You need not read any of below, I do recommend reading the article. I am uncertain if this has previously been posted on this forum
I recall reading some 12 or 13 years ago of a theory that submitting a man to ADT could slow the progression of PCa but lead to a lessening of his overall survival. I had even created my own analogy that suggested if you had a lawn of blue grass, with patches of crab grass and dandelions and you mass treated the lawn with chemicals to annihilate the weeds that you would too kill much of the blue grass. This could lead to a condition that would diminish the overall health of the lawn because the blue grass being more susceptible to the chemical and the weeds more vigorous, that the resulting lessening of blue grass which had limited the overtaking of the lawn by the weeds,,would no longer have the brake on the weeds, so eventually they would own the whole lawn.
Of course the parallel with ADT being that testosterone deprivation is far more damaging to the weaker “good” cancer cells and have very little effect on the far more dangerous stronger cancer cells. But if the blue grass cells remained,,,they would always hinder the evolution and growth of the so called weed cells.
This thought in my mind way back then had a great influence on my decision all these years ago not to treat this disease in any manner, particularly ADT until I saw the “whites of its eyes”,,,which I finally did in late 2017 after a massive leap in my PSA and signs of radiological progression, which until then had always been clean on scans
Of course now I am reaping now what I sowed some 14 years ago, however I have no recriminations as I did have an almost 13 years of an uncompromised QOL which otherwise I would not have experienced.
Incidentally this article brought to mind likely my favorite read on cancers and 4,000 years of attempts unsuccessfully to control.
The Emperor of all Maladies,,,now a 3 part PBS Ken Burns video documentary. A great read for anyone interested in this disease
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As it stands...I do believe that we have enough ingredients now to create all the special sauces needed for the many snapping heads of this hydra....all hidden in plain sight. I noticed yesterday they approved keytruda for lung cancers.
Merck & Co., Inc. (NYSE: MRK) announced FDA approval for its Keytruda as a monotherapy for first-line treatment of patients with stage 3 non-small cell lung cancer, who cannot undergo surgery or chemoradiation, or metastatic NSCLC patients and whose tumors express PD-L1 with no EGFR or ALK genomic tumor aberrations.
With all our algorithmic firepower it seems to me every one of our individual dragons should qualify for a perfect treatment fit and slayed with little or no fuss.
Since I’ve been sick I’ve noted and succumb to turmeric, yew berries, dukoral, angiotenive blockers...all my own doing while being treated with bicalutamide Eligard and abiraterone....officially...is it not possible to hit the jackpot with at least two of these in combination...my MO claims it has happened to only one of his patients in the past...not exactly inspiring odds...but if I should be that billion chance guy....I swear I will never abandon anyone on this site if they care to listen to whatever sauce I aspiringly brewed serendipitously.
As I've posted many many times, I am being treated for lung melanoma using Keytruda (at MSK) and it's working so far.... ($30K an injection - 15 so far, thank goodness I invested in carbon paper, and 8 track players year's ago).
Smart...I remember when Sony was the big ticket....oh horror of hindsight....must you always shadow the failures of my past....and taint the choices of the future.
While not an 'intentional' treatment protocol in my case, it is essentially the treatment approach I am now using. Time will tell how effective it will be. Be Well - cujoe
Curious as to what kind of tx you had initially and if you have been ignoring modest rises in PSA for all these years?..... I have been ignoring modest rises and now am at the point where ( though bone scan is still negative) I am considering ADT..... It's been 7 years since my initial Tx( EBRT alone) and my psa has been rising throughout to it's present 5.9..... I am still undecided about ADT.. but wondering if I am being stupid if I hesitate until it reaches my bones before treating as I cannot possibly afford the drugs they are , today, using for Bone mets..... I don't regret leaving it alone as ,like, yourself, I have had full QOL the entire time.....if I were going to change anything I think I might have done the recommended ADT prior to the RT to increase chances of getting it all...... Interesting article BTW...thanks
I would not claim that my rise in Psa from time of diagnoses some 14 years ago where it was 5.5 to late 2017 at 70 would be deemed modest.
