6/2019 video if you are considering A... - Advanced Prostate...

Advanced Prostate Cancer

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6/2019 video if you are considering ADT even with radiation -- > 0-6 months ADT shortens OS by nearly 2 years

George71
George71

"Long term Morbidity Mortality of ADT and Radiation Therapy"

youtube.com/watch?v=0CnbyiR...

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70 Replies
oldestnewest

Save me from rewatching the video George. We’re these studies primarily on non-metastatic men?

"extended neoadjuvant hormone therapy following radiation therapy for high-risk prostate cancer patients."

EXTENDED

NON-METASTATIC

These two operative words are extremely important.

gregg57
gregg57 in reply to BarronS

He tries to use this group of patients to justify his anti-ADT rants. In another post he makes a general statement that "ADT does not extend overall survival", then uses this group to justify it. Then the nonsense about how terrible it is to become castrate resistant. Yeah it's bad, but at least I'm still here.

ADT is a critical component of prostate cancer treatment for ADVANCED PROSTATE CANCER which is what this forum is about.

By the way, adding ADT to RT in intermediate and high risk patients with localized prostate cancer is beneficial from my research:

jwatch.org/oh20110726000000...

ncbi.nlm.nih.gov/pmc/articl...

Kaliber
Kaliber in reply to gregg57

Amen brother Greg57 ... amen . 👍👍👍

noahware
noahware in reply to gregg57

"the nonsense about how terrible it is to become castrate resistant. Yeah it's bad"

Not trying to bust your balls, but which is it... is becoming CR bad, or is it nonsense to say it's bad?

There's no doubt that ADT is a critical component of prostate cancer treatment, but there's also no doubt that ADT is harmful and increases risk for certain comorbidities (including the possibility of a WORSE kind of PC).

Both can be true. It does not have to be one or the other. The presentation of some information may be skewed or biased, but it is up to us as individuals to listen to presentations and opinions by doctors and researchers AS INFORMATION, not as some kind of imperative or command.

Some men (especially with pain) absolutely NEED any treatment that relieves symptoms or halts progression, including continuous and extended ADT (or "Lupron for life"). That does not mean ALL men with advanced PC need it forever, and it certainly does not mean they should simply ignore or accept its risks and side effects. They should review AS MUCH info as possible, and decide with their docs (and wives) how to proceed, while weighing costs and benefits of various options. How they weigh those risks and QoL considerations is subjective and individual and up to THEM. Nothing about this disease is "one size fits all."

Here is another doc with what I consider a reasonable position, even as he admits he is in the minority...

youtube.com/watch?v=UlW9Q86...

George71
George71 in reply to noahware

I agree with you--- but as you said -- I'm not saying anyone else has to.

After 70 years of doing the same thing and getting very little OS benefit -- (months or a year or so at best is all they have to show for it) -- they need to try something else.

The research for treatments other than more versions of the same thing (ADT) seems to be paying off ...especially since all the damage it does in so many other ways for what little good it does for the cancer. If doctors hadn't looked at the poor results of decades of the same thing there never would be any progress. The doctors that just do SOC are going to be the last ones to benefit from the leading edge of research.

They are giving high dose testosterone to CRPC patients with mets -- and in the majority of the trial patients it helped -- one was reduced to no evidence of disease -- I can't understand why any prostate cancer patient wouldn't hope they are successful in finding the best sequencing of high Testosterone -- it would be heaven sent. Instead many skeptics... I'm glad the doctors had the balls to push on for our sake ...

sciencealert.com/a-man-s-pr...

dm5migu4zj3pb.cloudfront.ne...

urotoday.com/video-lectures...

Further indication that TRT might sometimes be beneficial for those not getting T recovery after ADT? They call hypogonadism a "disease" for a reason.

If it makes sense to treat one disease (PC) with another disease (hypogonadism) then it might also make sense to treat THAT disease!

A video with no other references? No thanks.

The studies include all groups including one with 35% high risk Gleason 8-10s -- "Local" and "locally advanced" PCa. Thats not just BCF which many here have also. Many men here are at these stages and trying to determine whether to do radiation with or without ADT and how long. Just because this doesn't fit your exact situation doesn't have anything to do with it.

6357axbz
6357axbz in reply to George71

Locally and locally advanced are curable cancers. It’s my understanding this blog is Stage IV mPCa. That being the case this video doesn’t belong here.

