Consistent followers of this journal realize my PSA has steadily increased over a two year period. For discussion purposes the results of the past year appear below:
April 2012 2.0
July 2012 3.1
October 2012 3.96
January 2013 4.7
March 2013 5.9
April 2013 7.2
The last entry in the above table represents a treatment benchmark inasmuch as the blood draw occurred in the same week I implemented Dr. Myers' protocol. After following the plan for thirty days or so on May 27th my PSA came in at 5.25. This represents a change in direction and a reduction of nearly two points. Clearly this is a welcome development. Amen and hallelujah!
Oh I know only too well, it is much too early to celebrate. One PSA does not represent a trend. And even if a trend develops there are no guarantees. Even so from a medical standpoint I have had precious little to rejoice about over the past two years. So please understand my inclination to savor the moment.
Tuesday, May 28, 2013
Monday, April 15, 2013
A Miracle In the Making?
I have been to the mountaintop to consult with the recurrent cancer guru Dr Snuffy Myers. His office is located in the north western region of Virginia; thus the need to ascend the mountain to benefit from his wisdom.
Dr. Myers is a stately, grandfatherly, soft-spoken gentleman. It does not distract that he is super intelligent and possesses a near perfect background for treating prostate cancer. For most of his career he served as a cancer research scientist. When waylaid by a particularly aggressive form of prostate cancer nearly ten years ago, Dr. Myers converted to his current practice to serve out the remainder of his productive life. He has survived much longer than his doctors thought possible. He appears healthy at present following the protocol he now prescribes for his patients. Generally speaking his approach is as follows:
(1) Maximize one's health to enable the immune system to countract cancer
(2) Encourage a healthy diet ; eliminate foods that promote cancer and increase foods known to have anticancer qualities.
(3) Prescribe medications to restrict and/or eliminate the progression of cancer.
In my case Dr. Myers proposed the following treatment plan:
I. Prescription Drugs
A. Casodex--An antro antrogen. It works by preventing the actions of male hormones. It keeps testosterone away from the androgen receptor in the prostate cancer cell.
B. Avodart--interferes with the conversion of testosterone into dihydrotestosterone a hormone known to foster the growth of prostate cancer cells. Dr Myers indicated this drug may cause (1) a 30% reduction in my libido and (2) tenderness of the breast tissue.
C. Losartan--intended to bring my moderately high blood pressure into the normal range
II. Diet, Over the Counter Drugs and Supplements
A, Mediterranean Diet--as described in a 306 page handout with the definitive title"The New Prostate Cancer Nutrition Book" and as supplemented by a single page listing of foods to consume and foods to avoid.
B. Vitamin D3--the bloodwork submitted as a prerequisite for my initial appointment showed that I was marginally low on this vitamin which controls the absorbtion of calcium, phosphate and magnesium. As I understand it this deficiency interferes with the optimal function of my immune system. Accordingly this prescription is a corrective measure.
C.Full Spectum Pomengranate extract--this product has been clinically proven to dramatically reduce the doubling time of PSA in most cases
D. Super Biocurcumin--an anti-inflammatory antioxident that promotes good health
E. Optmized Reveratol--an anti-inflamatory antioxident that promotes good health
F. Lecithin--supports normal cholesterol levels.
This treatment plan looks far superior and is substantially more user friendly than the "full-blown" hormone therapy regimens recommended by oncologists #1 and #2. I am anxious to get started. I am in the process of filling the prescriptions and ordering the supplements. Dr Myers estimated my chances for a favorable outcome at 90% and thought it would be three to six months before we knew one way or the other. He intends to monitor my progress with monthly blood analyses including PSAs. I will update periodically as events indicate.
An afterthought. What's good for this goose may not be appropriate for any other goose. One of the characteristics that attracted me to Dr Myers initially was his individualized approach to the treatment of recurrent cancer. It is necessary to be seen by him to benefit from his expertise. In my particular case, too, the passage of time is necessary to determine the effectiveness of the above-described plan for me and my circumstances,
.
i
Dr. Myers is a stately, grandfatherly, soft-spoken gentleman. It does not distract that he is super intelligent and possesses a near perfect background for treating prostate cancer. For most of his career he served as a cancer research scientist. When waylaid by a particularly aggressive form of prostate cancer nearly ten years ago, Dr. Myers converted to his current practice to serve out the remainder of his productive life. He has survived much longer than his doctors thought possible. He appears healthy at present following the protocol he now prescribes for his patients. Generally speaking his approach is as follows:
(1) Maximize one's health to enable the immune system to countract cancer
(2) Encourage a healthy diet ; eliminate foods that promote cancer and increase foods known to have anticancer qualities.