However doubling time of over 2 years could be deemed so by some.
In my extremely diligent research, I decided that treating with local intrusive therapy on a G 9 was unlikely going to buy me anything at all,,,yes I am aware that in select cases it might statistically,,, but was absolutely convinced 100 percent that my QOL would be compromised beyond redemption, therefore for me and only me, to not submit to RP, Rt, Cyro, etc was a no brainer.
Of course naturally there was no way then to determine how long I was destined to live,,,I was 65 at the time,,,which meant that if I were to expire from some competing comoridity before PCa did me in,,,the bet I placed would have made me a winner.
Facts are that only some 15 to 20 percent of men diagnosed treated or not will ever die of the disease.
Yes I am aware that this includes everything from G6’s to G10’s. At worst I was facing 5 to 1 odds give or take that this PCa would not be my undoing given my median life expectancy and co-cormidity index. Which reminds me that in about year 7 of this journey while receiving one of my numerous scans(I never suggested that I just ignored this disease(a spot on my right lung that upon biopsy proved to be NSCLC lung cancer,,,,which was successfully excised by surgery. Which I likely would not have discovered if having been surgically if I had locally treated PCa and had foregone any future scans. Been over 7 years now, likely well taken care of,,,,,you Never can be certain.
Not a bad bet in my opinion given 100 prevent certainty of experiencing a possibly/likely compromised QOL that I myself would find intolerable. In my mind there are many things worse than death,,,particularly knowing with certainly that even if treatment were to buy me a bit more time,,,,I was certainly not going to escape this world without eventually confronting it sooner or later one day anyhow.
There was much more of course that went into my plan,,,this is only a recap of only one leg of it.
As for your personal situation,,,I would love to be into this disease for 7 years and had a very modest Psa as you now have. I cannot at all advise you what to do as we are all different.
The only difficulty that I had with my decision,,,”This disease is in me, I must destroy it and Medicare will pay for it destruction” and Physicians assuring me that if I did not submit to therapy I would be dead very soon. This did give me food for thought to ponder over,,,but once I made my decision it was a walk in the park that never was given much thought as I thanked daily my decision as I appreciated my QOL that many of my fellow travelers were not,,,some who suffered greatly from their therapies,,,what’s worse were those who I saw after years of suffering and fighting the good fight died of it anyhow
I have a really good MO that axed me once how I dealt with this mentally. I told him of an old adage that popped into my mind. “Like Whistling past the Graveyard” He tells me that whenever he sees me, that he is reminded of this.
In my very early research I found a reference to “Swedish or Scandinavian doing nothing or treating with Rp”..
Another later one called the PIVOT study. Place both into google for details
The Swedish study began in 1993 and still ongoing. Yes many volunteers are still alive.
I assume most patients and many treating Physicians are completely unaware.
Most of all Tommy, do your research. I do now have Mets, this is not pleasant so are best avoided. As this disease is basically a statistical numbers game with very little certainties it is impossible to suggest what might work for you,,,,just about the same scientific method that goes into buying Apple stock today or selling it short, or just hanging on. There are absolutely no firm answers.
Please excuse typos or grammar. I one finger keyed this out my iPad. Too lazy to go to my laptop.
I'll take a look at the referenced studies... Looks like you played the odds and came out a winner.... I go back and forth countless times a day as to whether or not to just leave this well enough alone.... my doubling time is 1.73yrs at this time( much faster when I was originally Dx'd. Ca was aggressive G8)....Somehow feel that I could outlive this at this rate if it doesn't change substantially.... could be ,with recent PSA rises that the disease is just beginning to gain some traction....... After reading of so many cases here where fellows are going to the ends of the earth to stop the disease and failing I wonder.
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Low PSA (Less than 2 ng/ml) but high Gleason (9) cancer which spread to liver
Oligometastatic Treatment - SBRT with or SBRT without ADT?
Article: ADT May Increase Risk of Death From Cardiovascular Disease in Prostate Cancer
