New here and confused please help

First, I want to welcome you to our little part of the web. Although I am not able to answer your question, there are many here who can and will. Don't worry, you will get plenty of opinions and info prior to your next Eligard. Although we are not Dr.s, we believe you have to be your own best advocate for treatment options.

This may help

www.cancerresearchuk.org/cancer-help/type/prostate-cancer/treatment/steroids-for-prostate-cancer

Post Edited (Startech) : 4/2/2013 6:38:10 AM (GMT-6)

Thank you both for your welcomes to your community/ family.

The way our doctor explains it is the eligard helps apply the brakes to the disease. We had asked about my husband going off it but the doctor said it does play a role in slowing the disease. I am not sure what would happen if he went off it. For now, he is staying on it and also taking zytiga and prednisone.
Stick around here - there is lots to learn and so many helpful members!

Could be time to consider Provenge.    It is indicated before chemo and some doctors are reporting that patients that have had Provenge then show better response to chemo, Zytiga, Keto, Emcyt, Xtandi, etc., and other second line HT drugs.

Important that Provenge comes before Zytiga as Zytiga requires Prednisone, an immunosuppresant.   You can't use Provenge until you have been off Prednisone for many months.  

That your PSA is rising while on HT shows that you are now hormone independent, or castration rsistant, or refractory, all terms to classify your situation relative tto the treatment.

Todd1963 has used Provenge with good results and can help you with information.

My sig shows I am in the same boat friend. There is bone scan and a soft tissue scan, I would want both updated if they had not been in the last 6 months. In my case it was 10 months between scans and I developed a nice large hip Met that is probably driving my psa numbers into doubling every 2 weeks. I was started with Eligard with Casodex (Bicalutimide). this was a crushing blow to my stamina, and I had every side effect there was. But it worked very well for a good long time.

There is prostate cancer that relies on testosterone, and then we find that it mutates (which is normal in G8 and G9 situations) into strange and aggressive new little buggers that dont need testosterone, but now feed on something else.

I think it wise in my case to continue keeping the door closed for the one area where they feed and hope Doctors find the door that is feeding the newer types. My last dosage was Keto which messed with the
Androgen production, But that didnt seem to be the problem so we dropped it.

I understand there are many different treatments available so its all about finding the one that works best for the moment. The trick is finding one quickly. Now that I have felt real cancer bone pain over the last week, I can say it really affects one quality of life and thats the key.

If you have concerns over your Onc with trust issues or just personality clash, maybe a second opinion is in the air?

IAJC,

I too am so sorry that you have joined us. We are within months of being the same young age to have to deal with this cancer.

I agree with David, locate a renowned Medical Oncologists for a second opinion in your area. If you can't find one, ask here on HW since members live all around the country and we have brothers around the world as well.

I was a participant on a Provenge study and received four treatments of the product. Tall Allen and others have recommended it so please research it on line. The corporation is Dendreon and the product is called Provenge. It uses your own immune system where you give your own white blood cells during a treatment called Leukapherisis. Mine was down at the Red Cross. It take about 3+ hours. They immediately (within minutes of completion) run it to the airport and ship it to a facility where they scrub up and clean up the blood and then they attach a bio-enigneered protien to your white blood cells and then immidiately fly it back to you (seems like I recall it was two days after the Leukapherisis) where they infuse in your arm, your blood with the product. This is done every three weeks as a recall.

My urologist oncologist was a participant in the study of only 40 men who were recently diagnosed with prostate cancer and were committed to having a radical prostatectomy so they could compare the cancer cells taken from the biopsies to the pathology cells at surgery and after the three treatments. I said i had four treatments because I was randomly selected to have a fourth treatment post surgery.

The U.O. who is in his early 60's told me that he strongly encouraged me to participate in this trail because at the time, the treatment looked very promising from what he had seen it perform on earlier studies of men with advanced Mets. So I did, and glad I did.

Provenge has subsequently to my treatments been approved my Medicare and Medicaid and most insurance companies are covering it.

There are a few of us on HW that have had the treatments and the numbers are growing. I am said to say, that I am aware of a couple of men who had Provenge did not have success and have passed. On a brighter note, there are a few of us who have had great success so far and give credit to Provenge for that success. Time will only tell.

