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Provenge versus Lupron Therapy

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Prostate Cancer
Is Kaiser offering Provenge as option to Luron.
Does this Provenge treatment require an appeal process - 0.0% - 0 votes
UCSF offers this across stret. Can I demand refferal - 100.0% - 1 votes
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Posted 4/16/2012 5:25 PM (GMT 0)
I am 69 year old male. I was diagnosed with prostate cancer in 2008. My psa was 6.3 and Gleason 3+4. I elected to have brachytherapy HDR Boost at Kaiser Santa Clara. I had 2 sessions of 2 treatments each spread over 2 weeks.

PSA History
PSA 30.4 03/15/2012
PSA 17.5 12/14/2011
PSA 15.2 09/502011
PSA 12.6 08/23/2011
PSA 4.6 06/21/2011
PSA 4.6 06/21/2011
PSA 3.3 02/28/2011
PSA 2.9 01/26/2011
PSA 1.9 07/09/2010
PSA 2.1 01/06/2010
PSA 1.4 08/31/2009
PSA 2.3 02/10/2009
PSA TND 01/30/2009
PSA 6.3 02/15/2008

As you can see my PSA has been climbing dramatically over the past 1 1/2 years. I have had 2 biopsies and 2 bone scans which were all clear. I had a CT Scan 10 days ago which revealed 2 tumors. 2 cm on in pelvic lymph area and 3.2 tumor near aorta before the area that splits left and right.

My urologist is recommending Lupron therapy and may want to do a biopsy on one or both of the tumors. He said that he is not recommending surgery or cyberknife since there may be other tumors that are not large enough to register on the CT Scan. He feels that these tumor most likely escaped from the prostate before the original brachytherapy procedures.
I have just read about PROVENGE and want to be recommended for this therapy and avoid the side effects that are associated with LUPRON and am especially encouraged by the information available about PROVENGE. How do I push for this exception to the Lupron ?
Posted 4/16/2012 5:40 PM (GMT 0)
Fairly sure you would not win that battle.

One can always try!

Bud
Posted 4/16/2012 7:01 PM (GMT 0)
I have Kaiser insurance......
Provenge is indicated for men who are asymptomatic or mildly symptomatic and now symptomatic with greater than six months to live, metastatic, hormone resistant Pca. What will keep you from provenge is the fact that you must first fail hormone therapy. Many of the new drugs require a man to be HRPCa. First....... the reason is that h/t works very well. As a six year veteran of h/t I can tell you that the side effects for me have for the most part been a non issue. I no longer notice them except for the shoe shopping fettish I have aquired. I got a nice pair of brown on black wing tips last week. Best regards Todd.

P.s. I had to do serious battle with kaiser tp obtain Provenge even after becoming hrpca. If in the future I can assist you please email me. Todd
Posted 4/16/2012 7:14 PM (GMT 0)
I suggest you consider starting with what is well proven and that is ADT3 for high risk situations. Many men get many years of effective control from the traditional treatment. I do see some oncologists that will add taxotere to the HT rather than waiting for the HT to lose effectiveness. Something you should discuss with your oncologist as you have mets and a very fast PSADT. Not long ago my oncologist was clear that there is an order to the drugs to be used and that it most always starts with HT. Provenge is not yet a front line treatment.

May I ask why HT wasn't started when your PSA started rising? Also with the rise, have you sought out a really good oncologist that specializes with PCa? I would suggest you are now out of the realm of the urologist and should be consulting with an oncologist with a lot of experience treating high risk patients with good results.

Don't worry about HT side effects, they are managable.
Posted 4/16/2012 9:16 PM (GMT 0)
This might be interesting. It is a trial of Provenge and Eligard sequencing.

clinicaltrials.gov/ct2/show/NCT01431391?term=provenge+lupron&rank=1

Post Edited (robertcool) : 4/16/2012 3:20:55 PM (GMT-6)

Posted 4/16/2012 9:28 PM (GMT 0)
That's right. I forgot about this trial as I was excluded. Kaiser may send you to the national cancer institute in maryland for that.
Posted 4/16/2012 9:30 PM (GMT 0)
If you are denied appeal appeal appeal. It works
Posted 4/16/2012 11:34 PM (GMT 0)
This will be an interesting trial.