(3) Prescribe medications to restrict and/or eliminate the progression of cancer.
In my case Dr. Myers proposed the following treatment plan:
I. Prescription Drugs
A. Casodex--An antro antrogen. It works by preventing the actions of male hormones. It keeps testosterone away from the androgen receptor in the prostate cancer cell.
B. Avodart--interferes with the conversion of testosterone into dihydrotestosterone a hormone known to foster the growth of prostate cancer cells. Dr Myers indicated this drug may cause (1) a 30% reduction in my libido and (2) tenderness of the breast tissue.
C. Losartan--intended to bring my moderately high blood pressure into the normal range
II. Diet, Over the Counter Drugs and Supplements
A, Mediterranean Diet--as described in a 306 page handout with the definitive title"The New Prostate Cancer Nutrition Book" and as supplemented by a single page listing of foods to consume and foods to avoid.
B. Vitamin D3--the bloodwork submitted as a prerequisite for my initial appointment showed that I was marginally low on this vitamin which controls the absorbtion of calcium, phosphate and magnesium. As I understand it this deficiency interferes with the optimal function of my immune system. Accordingly this prescription is a corrective measure.
C.Full Spectum Pomengranate extract--this product has been clinically proven to dramatically reduce the doubling time of PSA in most cases
D. Super Biocurcumin--an anti-inflammatory antioxident that promotes good health
E. Optmized Reveratol--an anti-inflamatory antioxident that promotes good health
F. Lecithin--supports normal cholesterol levels.
This treatment plan looks far superior and is substantially more user friendly than the "full-blown" hormone therapy regimens recommended by oncologists #1 and #2. I am anxious to get started. I am in the process of filling the prescriptions and ordering the supplements. Dr Myers estimated my chances for a favorable outcome at 90% and thought it would be three to six months before we knew one way or the other. He intends to monitor my progress with monthly blood analyses including PSAs. I will update periodically as events indicate.
An afterthought. What's good for this goose may not be appropriate for any other goose. One of the characteristics that attracted me to Dr Myers initially was his individualized approach to the treatment of recurrent cancer. It is necessary to be seen by him to benefit from his expertise. In my particular case, too, the passage of time is necessary to determine the effectiveness of the above-described plan for me and my circumstances,
.
i
Tuesday, February 5, 2013
Still Another Direction. Really? Yep.
Hormone Therapy (ADP) looms on the horizon. The first of two mainstream oncologists I consulted recommended a modified version of ADP. The second recommended standard ADP on an intermittent basis, but only when my PSA reaches 10 which should occur in a matter of months based on its current velocity and trajectory. This is a fate I wish to avoid for as long as I can or altogether if possible (while maintaining my current quality of life, of course). Accordingly I intend to consult yet another oncologist; one whose counsel and advice may well take me in a different direction. For the time being let's refer to him as oncologist #3.
My next entry will be devoted to this consultation. Stay tuned, but it may take awhile.
My next entry will be devoted to this consultation. Stay tuned, but it may take awhile.
Tuesday, January 29, 2013
Proton Pipedream Up In Smoke
By virtue of a series of mini-miracles, I returned to UFPTI to thoroughly explore the possibility of treating my recurrent cancer with another round of proton therapy. Prior to our meeting Dr Gud E. Nuff ordered a Pet-scan and a a triple contrast MRI. To kick off our "face-to-face" Dr Gud E. Nuff conducted an especially thorough DRE. Our dialog evolved along the following lines (liberally paraphrased):
Dr: "The Pet-scan, the MRI and my DRE all proved negative. Based on your rising PSA you probably have cancer somewhere in your system, but in my judgement it is no longer active in your prostate gland."
Pt: "How do you explain the findings of Mayo Clinic? You may recall Mayo Clinic identified a 1.1 cm nodule of recurrent cancer in the upper left quadrant of my prostate by way of the Choline scan. Mayo Clinic confirmed this finding the same day with an endorectal MRI."
Dr: "After radiation the prostate gland reacts to technological interventions in unpredictable ways. Based on our test results and my DRE, I am convinced your prostate gland is cancer free. Accordingly you are not a candidate for proton therapy."
Pt: "Please indulge me; let us assume Mayo Clinic's results are accurate."
Dr: "Even if your recurrence were restricted to your prostate, you would not be a candidate for retreatment with protons. During your initial treatment your surrounding organs were bombarded with the maximum prudent amount of radiation. Further radiation could potentially do more harm than good. You would be at risk for causing irreversible damage to your colon. More particularly your colon could be damaged to the extent that you would need a colonostomy. You wouldn't want to wear an external bag for the rest of your life, would you?
