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New study 18 vs. 36 months HT

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Posted 2/15/2013 11:12 PM (GMT 0)
Southerh Comfort,

Great post! The one variable with all these studies is the amount of Gy's (radiation) given to the prostate and the overall coverage to the prostate. This could have a major difference to these studiies regarding prostate cancer survival.

Dave
Posted 2/16/2013 3:55 AM (GMT 0)

Here is another publication on this:

http://www.medscape.com/viewarticle/779184

Phil

Posted 2/16/2013 11:45 AM (GMT 0)

irmaly said...
Hi, everyone. My husband (Gleason 7 (3+4); normal DRE; no mets) just finished IMRT and 6 months of lupron. I saw this thread (thanks) and asked our Duke doctor about it. I thought I'd share his response with all of you:

"I am familiar with the paper that you reference. The short answer is that the Bolla study included men with much more advanced disease than your husband. More than 80% had locally-advanced disease.

Additionally there is a larger study examining duration of androgen suppression that did not find an improvement in survival with longer courses in men with Gleason score 7 cancers. This study also had men with more advanced disease. I have attached the PubMed link below.

http://www.ncbi.nlm.nih.gov/pubmed/18413638

Finally I provided a link describing the most relevant paper for your husband’s situation.

http://www.rtog.org/News/tabid/72/articleType/ArticleView/articleId/18/RTOG-9408-Early-Stage-Prostate-Cancer-Published-in-NEJM.aspx

Glad he is doing well."

Interesting....what other stats does your husband have?
Posted 2/16/2013 3:05 PM (GMT 0)
FoxRun. My husband is 69 years old in March. His PSA was 5.2. His DRE was normal. His MRIs etc came back clean. There was a "bulge" indicted at the prostate wall, which is why we decided to treat the cancer aggressively. He is a Gleason 7 (3+4), in very excellent overall health. His post-treatment PSA came back as <.01. (That was a couple of weeks ago). He has his next test in July.

Here's the thing. I was under the assumption he had "locally advanced cancer" because all 12 cores of his biopsy evidenced cancer, although most were around 5%, with two (if I remember correctly) just under 50%. Perhaps I don't understand what constitutes "locally advanced"? Let me also say that we believe my husband's Duke doctor is excellent. I checked him out completely before we made an appointment with him and after we had "interviewed" 4 others. His care has been exceptional. But this thread had me concerned.
Posted 2/16/2013 4:47 PM (GMT 0)
Regarding Foxrun's comments about the time period the radiation occurred (1987-1995), that echoed a comment from my oncologist in terms of how long my HT should be. He said that the studies available relied on older "crappy" radiation (his words, not mine) and that a shorter period would be proper for me. In the end, I was told a 12-month period would be best, and that was after a consultation between two oncologists (Sholtz and Lam) and my RO at UCLA (Steinberg).

PS I had actually forgotten that rationale for my shorter treatment was due to the benefits of newer radiation technology until I saw Foxrun's comment about the time period covered.
Posted 2/16/2013 5:25 PM (GMT 0)
Hey all and Irmaly,
I am both a wuss and skeptic! I am a high risk gleason 8 with confirmed epe and it took over 1 year to get my psa down from .06 to undetectable. I currently have 2 6-month shots of lupron left to complete 3 years. My goal--which may be unreasonable--is to "kill"
this disease and not see a rise in my psa during my lifetime. Although many of us are content to "manage" this disease by intermittent therapy, that's not my intent.
Lupron can be really nasty stuff the way it dominates the emotions at least in my case..2 weeks ago 1 of my wife's MS doctors died from breast cancer--she was 42..3 days ago I took my wife of 46 years to the hospital for a "repeat Mammogram"..She, of course, took it in stride while I had the "highest anxiety" of my life..Thank god it was negative..
I would be lost without this woman who is now blind in one eye from MS...That's my vent for today!!
Bill
Posted 2/16/2013 5:47 PM (GMT 0)

Michael_T said...
Regarding Foxrun's comments about the time period the radiation occurred (1987-1995), that echoed a comment from my oncologist in terms of how long my HT should be. He said that the studies available relied on older "crappy" radiation (his words, not mine) and that a shorter period would be proper for me. In the end, I was told a 12-month period would be best, and that was after a consultation between two oncologists (Sholtz and Lam) and my RO at UCLA (Steinberg).

PS I had actually forgotten that rationale for my shorter treatment was due to the benefits of newer radiation technology until I saw Foxrun's comment about the time period covered.

Another interesting observation.....now thinking back to my initial treatment plan, it my URO who suggested I do 2-3 years of HT and that suggestion was carried on to my Primary ONC and when I visited my Brachy ONC, it was he who suggested that the 12 months would suffice but he was willing to go along with the URO's initial suggestion, but I was not.
Posted 2/25/2013 3:00 PM (GMT 0)
 

All,

Another good study from NIH (3 years ago). They used 9 months of HT with good results.

http://www.ncbi.nlm.nih.gov/pubmed/19493260

Dave

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