Friday, January 24, 2014

Hormone Lite: Results in the Short-term and a Brief Discussion of Long-term Prospects

With a PSA of 6.7 and rising, I implemented Dr. Myers' Hormone Lite treatment plan on November 11, 2013. Two weeks later my PSA dropped to 1.69. By late December my PSA descended further to .49. Thus far the only unambiguous side effect is sore-to-the-touch nipples. Their tenderness is certainly tolerable and more of a pesky distraction than anything else. Please be assured, however, I intend to closely monitor my general well-being for further developments.
With an eye on my future prospects, I used the Patient Portal to email  Dr. Myers as follows:

Based on your knowledge and experience, please address the following questions:
1, What is the likelihood that my cancer will become hormone refractory based on this protocol?
2. . The University of Michigan Health System issued a study in June of 2012 on survival rates for men undergoing androgen-deprivation therapy. Men on continuous therapy had a median overall survival time of 5.8 years, with 29 percent of these men surviving at least 10 years. In your opinion will "Hormone Lite" produce similar results?

Dr. Myers' response appears below:
Casodex and Avodart are given to arrest progression and cause a modest reduction in the number of cancer cells. Because it leaves your testosterone levels at a normal level, side effects are minimal. In cases like yours, I have seen it work for more than  a  decade, but sometimes progression is earlier.
When we do  full hormonal therapy including suppression of testosterone, our goal is to induce a complete remission. This is an aggressive therapy and must be done with careful attention to side effects. Once complete remission is attained, we stop full hormonal therapy and start a program to slow or arrest recurrent  disease. In that program Avodart, Statins, Metformin and diet are all key. 
The U of M data have no  relevance to your case. They have to do with wide spread metastatic cancer. Even so, these results represent yesterdays results and do not reflect any of the new drugs. Certainly, our results are radically better than this.

I turn 78 next month. If Dr. Myers' protocol maintains my existing quality of life for another 10 years or so, I will consider myself as one extremely fortunate fellow. Double lucky in fact. Double lucky indeed!

Thursday, January 9, 2014

A Brief Retrospective Triggered by a Current Event

  A dear friend of mine was recently diagnosed with prostate cancer with a Gleason score of 6 (3+3) and a PSA of 6. By pure coincidence Dr. Easy performed my buddy's biopsy, and true to form recommended robotic surgery as  he did for me.. Longtime readers of this journal  may recall the entry regarding my appointment with Dr. Easy (see: A Definitive Diagnosis).
My friend and I  had a wide ranging telephone conversation during which we discussed the value of (1) Bob Marckini's book, "You Can Beat Prostate Cancer,"(2) the need to conduct one's own research in general and (3) the increased risk of surgery as we grow older. My friend turns 70 next month.
  A follow up  email appears below:

"I cannot over emphasize the importance of research at this point. Not only will it enhance your chances of making a good decision for yourself, but it will enable you to ask good questions as you encounter various practitioners along the way. For upcoming meetings with practitioners as a matter of routine I prepare a list of (written) questions to which I want answers-- although I let the session evolve based on the purpose of the appointment. I think it is important to  hear the guy/gal out before steering the discussion. Toward the end of our meeting I raise my questions if they have not already been addressed.
FYI   Following my diagnosis I placed great emphasis on survival, i.e., extending my existence. Over time, when I realized I might be around a while longer, my priority changed to preserving my quality of life."

My friend's  regrettable  diagnosis  provided this opportunity to summarize a few  of the important lessons I learned during my tumultuous journey. I thought it may be of interest to those of you who have been tracking my progress