Pt: The latter question did not require a great deal of soul-searching on my part. I responded rather simply, and I suspect, rather predictably, "No" I said, "I would not."
From the get-go I realized my unscientific proposal may be nothing more than a pipedream. Nevertheless I launched my return trip with a fair degree of optimism. One of the mini-miracles preceding my journey put me in contact with the only man on earth (presumably) who successfully underwent proton therapy (at UFPTI no less) following failed IMRT. His very existence stoked my hope.Not only did his existence lend credibility to my grand plan, in addition. this fine gentleman contacted key UFPTI staff in my behalf. Shortly thereafter I received an invitation to return to UFPTI for the above described evaluation.Unfortunately neither his existence nor his influence could overshadow Dr Gud E. Nuff's findings and logic.
In the final analysis I pursued my (pipe)dream, that I would have evermore regretted had I not done so.
The search goes on.
Dr: "The Pet-scan, the MRI and my DRE all proved negative. Based on your rising PSA you probably have cancer somewhere in your system, but in my judgement it is no longer active in your prostate gland."
Pt: "How do you explain the findings of Mayo Clinic? You may recall Mayo Clinic identified a 1.1 cm nodule of recurrent cancer in the upper left quadrant of my prostate by way of the Choline scan. Mayo Clinic confirmed this finding the same day with an endorectal MRI."
Dr: "After radiation the prostate gland reacts to technological interventions in unpredictable ways. Based on our test results and my DRE, I am convinced your prostate gland is cancer free. Accordingly you are not a candidate for proton therapy."
Pt: "Please indulge me; let us assume Mayo Clinic's results are accurate."
Dr: "Even if your recurrence were restricted to your prostate, you would not be a candidate for retreatment with protons. During your initial treatment your surrounding organs were bombarded with the maximum prudent amount of radiation. Further radiation could potentially do more harm than good. You would be at risk for causing irreversible damage to your colon. More particularly your colon could be damaged to the extent that you would need a colonostomy. You wouldn't want to wear an external bag for the rest of your life, would you?
Pt: The latter question did not require a great deal of soul-searching on my part. I responded rather simply, and I suspect, rather predictably, "No" I said, "I would not."
From the get-go I realized my unscientific proposal may be nothing more than a pipedream. Nevertheless I launched my return trip with a fair degree of optimism. One of the mini-miracles preceding my journey put me in contact with the only man on earth (presumably) who successfully underwent proton therapy (at UFPTI no less) following failed IMRT. His very existence stoked my hope.Not only did his existence lend credibility to my grand plan, in addition. this fine gentleman contacted key UFPTI staff in my behalf. Shortly thereafter I received an invitation to return to UFPTI for the above described evaluation.Unfortunately neither his existence nor his influence could overshadow Dr Gud E. Nuff's findings and logic.
In the final analysis I pursued my (pipe)dream, that I would have evermore regretted had I not done so.
The search goes on.
Friday, January 4, 2013
Protons for Treatment of Recurrent PCa?
Earlier in my ongoing adventure I proposed the following "Clinical Trial of One" to Dr Gud E Nuff:
1. Begin with a shot or two of lupron to starve, weaken and shrink the 1.1 cm cancerous nodule identified by Mayo Clinic
2.Kill what remains with proton radiation at whatever volume it takes as determined by UFPTI
3.Reduce the liklihood of a recurrence by adopting a life long regimen of finasteride.
To date UFPTI has not responded substantively to this proposal. An unexpected turn of events has provided me an opportunity to thoroughly explore this option. Although it may take awhile to play out, and I have no way of predicting the outcome, this interim report seems warrented.
Stay tuned.
1. Begin with a shot or two of lupron to starve, weaken and shrink the 1.1 cm cancerous nodule identified by Mayo Clinic
2.Kill what remains with proton radiation at whatever volume it takes as determined by UFPTI
3.Reduce the liklihood of a recurrence by adopting a life long regimen of finasteride.
To date UFPTI has not responded substantively to this proposal. An unexpected turn of events has provided me an opportunity to thoroughly explore this option. Although it may take awhile to play out, and I have no way of predicting the outcome, this interim report seems warrented.
Stay tuned.
Tuesday, December 11, 2012
Setting the Record Straight
Following my diagnosis of recurrent cancer, a few folks have asked,"If you had it to do over, would you choose proton therapy?" My answer is an unqualified, unmitigated, "YES." My initial research indicated several available options demonstrated a high degree of success. Proton therapy and surgery appeared to be more effective when compared to brachytherapy, cryosurgery and various types of photon therapy. No less effective than the other options proton therapy stood out because of fewer, less severe side effects. A high success rate combined with minimal side effects appealed to me then and strikes me as being equally persuasive to this day.
