Dr.Charles Meyer's Triple Hormonal Blockade

[ctflatlander]

I'm MCSPC with 2 mets to the bone. I'm 75, current PSA is 1.4 and it has been that way for 3 mos. Currently on a Zytiga, pred, lupron treatment plan. Based on the STAMPEDE trial. I have had radiation to the prostate, the prostate bed and lymp nodes. I'm also planned to have SBRT to the bone. Does anyone know of a MO or a clinic that practices Dr. Meyers Triple Hormonal therapy to achieve an undetectable response? I'm in the USA, Northeast region?

[Tall_Allen]

You want to take less potent hormonals?

[ctflatlander in reply to Tall_Allen]

The treatment plan described by Meyers is more. He adds Casodex to the Lupron and combines it with either Proscar or Avodart

[George71 in reply to ctflatlander]

Maybe Dr. Bob Leibowitz He is in southern California

compassionateoncology.org/v...

[Tall_Allen in reply to ctflatlander]

No it is less, much less than you are already getting with Zytiga and Lupron - it is a giant step backwards.

[ctflatlander in reply to Tall_Allen]

Thanks Tall, I would love to get off Lupron at some point but I don't see that happening with my current treatment plan. It is taking a toll on my body even though I work out hard and maintain a healthy diet. Dr. Meyers book is dated but he has demonstrated success with his treatment plan. Thank you,

Bob

[curious-mind1 in reply to ctflatlander]

My dad was a patient of Dr. Myers for three years. He put him on a triple blockade: Zytiga + Lupron + Avodart.

Myers' book didn't include Zytiga, because it was not approved at the time the book was published. Just add Avodart and you'll be on the triple blockade.

Arthur

[ctflatlander in reply to curious-mind1]

Thank you Arthur. A side benefit of Avodart is reduced trip at night to pee but there are minuses. Am scheduled to see my MO in a couple weeks.

Bob

[cesanon]

I think as tall Allen indicates, the accepted protocols have moved on a bit. And are perhaps even stronger. And it looks like you are on it.

Why do you want to change? Cost?

[ctflatlander in reply to cesanon]

Thanks Patrick. Cost is not a factor. I'm dreaming of an undetectable PSA. Based on your input and others I should stay on my existing treatment plan. Bob

[Shooter1]

Any info more than a few years old is to be questioned . Xtandi and zytiga weren't available just a very few years ago. I had Xtandi added in the middle of my chemo when a new study came out showing its effectiveness and my PSA had started to rise. . It worked good but full dose side effects were too much for me. Cut dose seems to still be working.

[billyboy3]

I too have been a lucky PC survivor using triple IHT-intermittant. I stand by its use today if you start earlier enough and keep at it.

The fact is that PC is a lethal disease, has no cure presently, and ALL treatments have side effects. There is no magic pill or treatment, there is in fact, serious negative impact from any effective treatment and I hope that someday we convey to men who are now in the end stage because so much wasted energy etc. is spent in trying to find something that does not exist, or somehow to avoid the pain and suffering that accompanies any treatment.

Instead, focus upon living your remaining days as best as you can, make peace in your life, make up a bucket list and live large, STOP spending all your time and letting our cancer lead your final days. There is so much that you can still do, so live LARGE gents!

[kaptank]

That is interesting: I never knew exactly what a Meyers triple blockade was. Lupron and casodex are dreaded SOC. I asked my uro, who has expertise in the area, he said he could not see how Avo added anything to the party. None are comparable to enzalutamide and abiraterone. But there is a red flag of cross resistance and treatment induced change.

[EdBar]

I was a patient of Dr. Meyers for a couple of years until his retirement. I’ve been on triple ADT for almost five years, pretty much since the time I was dx. I was originally put on Lupron and Casodex by my urologist at the time of my G9, Stage 4 dx and later asked my GP to prescribe Avodart after reading Myers book prior to becoming a patient of Snuffy. I met no resistance, he probably figured it couldn’t hurt given my situation. Also added metformin - per Snuffy’s book, prescribed by GP.

When I started seeing Snuffy he switched Casodex to Xtandi although I was still hormone sensitive (way ahead of his time given recent study).