George71
George71 in reply to 6357axbz

There are 100s of people in this group that are not mPCa -- Many here are BCR after primary treatment -- (not sure where their cancer may be--- locally advanced -- distant -- both ? )... Many others here have N1 / some M1, M2, Some are NON Metastatic CRPC (don't know where it is .... yet they are already CRPC and therefore they consider themselves to be stage 4) others started ADT not knowing where it is and are not yet CRPC -- they are deemed Non metastatic - unknown -- but treated as if micro mets could be anywhere... thus the ADT till it fails..

6357axbz
6357axbz in reply to George71

Advanced prostate cancer is cancer that has spread from the prostate to other parts of the body. It's also called metastatic prostate cancer.

WSOPeddie
WSOPeddie in reply to 6357axbz

Are you an 'advanced prostate cancer' snob? Only those that fit this description belong here and everyone else just scram? I have local but aggressive (i.e. high risk) prostate cancer. I'm here to learn as much as I can to know what to do when it becomes advanced. Stop playing gate keeper. No one appointed you moderator.

gregg57
gregg57 in reply to WSOPeddie

The problem I see is not that we have people in your situation that are either cured or in long-term remission, but that these people are often the ones that are pushing the unproven "treatments" and using their good luck to try to prove things they are doing are working. This creates noise for those who have advanced disease and need real, proven treatments. It's seems hard for them to understand because thay are not in that situation.

My impression is that there are some people here that are using their long-term remission status to try to be the one-eyed king in the land of the blind, pitching their own "brand" of supplements, diets and other crap as self-promotion or to get attention. Like that one guy who claimed he had stage 4 for many, many years and everyone is like "wow what treatments did you do?" Then the answer: Here's a link to my book!

Personally, this is what I object to.

gregg57,

noahware still has a brain left and is using it.

gregg57
gregg57 in reply to George71

Thanks for the report.

podsart
podsart in reply to gregg57

The article discussing Supra T mechanisms of operation that seem to be those of straight supra T not the BAT offshoot from the basic Supra T mechanism. Then the dr moves to BAT , with the shock theory added, in terms of the major thrust of follow up. Why hasn’t he more fully pursued the straight Supra T admin in clinical trials?

From what I could find, ADT is beneficial to add to RT for high risk patients. Here's a link for anyone interested.

ncbi.nlm.nih.gov/pmc/articl...

From the article: "Extensive evidence from randomized controlled trials and meta-analyses has demonstrated that adt with rt—generally external-beam rt (ebrt)—provides benefit for the full spectrum of pertinent oncologic outcomes in localized pca: overall survival (os), metastasis-free survival, biochemical progression–free survival, and local failure2–10."

gregg57,

I titled the article "if you are considering ADT even with radiation ..."

Thats not you gregg57... Your article stipulates --- "Combined SHORT-course ... conferred a survival benefit to men with INTERMEDIATE-risk disease" thats no us... we are high risk gleasons 7-8-9-10s with BCF after unsuccessful primary attempt to cure or worse -- locally advanced and or N1 M1

SO, stop making everything personal -- this forum is to express our individual views -- backed with or without studies or trials etc... We are all grown men here and we can and hopefully will follow up and do our own research. Try respecting everyone else's right to do the same thing you are doing -- decide their own course of treatment. I'm pulling for you and everyone here -- it would be fantastic if they find a cure or at least a naturalizing treatment that allows us all to live a full life expectancy..

Meanwhile it is becoming abundantly clear that ADT does little good and no question does a lot of unquestionable sever damage the longer you take it.... As the studies clearly show it shortens overall survival.

If I get to the same stage as you and ADT is required in combination with some other treatment -- I would do it intermittently with super high dose testosterone. Super high T ALONE has proven to kill PCa with double strand breaks / shock cancer cells into dormancy for extended periods of time / reverse CRPC cells making them receptive again to ADT/ not to mention the improvement of overall health -- slowing muscle wastingm bone loss, dementia heart problems etc..

Dr. Denmeade / Dr Bob Leibowitz / Dr. Morgantaler and others have been doing it successfully for decades.

gregg57
gregg57 in reply to George71

"Meanwhile it is becoming abundantly clear that ADT does little good and no question does a lot of unquestionable sever damage the longer you take it.... As the studies clearly show it shortens overall survival"

Another non-specific, sweeping generalization that contradicts what I've read.

