Time to be more aggressive?

Good to see your positive response to the initial treatment. Recent studies have indicated that introducing chemotherapy early along with ADT can be beneficial for high risk. Steelguy and Southern Comfort have both pursued that protocol and can tell you more. Hopefully they will chime in.

I agree with adjust..You have already had very aggressive treatment so it will be hard to get MORE aggressive...Quality of life is important...I would see how long the ADT you are on can keep the beast confined..My MO feels when I become hormone refractory then Provenge will be the next step..He does not recommend chemo because of the quality of life hit and it's somewhat dubious effectiveness...We will save that one for later he says....With the new LINACS spot radiation treatment is an option not available in the past..Find a bone tumor, zap it! Just a few treatments needed, not 40...

Stay the course for now, would be my opinion, while taking the time to research and plan out the next step if needed. Sounds like you have had good results taming the beast thus far.

David

Depending on who your team of doctors are, you could possibly strengthen the team by adding Dr Fabio Almeida at AZ Molecular Imaging for future F18 Sodium or C11 Acetate tests. Also, Prostate Oncology in Marina del Rey has Dr Mark Scholz, Richard Lam and Jeffrey Turner for experienced prostate cancer medical oncology.

But no immediate action seems to be required, as you have already been very diligent.

I am soon to follow your lead with Provenge starting weekend of Sept 19-22 every other weekend for 3 total treatments and two weeks of SBRT starting Oct 6 every other day.

In my case it is initial treatment, having only been on Lupron (w/o Casodex or triple blockade) since 3-28-13 with no prior surgery nor radiation nor chemo.

Just keep doing what you are doing, since it is working for you.

For your psychological well being, ytou may want to join us at GFMPH Good For a Man's Prostate Health gathering in Rochester NY the last week of Sept. Guys and their spouses always enjoy hearing success stories.

www.healingwell.com/community/default.aspx?f=35&m=3132396

On your thread premise, it was at GFMPH a year ago in Rochester where several fellow G9's convinced me I had to be more aggressive than just Lupron. BTW, the spring GFMPH in April alternates sites odd years near Baton Rouge LA April 2015 and even years near Orlando area recently completed April 2014.

LupronJim

Recent ASCO meeting (American Society Clinical Oncology) reported a study that adding chemo all with Hormone Treatment early on, added an average of 17 months to survival time, as opposed to traditional method of doing chemo only after all HT therapies have failed. This result was described as the most important break through in treatment in many years. This would be an aggressive response for high risk men. You can find study by searching keywords: asco prostate docetaxel. Best wishes.

NewspaperLover

I just want to clear up some misunderstanding about what the CHAARTED study said and didn't say about early docetaxel treatment.

The study was done only among men with radiologically proven mets to bone or viscera. It showed that for men diagnosed with extensive mets, early use of docetaxel with ADT had an especially significant survival benefit. They defined extensive mets to mean ≥4 bone lesions and at least one beyond the spine/pelvis or mets in viscera (organs like lungs, liver, etc.). The study has not reached any conclusions yet among men who didn't have extensive mets. The survival benefit, if any, seems to be smaller so far for that group.

It does not apply at all to cases like the OP who only had LN mets.

- Allen