Please email me if you would like to talk in more detail about the treatments.

Good luck and best wishes my friend.

IAJC-

the Provenge prescribing information said...
PROVENGE is an autologous cellular immunotherapy indicated for the treatment of asymptomatic or minimally symptomatic metastatic castrate resistant (hormone refractory) prostate cancer.

He's right about the cost, but most insurance plans do cover it. Perhaps you can email him the link to the Provenge prescribing information.

- Allen

Post Edited (Tall Allen) : 5/4/2013 9:57:28 AM (GMT-6)

IAJC said:
"Talked to the Dr. about Provenge and he just shot it down saying that the trials were done on people that didn't have metastic prostate cancer and plus it's $93,000 per 3 time session."

IAJC,
Provenge (sipuleucel-T) is approved by the FDA as an autologous cellular immunotherapy for the treatment of metastatic castrate resistant (hormone refractory) prostate cancer.

Yes , it is cost 93,000$, but 75% patients don't pay anything, even 1 penny out of pocket ( you need have income less then 160,000 $ per year).

Many patients benefit from this treatment and you finish it during 30 days.

Dr. Freedland compared prostate cancer to a runaway train going over a broken bridge and immunotherapy is going to slow this train down.

I noticed that patients who received Provenge first and after move to other treatments like HT or Zytiga, Chemo, Xtandi usual have outstanding result from these drugs.

It is support Dr. EISENBERGER words:
" I just want to point out something we haven’t emphasized here. In our cancer immunology program, dealing with immunotherapies, one of the focuses is timing of immunotherapy. It’s possible that the interaction between immunomodulation and other treatments may be important. For instance, immunizing a patient before you give hormonal therapy, before you give chemotherapy. So it is also possible that immunotherapy may enhance subsequent treatment..."

Dr. SCHOLZ said:
"... if I am asked a slightly different question—“What type of new technology has the greatest potential for saving lives?”—my answer will always be the same for every patient: Immune therapy...
there is one intrinsic capacity in our bodies that successfully parries millions of different attacks on our health: the immune system. Therefore, if a cure for the myriad of different cancer types exists, it will probably result from successfully harnessing this incredible system...
The good news is that a properly directed immune system can and will eradicate cancer...

Double-blind, placebo-controlled trials show Provenge slows cancer progression and prolongs survival just as well or even better than other standard treatments such as chemotherapy or second-line hormonal therapy.
People forget that even though Provenge is administered over a six-week period, once the immune system is activated, it keeps functioning indefinitely; it’s the gift that keeps giving for the rest of your life. Therefore, even if Provenge only slows disease growth slightly, the inhibitory effect keeps accumulating over time. So over a period of years, even a mild effect can become substantial...
its pattern of improved survival with earlier stage disease seems to fit the hypothesis that the inhibitory effect of Provenge results in a progressively longer survival when its effects are allowed to accumulate over a longer lifespan. Based on this data one would logically conclude that Provenge induces the biggest benefits when administered at the earliest possible stage.
In the real world, where Provenge is only covered by insurance for men who are hormone resistant and have metastases, men on Lupron who have a rising PSA should be vigilantly monitored with scans such as Prostascint, C11 acetate PET and Sodium Fluoride PET scans every 6 months to detect metastatic disease at the earliest possible stage."

Dr. Oliver Sartor said:
" But on the other hand, you treat a population of men in this way ( Provenge) and they live longer than the population of men not treated in this way..."

All these doctors are outstanding, wellknown researchers and medical professionals in prostate cancer.

You can more educate yourself if you read here ( you also can find provider for Provenge in your
location):

www.provenge.com/

and also we discuss a lot about Provenge on this thread on HW:

www.healingwell.com/community/default.aspx?f=35&m=2487796&p=7

To as for your doctor , Provenge already approved treatment for 3 years and if your doctor still doesn't know what kind of patients are eligible for this drug and also doesn't give you enough time to talk to you,
walk away from him and find another doctor.

Post Edited (HOPENEVERDIE) : 5/4/2013 12:45:58 PM (GMT-6)