A few weeks ago an internet friend informed me that of the several thousand prostate cancer patients treated at UFPTI since opening in 2006, I am one of three individuals whose proton therapy proved unsuccessful. UFPTI issued a press release this November which contained the following stunning success-ratio statistic:
"Five year progression free survival rate of 99 percent in low-intermediate-risk prostate cancer patients."
If only I could locate an equally effective means of treating my recurrent cancer.
If I made a mistake along the way it was not securing a second opinion on my original biopsy as recommended by Marckini et. al. Although, before initiating treatment, UFPTI confirmed my original Gleason score as being 7(4+3). At a much later date using the same set of slides Mayo Clinic concluded my score was actually 8(4+4).The Mayo clinician who called this to my attention speculated that had UFPTI concluded likewise my radiation may have been preceded by one or more doses of Lupron which may have prevented the recurrence.
Why the soul searching and hand wringing at this point you might wonder? Well this exercise represents my attempt to set the record straight. In so doing I hope to enable others who follow in my footsteps to make a good decision for themselves. A 2012 Christmas gift? Perhaps.
A few weeks ago an internet friend informed me that of the several thousand prostate cancer patients treated at UFPTI since opening in 2006, I am one of three individuals whose proton therapy proved unsuccessful. UFPTI issued a press release this November which contained the following stunning success-ratio statistic:
"Five year progression free survival rate of 99 percent in low-intermediate-risk prostate cancer patients."
If only I could locate an equally effective means of treating my recurrent cancer.
If I made a mistake along the way it was not securing a second opinion on my original biopsy as recommended by Marckini et. al. Although, before initiating treatment, UFPTI confirmed my original Gleason score as being 7(4+3). At a much later date using the same set of slides Mayo Clinic concluded my score was actually 8(4+4).The Mayo clinician who called this to my attention speculated that had UFPTI concluded likewise my radiation may have been preceded by one or more doses of Lupron which may have prevented the recurrence.
Why the soul searching and hand wringing at this point you might wonder? Well this exercise represents my attempt to set the record straight. In so doing I hope to enable others who follow in my footsteps to make a good decision for themselves. A 2012 Christmas gift? Perhaps.
Saturday, December 1, 2012
Mainstream Oncologist #2
Dr Trewkare may not be infallible, but I suspect he is about as good as they come. Even though we had seen him only three times over a four year period, he greeted my wife and me on a first name basis as if we were old family friends. Apparently Dr Trewkare reviewed most of the medical information I had submitted prior to our appointment. We quickly reviewed the treatment plans that I had considered and rejected including brachytherapy, cryotherapy, HIFU and surgery. It seemed evident he agreed I had not overlooked the ideal option. He visibly shook his head ever so slightly at the mention of HIFU.
At this point I asked him about the advisability of the Casodex plan. "Who recommended that" he wanted to know? "An oncologist by the name of Dr Cy Fer," I answered. "I know him," he replied, "he irritates me every time I see him at one of our meetings, and now it is all the more obvious that he DOES NOT KEEP UP WITH THE LITERATURE." It was fairly apparent that this is about as bad as it gets in the medical community in general and the oncological profession in particular.
"Your PSA remains fairly low," Dr Trewkare returned to the task at hand, " and in my opinion its rate of ascent is not particularly worrisome." ( Although this observation runs counter to my perception of my predicament, it directlly parallels Dr Gud E. Nuff's judgement precisely). "We should begin to think in terms of treatment when your PSA reaches 10," he continued. "When we do treat we should consider traditional hormone therapy on an intermittant basis. Please monitor your PSA, provide me with the results, and when you return from Texas in six months come in and see me." So goes the current plan
At this point I asked him about the advisability of the Casodex plan. "Who recommended that" he wanted to know? "An oncologist by the name of Dr Cy Fer," I answered. "I know him," he replied, "he irritates me every time I see him at one of our meetings, and now it is all the more obvious that he DOES NOT KEEP UP WITH THE LITERATURE." It was fairly apparent that this is about as bad as it gets in the medical community in general and the oncological profession in particular.
"Your PSA remains fairly low," Dr Trewkare returned to the task at hand, " and in my opinion its rate of ascent is not particularly worrisome." ( Although this observation runs counter to my perception of my predicament, it directlly parallels Dr Gud E. Nuff's judgement precisely). "We should begin to think in terms of treatment when your PSA reaches 10," he continued. "When we do treat we should consider traditional hormone therapy on an intermittant basis. Please monitor your PSA, provide me with the results, and when you return from Texas in six months come in and see me." So goes the current plan
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