Todd - It ain't over till the Fat Lady sings (lol) or it ain't over until its' over...Like Ralph mentioned and he runs a support group and website on PCa and been in this mix for near 20 yrs., he has seen and I have seen similar scenarios and guys getting renewed results with second line therapies and today there are more choices than ever before, pricey if you don't have insurance (usually). I got many things I could throw out for you to consider and look into and will send you an email later on such. But, not only are there second line or third line drugs/protocols, there are even other angles to fight this like drugs that are used on 'anti-angio-genesis' (stops blood vessel growth, the VEGF growth factor on PCa and has effects), then unique internal radiation drug protocol and in Phase II now is Radium 223 or Strontium, next after all those chemos, vaccines, and newer drugs, there still exist either novel therapies or some new found evidence in combination drugs that appear super in responses to various variants and types of PCa's it has been test upon.
How weird can PCa be? Some patients have revisited casodex after failing on it prior and got a new response, or some patients have switched from casodex to eulexin or nilandron and got further response or new responses and yet they are in a similar family of drugs. You might even get a different response from using emcyt instead of DES, even thou they are in a similar family of general drugs. I doubt the estradiol patch or gels would do much for you, but still that is unknown at the moment. It is likely that Keto drug would give you a response and may be useful for even year(s), it is trickier and strick adherence to doseage and timing is paramount (it is cheap and even if insurance doesn't cover it you can buy it cheaply at www.northdrugstore.com) they also sell Prednisione used in conjuction usually.
Trials on MDV3100 and it is looking like future FDA approval coming on this one, binds to AR receptor better than casodex or anything in current existence...very possible it could assist you right now and side effects should not be that big...it is also called 'super casodex' (might be possible to get it through DR. Myers, too)
Of course Abiraterone (Zytiga) is a choice and is like Super Keto, targets the same enzyme CYP17 that Keto does, but for thousands more dollars (hopefully it is way superior), the latest new chemo drug appears to outperform the prior taxotere and others. The inventor of MDV3100 has another one coming out that is supposedly more potent than this one, called ARN-509 look for possible trials coming. Sometimes you can plead drug companies to let you use a drug under the 'compassionate use concept' and maybe have a chance of getting and bypassing FDA or super expense of buying it when insurance company says it is not covered or experimental. Provenge may do you some good, I would talk to guys using it now to see what you can learn.
Outside the box or novel idea areas: rapamycin, celastrol, gedunin(if you can get them or try them), or a combo- Sprycel+Chloroquine is actually FDA approved but not on PCa but found very effective in lab test), Sandostatin (expensive) and used on some patients not alot known on how it may work for high risk scenarios.
Unique protocols found effective by Dr. Scholz, Dr. Myers (et al???)- Leukine+Celebrex+Cytoxan (some patients also used Revlimid) or Leukine+Keto+Estradiol
These have been used on patients who were hrpca patients and failed on many other protocols, I know a guy using the Dr. Scholz above protocol and is getting great results for over 4 yrs. on it and he claims like no side effects. Luckily his insurance pays for it, if yours didn't you could buy in Canada for alot less, but still could cost $1500-2000 a month for Leukine from Canada vs. $5000 here.
Well that might get you contemplating plenty (LOL), this is all based upon further evidence that your psa is out of control or refractive, tests all need verifying or retestings to make sure. Best to your choices and Merry Holidays with the family and friends. Suggest contacting www.Paactusa.org (Patient Advocates for Advanced Cancer Treatments- Rick Proffitt) their email contacting or phone number is therein and read there Newsletters for free in the tab section, pdf files you can print off too. 
Post Edited (zufus) : 12/23/2011 6:29:21 PM (GMT-7)