It's very clear that in cases of advanced metastatic prostate cancer, there is a survival benefit so I think we are in agreement about that.

From what I've been able to find, ADT adds benefits for high risk groups with localized PCa, including overall survival (I've posted links above.)

Several phase iii randomized trials have proved the benefit of combining neoadjuvant and adjuvant adt with ebrt for patients with high-risk pca2–6 (Table II). Although a meta-analysis showed that the addition of adt significantly lowered the risk of biochemical failure, local failure, distant metastases, disease-specific survival, and os...

Emphasis mine

ncbi.nlm.nih.gov/pmc/articl...

There are lots more articles on this subject so readers should do their own research and talk to their doctors.

Here's Tall Allen's Blog on the subject:

prostatecancer.news/2020/09...

The video I posted makes clear that the trials you cited are for 8 to 10 year overall survival -- As the video I posted shows, the OS benefit shows up @ 10 - 15 years out ... can't you understand the difference? The video I posted points out that most men in both groups will live 10 years either way -- the overall survival curve drops significantly from 10 years on. And, just as I said 0 to 6 months ADT plus radiation was significantly greater 15YEAR -- OS compared to longer than 6 months of ADT plus radiation.

If you can't understand what the doctor said in the video or didn't watch it -- then just don't comment. Anyway this doesn't pertain to you. We have a right to make up our own mind. The video says exactly what I am telling you, so relax. Try and get along...

Earlier you accused me of misrepresenting that M D Anderson doctors at a seminar I and 150 + patients attended in person -- said ADT did not extend OS at all.... When in fact they said it several times! my wife was there also ! I have talked to and was a patient of the very doctor that said it in his presentation.

greg57 you are simply wrong on this.

Schwah
Schwah in reply to George71

I did not see that post about a dr at MD Anderson. Do you have any video or written comments from this doctor saying that? What was the name of the doctor? I am not saying that that is not what you believe you heard. I just find it hard to believe that is what he actually said and meant and that there was no caveat.

Schwah

George71
George71 in reply to Schwah

I've had several other doctors say it .. I've posted a half dozen or more articles that state it.

The video to this thread says it.. that was the point of the post: Even when used in combination with radiation overall survival is reduced by nearly 2 years by taking more than 6 months of ADT + radiation -- compared to 0 to 6 months of ADT + radiation) -- the video is using ADT in combination with radiation -- that is when it is helpful... yet all cause OS is reduced anyway if you take more than 6 months ADT as compared to 0 to 6 months ADT. Many in the 0 to 6 months cohort took NO ADT with radiation and that cohort still had greater OS than the group that took over 6 months ADT with radiation.

Here is another study :

"Despite a lack of data, increasing numbers of patients are receiving primary androgen deprivation therapy (PADT) as an alternative to surgery, radiation or conservative management for the treatment of localized prostate cancer.

Objective

Evaluate the association between PADT and survival in elderly men with localized prostate cancer.

Main Outcome Measures

Cancer-specific and overall survival.

Design

Population-based cohort study of 19,271 men who did not receive definitive local therapy for T1-T2 prostate cancer.

Medicare patients aged ≥66 years diagnosed in 1992-2002.

Results

"Even though 41% of the population (median age 77) received PADT, PADT was associated with SOMEWHAT WORSE 10-year prostate cancer-specific survival (80.1% vs. 82.6%, hazard ratio [HR] 1.17; 95% CI 1.03–1.33) and no improvement in 10-year overall survival (30.2% vs. 30.3%,, HR 1.00; 95% CI 0.96–1.05) compared to conservative management. However, in a pre-specified subset analysis, PADT use in men with poorly-differentiated cancer was associated with marginally improved prostate cancer-specific survival (HR 0.84; 95% CI 0.70–1.00, P =0.05) BUT NOT OVERALL SURVIVAL (HR 0.92; 95% CI 0.84 – 1.01)."

Conclusions

"Primary androgen deprivation therapy is not associated with improved survival among the majority of elderly men with localized prostate cancer when compared with conservative management.