So far so good, PSA remains undetectable, I’ll be going on 5 years since dx next month. Still on triple ADT, none of my docs, including doctor Sartor have a problem with it, not sure why anyone would have a problem with adding Avodart.

Ed

[podsart in reply to EdBar]

I also was a Snuffy patient, also put on Xtandi early. What levels of T are u seeing?

[EdBar in reply to podsart]

Total was 13 and free is 0.8, been staying around these levels for a long time. Who do you see now?

[podsart in reply to EdBar]

I now see Dr Drake in Columbia Dr in Presb Hosp -- NY: was Dr Myers recommendation for me. Who did Dr Myers recommend for you?

[EdBar in reply to podsart]

I now see Dr. Sartor out of Tulane in NOLA. I learned of him thru my local medonc, they are hunting buds. When I asked Snuffy about him he said he would be an outstanding choice, turns out a number of Snuffys patients see him. Very knowledgeable, specializes in PCa, really up to speed on new therapies, nice guy. Not quite as out of the box as Snuffy but a good replacement.

And it’s nice to go to NOLA twice a year.

[podsart in reply to EdBar]

NOLA --New Orleans ?

What about the supplements part of Dr Myers process--does Dr Sartor deal with that?

[EdBar in reply to podsart]

Yes New Orleans, Sartor reviews supplements and just advises if he thinks you should not take one - example B12. He deals strictly in study driven treatment so supplements usually don’t fall into that category.

[monte1111 in reply to EdBar]

Congrats on 5 year March anniversary. Will be my 2 year in March. 6 months left till my expiration date. Unless I have a heart attack or a stroke, I think they got that wrong. You are definitely the role model many of us would like to follow. Enjoy.

[EdBar in reply to monte1111]

Thanks Monte, hardly a role model, just fortunate to have a good group of docs early on, especially Myers. Also feel very fortunate and truly blessed. Just gotta keep on keeping on, lots of fish on the bucket list to catch yet!

[ctflatlander in reply to EdBar]

Its a remarkable story and best to you Ed. I'm not sure I am still in the window for the triple hormone treatment.

Bob

[EdBar in reply to ctflatlander]

Hey Bob, not sure why you wouldn’t be, I’m not aware of any time limit on it. It’s available as a generic with minimal side effects as far as I know, and part of a “multi dimensional treatment “ as Snuffy used to put it. Wouldn’t hurt to review Snuffys rational for using it (from his book) with your doc and see what he says.

Ed

[JimVanHorn]

I was on Lupron (Eligard - generic) for 6 1/2 years with 72 radiations, and now I an cancer free. I wish you well and my hat goes off for all the men who made Lupron therapy possible! Good luck!

[monte1111 in reply to JimVanHorn]

And congrats to you! Along with EdBar and some others here you give the rest of us that whisper of hope. I know it is not a huge percentage, but would be nice to still be lurking on this site 3 years from now.

[JimVanHorn in reply to monte1111]

We never know the future, but we can try to do what is the best ad turn it over to God. You understand there are many forms of PCa, but there are some similarities. We each have different places affected, different doctors, different insurances, different other diseases, and different results of therapies. The similarities are that without androgens the prostate cells can not multiply. Also, radiation (including seeds) can stop the cancer from spreading. Prednisone helps the healing process. Cells die off with time. So doctors do the best with each patient so that these ideas help stop the cancer. There are no guarantees, yet I have gone through many problems to get where I am today. I wish you well in your choices.

[j-o-h-n in reply to monte1111]

Give me a break.... you'll be around for another 33 years and still busting balls...

Good Luck, Good Health and Good Humor.

j-o-h-n Tuesday 02/19/2019 5:25 PM EST

[ctflatlander]

Thanks as always Nal for your input. How do you define that I'm past the point for this triple treatment? I've been on lupron and zytiga for 14 months since diagnosis, my lowest psa since starting hormone treatment has been .7 and been stable at 1.4 for 3mos. My testosterone staedy at <7. My mo doesn't think I'm hormone resistant yet.

