When I began the Stampede protocol 1 1/2 yrs ago, it was my understanding that two years of Zytiga/Prednisone and three years of Lupon with radiation to the pelvic area at the 7 mo - 1 yr mark gave a chance for a "cure" under my conditions (3+4 gleason, etc). Now, my non-medical view of things is convincing me that what the Stampede protocol actually did by including the third year of ADT was smash for many years the production of testosterone so that there was not a rebound of cancer growing conditions for a longer while.
I suspect that my view, though based on studies and charts referenced in this site about that 3 yr of ADT, is uninformed and of no greater value than desperate guess work.
Is it stated anywhere in the medical studies what that 3 yr of ADT does and why it makes a difference toward a cure, or at least why the Stampede protocol insists on it.
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duxlubber
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You seem to misunderstand the trial. Both groups had 3 years of ADT +RT. The control group was only 3 years of ADT. Those getting the combination of abiraterone (2 yrs) + ADT (3 yrs) survived longer and survived without progression longer. In fact, 6-year metastasis-free survival was 82% in the combination-therapy group and 69% in the control group, and biochemical failures were reduced by 61% by the combination.
I see the subtlety there, and it does dispel my suspicion about that 3rd year of ADT being the significant factor. I still wonder where the 3 yrs of ADT stands over 2 yrs of ADT but that’s another trial altogether, I suppose.
My Dad died of this disease in 2006. DX in 1983. Doctors talked of a cure coming in 5 to 10 years back then. The drugs are just maybe better today. Do I believe a cure is coming? NO, there is to much money involved in treatment. He lasted 23 years with the old treatments. Many people still do that with today's treatment . Hopefully you are one of them. Good luck.
Just my 2 cents. After 17 years of dancing with the beast my approach is more control and try to live with this thing. It seems the incidence of return is high. Presently employing BAT with an intermittent approach.
Perhaps Tall_Allen could say if there are any trials comparing medium-term ADT (18-24 months) to long-term ADT (3 years)? I know there are studies that compared short-term ADT (4-6 months) to medium-term ADT(18-24).
I was treated using stampede trial and at the 18 month point they said 18 months is the same as 24. I actually stopped at 20 months of zytiga and lupron. Gleason 4+4 tumor outside of the prostate. Psa sitting and holding at .08. Dreading going back on lupron.
Thanks for your comments. Any way to avoid Lupron ADT is worth a try. I will be starting high-dose estrogen patch therapy next week in place of Lupron ADT. Stay tuned...
I'm currently working on a manuscript with Prof. Wassersug in Canada about the history of estrogen therapy for Prostate Cancer. Here's a timeline of the important milestones in E-therapy.
Estrogen therapy was the gold standard of care for over 25 years from 1940-1965, before Lupron was invented in 1985. Unfortunately, it was discovered in 1965 that high-dose Oral Estrogen caused blood clots. Then, transdermal estrogen gel was first used in 1980. The transdermal route (patches, gels), bypasses the liver and, hence, doesn't have the same problem with blood clots or other CV events as oral estrogen.
Estrogen patches have been studied since 2005, particularly by the PATCH phase I, II, and III randomized, double-blind trials. The current Phase-III trial in the UK is being done at 52 different treatment centers and has about 900 men enrolled. It's doing a head-to-head comparison between Lupron ADT and estrogen ADT. Final results of the 10-year survival outcomes will be published this Fall. That's what everyone is looking for...the survival outcomes.
Early results from the PATCH trials show that transdermal estrogen prevents the bone loss with Lupron ADT, reduces hot flashes, reduces fatigue, improves lipid levels, reduces glucose levels, and generally improves quality of life (compared to Lupron). Estrogen causes chemical castration (T < 20 ng/dl) in men, just like Lupron does. The only downsides are enlarged breasts, muscle loss and weakness (due to the low T), and increased risk of breast cancer in men who have BRCA 1/2 mutations.
If you are interested, send me an email to janebob99@lobo.net and request information on estrogen therapy.
Depends what your definition of cure is. Personally, I don't like the use of the term 'cure'.
The only thing that can target your cancer discriminately is your immune system. Everyones body creates cancer every day. As a result, you always have some form of cancer. So in some ways, everyone has cancer and there can never be a cure. How can you cure something that is a part of your design, that you always get?
On the other hand, if you don't die from the cancer and you die from something else, is that a good enough? In that case, you could look at like you were cured.
One question is how much does the lengthy ongoing treatment one encounters contributes to an earlier death from something other than cancer. Once you begin long treatment regimens along with the cancer, that often leads to or aggravates other negative forces. But I'm trying to make 100, just like everyone.
Well, I personally think it's all a craps shoot.Treatments aren't necessarily going to extend your life expectancy. I don't believe this should be the primary goal.
To me, it's either follow the standard protocols with the aim of dying from something like a heart attack or other conditons brought on by the treatments ; or not doing them, risking metastasis and having separate issues like bone pain, possible urinary issues etc. Some people don't even suffer pain with bone metastasis.
It's worth noting that not following the standard protocols may also require some medical intervention at some time.
Everyone's different, will react differently, and so it's a case for N=1 for whatever path you take.
Be careful for what you wish for. I have an aunt who is 96 and in pretty good physical shape but she will tell you that she is ready to die. She has no one left and feels like a burden and life has lost its allure.
My reading on The Moss Report also indicated that the protocol was inconclusive, but it' all they have at the moment. I am always on the lookout for other treatments. I have been looking into thermal treatment options but unsatisfied with what I have discovered thus far for my situation.
i went through 6 weeks of external radiation and HDR surgery, and I am sticking with the protocol. I have not seen any studies that differentiate between pre and post-radiation results.
I guess what I was really asking was if heat could be used after undergoing radiation because additional radiation is limit if there is a recurrence in the prostrate. Could you then use heat to kill the cancer?
Again, not sure about post-radiation. However, UCSF has the latest device for thermo treatments and the hospitals in Germany use it as a regular treatment. I have seen articles on cryo-ablation as well as thermal therapy, but most mainstream MDs in the US show any enthusiasm for it. There are many articles and studies on it. It would also depend on what degree, if any, there is metastises. Since my metastisis is presumed but onprovable, I figure anything that can kill off cells is a good thing for me.
does anyone have the link to the chart of months on Lupron (adt) vs recovery of testosterone or recurrence. I’ve seen it twice on this site but can’t find it now.
I dont know what to do. My MO insist 2 years ADT even though referenced STAMPEDE for all my treatment. She says all their Emory oncologist agree on 2 years only. My 2nd opinion agreed.
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