Survival outcomes"

"There were 1,560 prostate cancer deaths and 11,045 deaths from all causes in the study cohort. Unadjusted and adjusted prostate cancer-specific and overall survival were worse for PADT treated patients when analyses were conducted using a traditional Cox multivariate model (Table 3). The Cox approach, however, is unable to adjust for unmeasured confounders and selection biases (eg., higher risk patients may be preferentially selected for PADT thus yielding apparently adverse outcomes for this group). When instrumental variable analysis was utilized (Tables 3, ​,4,4, ​,55 and Figure 1), PADT was still associated with increased unadjusted and adjusted cancer-specific mortality (HR 1.17, 95% CI 1.03–1.33), but there was not associated effect on unadjusted, and adjusted median overall survival (82 months vs. 82 months, HR 1.00, 95% CI 0.96–1.05). Results were similar when analyses were restricted to men with comorbidity scores of 0 or without other cancers, suggesting that the results were independent of comorbidity."

ncbi.nlm.nih.gov/pmc/articl...

"Results

With a median follow-up of 110 months, primary ADT was not associated with improved 15-year overall or prostate cancer-specific survival following the diagnosis of localized prostate cancer. Among patients with moderately differentiated cancers, the 15-year overall survival was 20.0% in areas with high primary ADT use vs 20.8% in areas with low use (difference: 95% CI, −2.2% to 0.4%), and the 15-year prostate cancer survival was 90.6% in both high- and low-use areas (difference: 95% CI, -1.1% to 1.2%). Among patients with poorly differentiated cancers, the 15-year cancer-specific survival was 78.6% in high-use areas vs 78.5%, in low-use areas (difference: 95% CI, −1.8% to 2.4%), and the 15-year overall survival was 8.6% in high-use areas vs 9.2% in low-use areas (difference: 95% CI, -1.5% to 0.4%).

Conclusions and Relevance"

"Primary ADT is not associated with improved long-term overall or disease-specific survival for men with localized prostate cancer. Primary ADT should be used only to palliate symptoms of disease or prevent imminent symptoms associated with disease progression."

ncbi.nlm.nih.gov/pmc/articl...

Stevecavill
Stevecavill in reply to George71

Why is a conclusion about localised prostate cancer relevant to a metastatic prostate cancer group?

6357axbz
6357axbz in reply to Stevecavill

Good question Steve

treedown
treedown in reply to Stevecavill

I agree seems appropriate on the non advanced forum where it might actually be SOC if I am not mistaken. Does anybody think any of us if proven wouldn't prefer to not be on ADT? If this is a valid discussion why is it just a video here and not coming up in any of our Drs appts? Clearly he did not do these tests and achieve these stats with Stage 4 patients.

gregg57
gregg57 in reply to Stevecavill

It's not relevant to this forum and that's the problem with this guy and some others on this forum.

ck722
ck722 in reply to Stevecavill

I am under the impression that a good percentage of men have mets independent of Gleason score. The higher score and staging does increase the odds of mets tho. Those little buggers do like to escape and cause hellish problems.

noahware
noahware in reply to Stevecavill

Why is it NOT relevant? Would you somehow suppose ADT has potential negative effects only on men with non-metastatic PC, and that the discovery of clinically significant metastases suddenly makes one somehow immune to those potential effects?

gregg57
gregg57 in reply to Schwah

I'm getting in contact with MD Anderson to let them know that I think their doctors are being misrepresented on this forum.

George71
George71 in reply to gregg57

you should do that !!!

I've had several other doctors say it .. I've posted a half dozen or more articles that state it.

The video to this thread says it.. that was the point of the post: Even when used in combination with radiation overall survival is reduced by nearly 2 years by taking more than 6 months of ADT + radiation -- compared to 0 to 6 months of ADT + radiation) -- the video is using ADT in combination with radiation -- that is when it is helpful... yet all cause OS is reduced anyway if you take more than 6 months ADT as compared to 0 to 6 months ADT. Many in the 0 to 6 months cohort took NO ADT with radiation and that cohort still had greater OS than the group that took over 6 months ADT with radiation.

here is one more:

Results:

"Even though 41% of the population (median age 77) received PADT, PADT was associated with SOMEWHAT WORSE 10-year prostate cancer-specific survival (80.1% vs. 82.6%, hazard ratio [HR] 1.17; 95% CI 1.03–1.33) and no improvement in 10-year overall survival (30.2% vs. 30.3%,, HR 1.00; 95% CI 0.96–1.05) compared to conservative management. However, in a pre-specified subset analysis, PADT use in men with poorly-differentiated cancer was associated with marginally improved prostate cancer-specific survival (HR 0.84; 95% CI 0.70–1.00, P =0.05) BUT NOT OVERALL SURVIVAL (HR 0.92; 95% CI 0.84 – 1.01)."

