Dr Slovin from MSKCC discusses treatments for advanced prostate cancer

[Darryl]

Latest approaches to Castration Resistant Prostate Cancer, for patients who need to know

youtu.be/7e51R8KPOsI(Not working as expected?)

[NRYnurse]

Thank you! Good information

[StayingOptimistic]

Thanks, Darryl.

[fmenninger]

nice. She’s my MO at msk!

[Murph256]

This lady makes it sound as if chemical castration is a minor inconvenience. It is not an inconvenience; it’s a permanent, life altering condition. I’ve had surgery, salvage radiation and ADT, and as bad as the SEs from surgery and radiation are, by far the worst SEs are from ADT. Just my opinion… We all do what we have to do, but let’s not minimize the side effects of ADT.

[Darryl Partner in reply to Murph256]

How would you respond to this video? Life Without Testosterone for Prostate Cancer Patients

youtu.be/MjOdnQU4jw4(Not working as expected?)

[Darryl Partner in reply to Murph256]

Not to sound too snarky, but the "lady" you refer to is Susan Slovin, MD a highly regarded oncologist at Memorial Sloan Kettering Cancer Center.

[Murph256 in reply to Darryl]

I’m not impugning her qualifications. I know first hand that MSK in a highly esteemed institution, and rightfully so. I did find her opening attempts at humor (“tickling your prostate” and “leaving your pecker intact”) to be in poor taste. Also, I in no way used the term “lady” in a derogatory or demeaning way.

[anonymoose2 in reply to Murph256]

Brings back memories of the comments about the doctor who used leaches as a metaphor.

Get off my lawn and take your leaches with you.

[Murph256]

I think men’s reaction to the side effects of ADT varies greatly. Even on this forum I’ve noticed some men are barley effected at all and some men are deeply effected. I’ve noticed several variables. Age seems to be an important variable. That is older men are less effected by ADT than younger men. Whether or not the men are in long term stable relationships is important. That is men with LT stable partners seem less effected than single men. And the level of exercise that men get seems important. That is the more physically active men seem less effected than more sedentary men. Just my unscientific observations…

[SeosamhM in reply to Murph256]

I'm absolutely buying all of your insights and observations, Murph. They are on point and thoughtful. But I'll be the apologist for the good doctor:

During this entire conference, I believe that Dr. Slovin was simply venting her pent up exasperation to a friendly crowd. She related specific and general instances of patients focusing on the side effects of ADT and not the very basic reality is that it keeps men with PCa alive longer. Period.

Six plus years in after diagnosis in my late forties, I'll admit that I find myself straying from your camp of genuine sensitivity and support and into Slovin's camp of frustration. I am gobsmacked reading the entreaties of men who, somehow, turn a blind eye to their diagnosis of late stage, high Gleason PCa and focus on potential side effects of a treatment.

Like everyone, I am a creature of my own experience. I had a wonderfully blunt urologist when we discussed my G9 biopsy results: "Joe, just based on your results, you have a 30% chance of living more than 5 years. But with the developments in prostate cancer treatments and your current health, I put it at more like 7 - 10 years. If I was in your position, I'd throw the kitchen sink at it."

IMO, there is too much noise for the newly-diagnosed late state, high Gleason man. It amazes me that anyone can second guess ADT as a first line treatment in this instance, but it seems to happen here on HU often. Dr. Slovin is just giving a snarky voice to that reality.

[Murph256 in reply to SeosamhM]

I’m not questioning ADT. I’m on it myself, intermittently. I just seem to be more adversely effected by it than many others.

[SeosamhM in reply to Murph256]

I do understand, Murph. I hate ADT. I vividly remember walking out of my urologist's office with a 'script for bicalutamide while I awaited his referral to an MO and the inevitable Lupron shot. I took the bicalutamide and went back to work. What a horrible feeling it was, losing my energy and will and focus over the course of an afternoon.

While I understand Dr. Slovin's attitude, yours hits closer to home.

Oh, and by the way, your are a much braver man than I. I honestly don't know if I could go on intermittent ADT - I don't know if I could go on a break from it and force myself to go back. I'm fortunate in a sad way - I simply accept that I will be on ADT for the rest of my life, and it releases me.

Take care!

[joeydashoe]

Thanks

[SeattleDan]

The second lady’s talk about really advanced pc got cut off. Is there a follow up video or written transcript?

[Darryl Partner in reply to SeattleDan]

Not to sound too snarky, but the "lady" you refer to is Carolyn Salter, MD a urologist, and a US Army Major. If I remember correctly, the video ends close to the end of her talk.

[Johnson411]

Thanks Darryl, very informative.

[SeattleDan]

Yes, this is an excellent overview (mine just seemed to get abruptly cut off). Not giving the presenters names and titles in my question to you is my own laziness more than sexist dismissiveness, but snark taken.