I suspect many of the new drugs will eventually be in trials to see if they should be introduced earlier. It is probably difficult to get participation, since ADT works.

Mel

Posted 4/20/2012 2:46 AM (GMT 0)
I pressed the issue in Sept when PSA readch 15 but bot urologist and radiation oncologist recommended another biopsy...which turned out clear. Both thought it might be a PSA bounch and recommended another psa test in December. When it went to 17.5 they set up bone scan which was clear. I pressed for additional tests and when PSA hit 30 in March the CT Scan revealed 2 masses (one in pelvic area dn 3.2 cm mast near aorta. Have now decided on Lupron and also set up biopsy of larger mass to confirm prostate cancer as opposed to some other type. I start Lupron May 1st.
Have also asked for oncologist to be assigned in addition to my urologist and rad. oncologist.
Am also in prostte support gp at UCSF.
Posted 5/2/2012 9:20 PM (GMT 0)
 

End of meds 3-09-2012 end of trial 4-02-2012   TAK 700

4-02-2012 PSA=5.52 UP 1.41

4-30-2012 PSA=9.26 UP 3.74

As you can see my PSA is moving up fast.

Just ended TAK-700 and as 5/1/2012 started PROVENGE.

Had my first withdrawal Tue and will have it put back Fri 5/4/2012.

Hope it stops my rising PSA.

Mr. Packard 1949

Posted 5/2/2012 11:41 PM (GMT 0)
Good luck Packard.

I thought that Provenge could be successful, but PSA does not necesarily get lowered.

They use other tests.

Perhaps someone can correct me or otherwise elaborate.

Mel

Posted 5/3/2012 12:20 AM (GMT 0)
Had my 1st lupron injection yesterday and also had biopsy performed on one of the tumors (the one in the pelvic lymphs since it was easier to get to). I wanted to satisfy myself that these tumors are in fact prostate cancer and not something else. Expect to get results in a week. Have asked for referral to PCa Oncologist from my urologist. Thanks for the recommendation.

Rod
Posted 5/3/2012 1:23 AM (GMT 0)
SFHOTROD,

We too are in the Bay Area and are currently looking for PCa Oncologists as my husband was DX with 1 isolated met. in T11 spine. We were told by UCSF he could benefit from radiation to that met., however UCSF is not in our network so we are currently on the hunt for a PCa oncol.


We may also be changing medical insurances and Kaiser may be one of our choices.

Who do you use there for Oncology and is he (she) a PCa specialists?

Thanks,

BOOGEE

Posted 5/3/2012 2:50 AM (GMT 0)
Boogee,
My urologist at kaiser has been directing my treatment but I am requesting a PCa oncologist referral here at kaiser facility on Geary St. Will advise.
Posted 5/3/2012 3:58 PM (GMT 0)
Boogee,
FYI...UCSF has a support group of prostate cancer that might really be helpful at this time. Here is the contact info:
Vittorio Comelli, PsyD
Assistant Director
UCSF Medical Students Well-Being Program
Health Sciences Assistant Clinical Professor
Department of Psychiatry and School of Medicine

735 Parnassus Avenue, Box 0410
San Francisco, CA 94143-0410
Tel: (415) 476-0468 ext. 1
Fax: (415) 476-4477
[email protected]
www.vittoriocomellipsyd.com
Posted 5/3/2012 7:34 PM (GMT 0)
Packard, So cool we are getting provenge on the same day. My ist cell collection was on the 1st and my first infusion is on the 4th. Todd
Posted 5/5/2012 3:36 PM (GMT 0)
Just got the results on the biopsy of the tumor mass near my aorta. I is in fact prostate cancer. This confirms an unknow and I am a bit relieved that the lupron therapy I began this week is in fact the right treatment.
Posted 5/9/2012 1:21 PM (GMT 0)
 

living1963


 You started April 24 I started May 1. I had a little problem about 3/4 of the way threw with low calcium.