Conclusions

"Primary androgen deprivation therapy is not associated with improved survival among the majority of elderly men with localized prostate cancer when compared with conservative management.

George 71 paints a gloomy picture for men who are chemically castrated by long term ADT.

These men, ( and I am one ) who have had continual ADT since 2010 may die up to 3 years earlier. Well really?

If I had not had ADT for so long, my Pca would have turned much nastier years ago and I may have died sooner because I did not keep myself castrated by Lucrin etc, and no mention is made of add on drugs that muck about with Testosterone such as Cosadex, Zytiga and Ztandi. There's a point where the Pca makes its own di-hydro testosterone, and it makes no difference if you have ADT or not. My balls probably would not restart making testosterone if I stopped my monthly Lucrin injections.

Lifestyle, age and co-morbidities seem to have a tendency to cause death at an earlier age.

A man of 66 who lasts 15 years after diagnosis of Pca will be 81. Well who can predict a man will live that long? There's a pile of men younger than my age at 73 who have died from a variety of illnesses. Not one managed to ever cycle 228km like I did last week and since 2007. So despite being castrated I have good cardio vascular health and I have not been over taken in my rides each week by anyone aged over 60 for last 5 years.

So if a man does the work, and stays off the grog, off the smokes, and eats healthy, then he lasts far longer time, even with Pca, as long as it can be kept under control.

But whether this is possible is indeed a "black box" of unknowns because DNA of all men varies and so Pca varies between being a weak disease needing little medical intervention to being a real serious adversary which defeats all treatments used to stop it killing a man too early.

Luck is on my side for now, but at some time luck could run dry, and Pca mutates to defeat all things thrown at it. I've seen this happen in some men.

I'll just keep going with my straight and narrow path of healthy living that is all maybe a bit anti social but so what, I see that much of the world hastens dying early because of lack of control over many bad habits right through life from a young age.

I had a phone call from an old friend I knew since school days, he's 71, got bad emphysema and needs an oxygen bottle. All my mother's friends who smoked died in their 70s, but she made it to 98, but smoked only a little bit socially. She, like myself, had non addictive personalities, but my old friend who needs oxygen smoked and took a pile of things, always too much, always out of control.

I am glad I was square and boring and gave up smokes cold turkey at 34. I'd got up to 11 cigs a day. A GF Veronica said I smelled bad when we went to bed, so I said I'd quit, and she replied that "Ah, you men, you make promises you cannot keep..." but I did keep that promise, and all the other promises, which is why so many relationships went bad because women could not keep their promises. So most felt bad and fled. But that story does not belong here. I got along just fine as a single man without bad habits which would lay me low sooner rather than later. Not marrying a bad woman has helped me fight Pca. I fight things alone quite well, like I cook well, and do exercise with a fairly pure & simple lifestyle. I just never found a good woman.

Patrick Turner.

More tired carnival barking against ADT. It does little good and possibly a lot of harm.

Bark about how it exacerbates co morbidities if you want to help. The risks of ADT are FAR greater for those who are obese, are diabetic, have heart disease, metabolic syndrome etc.

For these men ADT is flat out dangerous without a doubt. And at least here in the US it’s a substantial portion of the population.

For the otherwise healthy and fit it’s a completely different story. I’m not saying ADT is benign for them, simply that it’s MUCH safer.

Therefore, sweeping generalizations about OS and the dangers of ADT in general are of little value. I don’t claim it’s effortless to tolerate for anyone. However It does work very well for many.

Again, citing OS numbers for ADT to claim it does little good and to warn people against it is s pointless. I don’t understand why people like you are so invested in simplistic posts like these.

ADT is a challenge no question. If you are sold that it will assist, then you MUST be healthy and fit enough to handle it, and then STAY that way when on it.-an equally big job.

There are too many who hop on ADT unable or (more likely) unwilling to make the effort. This makes OS numbers for ADT meaningless.

I’m not sure if it’s my setup, but the video link doesn’t work. It says health unlocked won’t let me play it. Is there a link to a published paper instead?

It has been explained thoroughly above several times by me and others.

If you want to just post the link then you should just do that... Likewise -- I will post what ever I think is relevant.

