers I thought others might be interested in his opinion. He had a 104 yo patient who couldn’t tolerate Xtandi full dose. He gradually reduced from one capsule every other day until he died at age 107 when he was taking one Xtandi capsule per week.
This conflicts with our MO advice for my husband to get back to full dose after experiencing a seizure-like episode and fall. We will go with Snuffy’s opinion.
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Grumpyswife
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No one should extrapolate a conference presented patient treatment case study and apply it to their own treatment without First discussing it with their own doctor. Let me know if this isn’t obvious and I’ll write more on Monday.
Snuffy Myers is just offering his opinion, which is certainly open to question. I hope that patients DO question what they hear from him or anyone else - that's what patient empowerment is all about. Some, like you, evidently, just accept everything you hear as gospel. I advocate a more questioning attitude. NCCN differs and they set the standard of care (not Dr Myers) because they represent a consensus of the top prostate cancer physicians in the US and they rely on research. They advocate watchful waiting when life expectancy is ≤ 5 years:
"Patients with life expectancies ≤5 years with high, very high, regional, and metastatic disease are also candidates for observation if the risks and complications of therapy are judged to be greater than the benefit in terms of prolonged life or improved QOL."
first where i do live i don't have confident with these so called oncologists. its sad we in Spokane WA don't have true specialist in cancer of the prostrate they are over 300 miles away and worst if u live out of town from Spokane so a true doctor is what we need for sure.
I was also at the talk Saturday. This patient chose to continue active care, and to work with Dr. Myers on that, which they did. I’m not sure whether the experience of this otherwise apparently physically and mentally healthy gentleman of such unusual age can translate to group data, but it’s important to have all kinds of data on individuals — average and outliers — to understand more fully treatment possibilities.
Now that you mention it.... I do recall reading about you and your mistresses in the New York Times. They are twins who were named by their dad Arthur. He named them Mona and Lisa... The Times quoted you as saying that "they both drive you crazy cause they keep smiling all the time" and that "both of them are just cold and lonely".
Warning beware of their former boyfriend Leonard (he's known forshooting in an upside down position)..........
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