 RN had to give me IV calcium to keep me from shaking. Outside of that, all went well even with the infusion.

It almost feels like nothing is working. My PSA was 9.3  7 years ago and it is 9.26 today.(no side effects)

You will be doing your last when I do my second.(5/15/2012)

send e-mail  will give call . I am in Maryland.

[email protected]

[email protected]

I am 71, was diagnosed in 2005 Nov. a Gleason 9 with a PSA of 9.3. My prostate cancer came back in 2007 with my PSA hitting 22.6 now on a new test trial at Johns Hopkins called TAK-700. I started Oct 2010 PSA at 17.6 with good results my PSA as of 9/20/2011 -- 1.04PSA. Lots of ankle swelling plus a spike in blood pressure. Ended TAK-700 on 3/09/2012 PSA 4.11

Started PROVENGE 5/1/2012 with a PSA od 9.26 same as 7 years ago    (big jumps).

 

Posted 5/9/2012 6:39 PM (GMT 0)
Actually no, I was delayed a week due to a scheduling problem with dendreon. My first infusion was may 1st. So we are getting provenge at the same time
Posted 5/14/2012 1:51 PM (GMT 0)
 

living1963

I guess you are drinking lots of water today.

Mine starts at 12:00 Tue will be my second.

Hoping I have increased my calcium to get me threw  Tuesday.

Up to three pills a day should be 1100 mg a day. 

Posted 5/14/2012 3:16 PM (GMT 0)
49 Packard,
I just woke up so after my mandatory two cubs of coffee I will be on the water and also the calcium. Mine begins at noon as well. Noon Pacific time.... So how do you like those ten penny nails the call needles. lol Good luck tomorrow. Todd
Posted 5/22/2012 2:53 PM (GMT 0)
 

living1963
 I had all kinds of fun on my 2nd withdrawel.

First I had to get my calcium at the sane time as Withdrawel.(low)

Second after into it by one hour a hose sprung a leak and they had to throw everthing.

This ment 4 hrs on table.

Also with all the liq. I had to pee. (new experance for me with urneral) Some body else holding it!

Made it threw and all went great Fri. 2/3 done.

49 PACKARD

President

Wheels for Prostate Cancer Research, Inc.

Fighting PROSTATE CANCER  With PROVENGE

 

    www.WfPCR.org/

 

Posted 5/23/2012 3:29 AM (GMT 0)
49packard,

Good luck with your treatment. I hope the next infusion is a little easier. Keep us updated on your next infusion.

Provenge isn't known to bring down PSA, but does should increase your lifespan. You'll have to talk to your doctor about how to monitor it's effectiveness. Some people haven't noticed much difference right away. But when they start taking chemo, the Provenge + chemo prove to be quite effective.
Posted 5/30/2012 2:49 PM (GMT 0)
  living1963 , ranch99 Just finished my last LEUKAPHERESIA   onTuesday 29, 2012. All went well with this withdrawal. I fact I was finished before 3 hours. Got a great cup of real coffee on way home. It is going to hard to not see my PSA go down each visit. Living with ups and downs of PSA has been my life for the past 7 years. It has been zero or 22.6. I go Friday for my last infusion. (This always sends me to nap time when I get home.)   President Wheels for Prostate Cancer Research Inc. Prostate Cancer Survivor www.WfPCR.org/
Posted 5/30/2012 7:50 PM (GMT 0)
49 Packard, I as well had my last cell collection yesterday. I slept for 16 hours afterward. The Leukapheresea always seems to knock me out. I have also developed a slight rash at the needle site. It looks a lot like prickly heat and comes and goes. Good luck on friday. I will be thinking of you. Todd
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