Thank you for posting this video George. I suspect that this information is why the Pulse method of administering ADT has evolved. The video seems to be concentrated on the continuous administration of ADT. From what I can determine the longer one goes on the continuous ADT the greater the incidence of SERIOUS side effects (like Osteoperosis, cardiovascular problems) which impact Quality of Life significantly. I have not found any study that looks at the intermittent (Pulse) administrations of ADT and longevity and/or long term side effects.

A lot to know and difficult to understand and then there is this written in 2005

journals.plos.org/plosmedic...

George71
George71 in reply to lancer82801

Hi lancer82801,

Thank you for the article -- thats good stuff..

"What matters is the totality of the evidence. " there will always be outliers.

I think the broader the conclusions and longer the accrual of the test data, the more reliable they are likely to be especially in PCa because of the relatively long overall survival (even at the incurable state). 99% will live 3 to 5 yrs no matter what -- a trial drinking one beer a day would show 97% still alive at 3 years and 89% at 5 years - lol.

What is "OS"?????

6357axbz
6357axbz in reply to cesanon

Overall Survival

cesanon
cesanon in reply to 6357axbz

Thanks.

That then makes the title of this post a pretty bold statement.

I have to admit I am prejudiced, but whenever anyone chooses to rely on jargon to burnish their credibility, it makes me question how much on should rely on what they are attempting to convince me off.

I think this is too complicated a subject for such a simple proposition to be considered reliable.

I don't think I am going to trust a simple, fits all sizes, answer to such a complex problem.

There is no such thing as locally advanced prostate cancer? WHEN PROSTATE CANCER EXTENDS BEYOND THE PROSTATE, you now enter into endstage prostate cancer, wherein there is NO possible cure, at this time.

You are totally wrong in saying that AHT does not add life. In particular, intermittent AHT which offers time off for the body to recover, thus has less side effects etc.

That said, remember, that we have made LITTLE PROGRESS in the treatment of advanced prostate cancer over the past 20 plus years. Very sad and scary to say the least. However, we do know that aggressive treatment to lessen the amount of cancer in the body and do whatever it takes to lower the spread, the longer the man will live.

Each man will react differently to different drug treatments. Also, remember, MANY MEN ARE OLDER AND HAVE OTHER MEDICAL CONDITIONS. The effects that these pre-existing medical conditions have on treatment and outcomes is huge, and makes it very difficult to accurately determine what caused a man's death etc.

To embark upon the long medical treatment protocols that now exist, requires one to be in pretty good physical condition from the start, as it is fact, that these treatment can and do cause many side effects, some that will or could cause early demise.

Thus, one needs to get up to speed on one's own disease, the extent of it etc. along with age, physical condition, MONEY available etc. in order to determine the plan that will maximize one's life. Quality of life with whatever times remains, also should be considered in looking at the options-as few as they are.

PC has approx 100 different strains-please correct me someone, which is why some react extremely well to treatment-as is my case now some 20 plus years, other strains are absolutely lethal no matter what treatment embarks upon.

I also abhor the word remission, as prostate cancer cells are extremely difficult to kill and adt simply puts them to sleep.

In reference to the posts, I note that one referred to men 77 years of age. That is old boys, sorry but the facts are that your body in most cases, is on its last let in totality so to expect some great change to occur is beyond medical treatment and certainly, NO cancer treatment will make a 77 man 55 again!! In other words, be practical in your thinking and what you expect as the resultant from any treatment protocol!!!!!

6357axbz
6357axbz in reply to billyboy3

This from Texas Oncology but is a standard definition:

STAGE III PROSTATE CANCER

Overview

Prostate cancer is referred to as stage III if the cancer has extended through the capsule that encloses the prostate gland and may involve nearby tissues. Stage III prostate cancer is further divided into the following categories, depending on how extensive the cancer is:

T3a: The tumor has extended outside of the prostate on one side.

T3b: The tumor has extended outside of the prostate on both sides.

T3c: The tumor has invaded one or both of the seminal vesicles, which are small bag-like organs near the bladder.

Prostate cancer is typically a disease of aging. It may persist undetected for many years without causing symptoms. Patients with stage III prostate cancer are curable and have a number of treatment options, including external beam radiation therapy (EBRT) with or without hormone therapy, surgical removal of the cancer with radical prostatectomy, or active surveillance without immediate treatment.

This video has a number of questions, did not do follow up, etc. not to argue with the fact that some will not likely benefit as much as others. I maintain that younger men will benefit the most on aggressive treatments.