Bob

[kaptank in reply to ctflatlander]

see my reply to Nal. I see that your overall aim is to get PSA to zero and then probably, to work out a way to wean yourself off ADT presumably by going to bicalutamide monotherapy. I have that dream too.

[ctflatlander in reply to kaptank]

KAP, That's my dream, but the reality is it may not happen. This forum keeps my hopes up for a treatment that will buy me time.

Bob

[kaptank in reply to ctflatlander]

Same here. Whittling down that last 0.5 PSA is difficult. The bicalutamide bought time. Enz or Abi may get us there according to others reporting here but I want to squeeze every last drop from Bic first. I'm wary of the cross resistance between Enz and Abi and of a suspicion they may cause changes to the disease that make it hard to treat later.

[j-o-h-n]

To me "Snuffy", a doctor's nickname that wouldn't build a lot of confidence in that doctor's treatments.

Snuff:

extinguish, put out, douse, smother, choke, stamp out, blow out, quench, stub out, turn out, dampen, damp down

Good Luck, Good Health and Good Humor.

j-o-h-n Tuesday 02/19/2019 5:39 PM EST

[Hidden]

This is my first post. When I first received my diagnosis

of prostrate cancer it sounded so severe my response was

"Sounds like I have about 20 minutes to live." I was told

that my prostrate cancer had already metastasized to my

hip, ribs, spine, and lymph nodes near the prostrate.

That was in July 2017. My initial PSA was 3,375 (!) and it

spiked to 3,986 (!!) after my first round of treatment

with Casodex and Lupron.

I then switched to Lupron/Zytiga/Prednisone. My PSA

dropped rapidly. Monthly tests showed 142.50,

21.89, 10.25, 3.70, ... , 0.08, 0.07, ... , 0.04

over the 17 months of this treatment.

While on Casodex/Lupron my Testosterone was 547

and 556. When switched to Lupron/Zytiga/Prednisone

it fell to 29, <3, <3, ... , <5, <5 over 17

months of treatment.

I have lost some energy and have a few so-called

hot flush experiences every day. Sitting in front

of a fan for just a few minutes takes care of that.

Pain has been practically non-existent, except

for about 10 days recovering from my prostrate

biopsy in late 2017.

Maybe I'm just one of the lucky guys with this

hormone therapy, but it sure has been doing well

by me so far.

I give full credit to God for getting me to the

hospital just after Zytiga became available

to me.

[j-o-h-n in reply to Hidden]

Congrats Way to go..... These are my stock questions for new members (so don't feel insulted and no need to answer). Age? Location? treatment center? doctor(s) name(s) and their specialty? Greetings by the way....

Good Luck, Good Health and Good Humor.

j-o-h-n Tuesday 02/19/2019 7:38 PM EST

[ctflatlander in reply to Hidden]

What a remarkable story on what hormones can do. Best wishes for a continued success.

Bob.

[kaptank]

I get how 5AR inhibitors work. Its a very convincing bit of theory but very variable in the real world. And their masking of PSA makes vital blood tests problematic. The Tall one's point was that Enza and Abi are overall far more potent anti androgens than bicalutamide which is itself far superior to Avo and finasteride. Only if there was a major systematic interaction of Bic and AVO would they be superior in action to Enza or Abi. Flatlander is already on Abi. Is there any evidence of fortuitous feedbacks that would render ADT+Bic+Avo more than the sum of the components? Abi is a far more potent antiandrogen than Bic and Avo and if its still working, don't mess with it.

[kaptank]

I have regarded Dutasteride and Finasteride as androgen blockers. By blocking the production of DHT they block the cancer cell's access to a potent androgen. A different type of anti androgen to the "keylike" Enz or Abi. I think we are basically in furious agreement.

[erjlg3]

Elgies triple blockade from Dr. Myers is Trelstar, Finesteride and Casodex. He's still in remission since 2nd radiation at Datolli in Sarasota and some type of liquid radiation prescribed by Datolli...I think it was 2013. 1st radiation was at Ann Barshinger.

Hope everyone's doing well It's snowing here then some ice. Going up to 47° tomorrow so it will melt quick

Take good care,

🌼Jackie