He also did not note intermittent at all, which is a major error in terms of greater benefits vs side effects etc.

He did make some good points, and each case is different, which is why again, one MUST GET UP TO SPEED on one's own disease.

I will also add that radiation docs vs surgery docs do not agree on which is better treatment etc.

He did CLEARLY STATE THAT MORE RESEARCH WAS NEEDED!!!!!

Again, this is not a game but a war that men are far far behind on today, in terms of where we need to be in order to win the war. Until then, men die by the thousand every year to this scourge!!

“ WHEN PROSTATE CANCER EXTENDS BEYOND THE PROSTATE, you now enter into endstage prostate cancer, wherein there is NO possible cure, at this time.”

Billyboy uses all caps so it must be true. There is more nonsense in this thread than I thought possible.

Cancer that extends beyond the prostate but has not metastasized to bone, organs or other distant sites is most definitely not incurable. These cancers have been extremely under treated in the past, much as early stage disease has been over treated. That is repackaged 20th century information.

Non metaststic vs metastatic ( <1.5 PSA VS >1.5) treatment. See the video:

ascopost.com/news/april-202...

Being Gleason9, 3b I suppose I am metastatic but my pre SRT PSA was .039. Continue Lupron, after 7 months, next month or not?

George71
George71 in reply to ck722

Thank you ck722,

That is an excellent video -- it just confirms what I have been reporting about what the doctors have been saying. As for you -- I would seriously consider ending the ADT and starting continuous high dose testosterone immediately after -- and shock any surviving micro mets to death. Did you see Dr. Morgantaler's video and Dr. Denmeade's and

Dr. Bob Leibowitz's video - I posted them a few days ago --- that is similar to what he does after chemo and ADT -- nothing but continuous super high testosterone and one a day Avodart. He has patients that had PSA in the hundreds and bone mets on nothing but continuous super high testosterone for a decade or more.

ck722
ck722 in reply to George71

Oooooh! High dose T, I love that! So would my wife. Spending the rest of my life as a eunuch is real grim.

Lacking a prostate, why the Avodart?

George71
George71 in reply to ck722

I'm not sure on why the Avodart -- It takes out most of the DHT --- . Dr. Morgantaler doesn't use anything but high testosterone -- I don't even think he tries to get super physiologic levels of testosterone ... but he still has success with PCa patients getting remission ... In one of his videos he talks about an 84 year old guy who had PCa with a PSA of 8 and just started him on Testosterone and his PSA went down to 7 then 6 then 5 and back up to 6 and stayed at 6 till he was 90 and he developed dementia and was taken off.

I am very similar to what I think you described about yourself ... My PSA is currently 1.37 --- 4 and a half years post surgery -April 2016- I have taken nothing but supplements and started 2 years ago with on and off one Avodart every other day or so ... My post surgery PSA was 0.03 rising so slow they didn't want to do anything... I looked for trials -- most wanted a minimum PSA of 1.0 -- I almost made it on the SM-88 trial but never got to 1.0 before the trial filled up. Then I went for an immuno trial at NIH Washington DC and it was cancelled right before it started in March due to Covid-19... Now I am considering Radiation and doing it while on continuous super high testosterone. I live in Houston -- have been to all the leading cancer Inst.. in the med center... Baylor -- University of Texas Cancer inst. -- M D Anderson -- Methodist -- Houston Memorial cancer center. Hermann Memorial cancer. We went to San Diego -- New Orleans -- they don't have anything but radiation and/ or ADT ...

They can't find the cancer ... i had a PSMA scan in march NIH found suspicious one quarter inch spot near prostate bed ... at the time of surgery they dissected 10 lymph nodes and found 4 with micro mets --- RO at Methodist said radiate the prostate bed and 2 rows of nearby lymph nodes 36 sessions (he said safer than SBRT) they have the very latest equipment. He said 80% chance BCF survival 5 years with 6 month ADT vs 65% BCF survival 5 years -- without ADT. He agreed the modest 15% increased odds may not be worth the risk of adding ADT. I think If it ever comes to having to do some form of ADT I will try estrogen patches -- they seem to to much less damage... What is your situation?

The video is for doctors given by a doctor at a doctors symposium ... its not our opinions.

He said they adjusted for co-morbidities. You lose on average nearly 2 years of life when ADT is taken more than 6 months even when combined with radiation compared to not at all or 6 months of ADT with radiation.

The point is that those of us that are trying to decide when or if we are going to start ADT and for how long etc.. be cautious.

one other point -- I/we didn't say this -- the doctors and their reporting on their findings said this -- they said it to and in front of other doctors.... not in secret -- you should complain to him if you can't accept it. Consider telling him/them why they are wrong...

If you had been at the seminar sitting with the doctors would you have jumped up and told him he is crazy?

I'm saying this in a positive way -- The facts are the facts -- therefore we need to look for better approaches .... Dr. Denmeade / Dr. Morgantaler / Dr. Bob Leibowitz ... super high testosterone is showing promise -- it took 60 years to finally try it in trials. whether bi-polar or continuous --it is a real possibility -- super high testosterone is nearly as effective at stopping PCa progression as no testosterone -- and super t doesn't make you CRPC and has few side effects.

No wonder everyone is or should be looking for something better -- better combinations -- immuno therapy --- something better than 70 more years of ADT -- which has had minimal benefit (at best) in the over all scheme of things.

Docetaxel with get you 2.4 more months.

“It is estimated that more than 600,000 men in the United States receive ADT.[2] A recent report on practice patterns suggested that almost 70% of hormone therapy is prescribed to patients for whom there is no proven benefit.”

cancernetwork.com/view/andr...

“Docetaxel was initially approved for the treatment of metastatic CRPC in 2004 based on 2 separate studies that for the first time confirmed a survival benefit in that setting.22, 23 Despite the small increase in overall survival (2.4 months in TAX 327 and 1.9 months in SWOG 99-16, respectively), it was approved for the treatment and paved the way to subsequent studies that saw an increasing number of newer agents for CRPC management “

ncbi.nlm.nih.gov/pmc/articl...

Bong!!! Round Two.....

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 09/27/2020 6:30 PM DST

George71
George71 in reply to j-o-h-n

lol -- join the circus j-o-h-n !

j-o-h-n
j-o-h-n in reply to George71

Thanks, I normally would but I mispaced my red bubble nose..........

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 09/27/2020 6:39 PM DST

SPEEDYX
SPEEDYX in reply to j-o-h-n

Larson E Whipsade!!!

George71
George71 in reply to SPEEDYX

HAHAHA I had to look him up -- you got me on that

SPEEDYX
SPEEDYX in reply to George71

Not easy to do

j-o-h-n
j-o-h-n in reply to SPEEDYX

Whipsnade..............

picky picky picky

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 09/27/2020 6:48 PM DST

George71
George71 in reply to j-o-h-n

SPEEDYX -- I have a trivia question for you -- Do you know how long

j-o-h-n lived next door to Alice ---?

youtube.com/watch?v=0AUF21Y...

no line dancing j-o-h-n

j-o-h-n
j-o-h-n in reply to George71

I'll answer that.....I did not live next door to alice..... It was all a ruse, I lived together with Alice...

I always get on line to dance....

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 09/27/2020 7:19 PM DST

SPEEDYX
SPEEDYX in reply to j-o-h-n

I thought Alice didnt live there anymore

George71
George71 in reply to SPEEDYX

Did you know how long she lived next door to j-oh-n before she moved?

SPEEDYX
SPEEDYX in reply to George71

Tell me 24 years???

j-o-h-n
j-o-h-n in reply to SPEEDYX

Yep, she left me and moved in with George71....

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 09/27/2020 7:46 PM DST

SPEEDYX
SPEEDYX in reply to j-o-h-n

😂

George71
George71 in reply to j-o-h-n

No - I was hanging out with Sally for 24 years till you went and messed it all up

George71
George71 in reply to j-o-h-n

That's not what Sally said -- she said she cured you of Alice in less than 2 weeks.

j-o-h-n
j-o-h-n in reply to George71

And it was a wonderful 2 weeks.......

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 09/27/2020 7:48 PM DST

SPEEDYX
SPEEDYX in reply to George71

Well John and Alice lived nearby on long island Coltrane's that is....I think John put Alice in Chains...

George71
George71 in reply to SPEEDYX

lol -- nooo --- what j-o-h-n told me was Alice dropped a bomb on him

youtube.com/watch?v=17lkdqo...

Just data, if you are into it. We are all just bites.

j-o-h-n
j-o-h-n in reply to carbide

Bits and Bytes.....

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 09/27/2020 7:21 PM DST

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