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Should I join this trial?

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Prostate Cancer
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Posted 3/31/2015 12:25 AM (GMT 0)
Short set of details:

Age = 42
January 2015 - first DRE and PSA results - PSA = 7 (or 9... i can't remember)
February 2015 - second DRE and PSA results - PSA = 13
March 2015 - Biopsy results 4 of 12 cores = 4+3
March 2015 - Lupron shot

My initial urologist wanted to cut it out immediately. Which I was ok with but... I liked him but I just wasn't comfortable with him. Office was dirty. Staff were questionable. Felt like he was fine for the initial determination but having him cut on me... not so much.

Went to oncologist. He also thought removal was the best choice. brought up my hesitation with doctor #1. oncologist said he would help me find 2nd opinion.

Met today with 2nd urologist at OU Stephenson Cancer Center. Was much more comfortable with him. And now after the googling has been done, he looks to be one of the best possible candidates I could have hoped for (taking into account my financial resources). His Bio.

Now then all that said after looking at all my numbers and what not he wanted to know if I qualified if I would be interested in a clinical trial. He initially didn't think I'd qualify but after plugging numbers into a computer and performing another DRE he thought I might. I did.

The study in question is calgb 90203
So the question is, do I want to be a part of this study?
Posted 3/31/2015 12:30 AM (GMT 0)
Well Jet, that's something you're going to have to decide, don't you think?

Cheers, Doug
Posted 3/31/2015 12:49 AM (GMT 0)
If there's a perceived benefit that I would want to. If there's not I don't. Is there a benefit to being in the trial.

Trial is basically
Group A = 6 sessions of chemo @ 3 week intervals followed by the robot.
Group B = robot

If I join the trial and am attached to group b then it doesn't really matter, that was going to be my choice anyway.
but if I join the trial and am attached to group a... I'm not concerned about getting through the chemo. I know it will suck, but I've watched mom, dad, and brother go through it and know that i can make it through that. my question is... would having chemo prior to the removal be a net positive or negative in chances of relapse? I know that's why they're running the trial. But what are the possible negative outcomes of chemo first followed by removal in ~5 months?
Posted 3/31/2015 12:53 AM (GMT 0)
Jet, again that's something you are going to have to think long and hard about.

Cheers, Doug
Posted 3/31/2015 1:29 AM (GMT 0)
I would be concerned that the Chemo might make recovery from the robot more difficult. You want to be as strong as possible going in.
Posted 3/31/2015 1:55 AM (GMT 0)
My husband is now in his third year of being involved in a similar study for high risk patients, using open RP instead of robotic but offering the same chemo and hormone therapy before surgery or straight to surgery. He was randomly selected to be in arm B, which meant no chemo or hormone. The docetaxel is not as toxic as some chemo and well tolerated. My husband's doctor said early indications are the protocol is effective and he is encouraged by the early results. It is an ongoing study, which means my husband, even though only receiving the standard treatment, is checked every three months for the next 15 years: psa is taken, blood pressure, heart rate, weight is monitored closely. He sees the doctor at ever visit and then sends some time with the nurse who runs the study, and discusses any changes in health, any concerns, reviews the stats.
Since there are a few hundred in this study, and half are sent to the chemo and hormone arm, it doesn't seem that recovery from the surgery after chemo is a problem.
Studies show that people in studies do better just by virtue of being in a study, whether they are receiving conventional therapy or a new untried therapy. They are more closely monitored, have access to a doctor quickly if there are any problems, and perhaps look after their ongoing medical issues more closely because someone is going to be checking their weight or blood pressure again in three months. Doctors like to look after their study patients because they are paid per patient to run the study, and they like to keep you alive.
The benefits are also for those who might be facing this disease in the future, and who might have the benefit of your involvement to make a decisions.
Posted 3/31/2015 3:34 AM (GMT 0)
Sounds like a trial that could help both you and the PCa community in general but the way I read it you have to be Gleason >=8.
Posted 3/31/2015 3:43 AM (GMT 0)
I will second the comments made by Beejane that people in studies tend to do better just by virtue of being in a study.

I am in a study for lower-risk patients, and can tell you that our monitoring and protocols are strict.
You are followed for a long time, to the end of the study, or your natural life. They do not like to lose anybody, or even lose track of anybody. A lot of smart people debate the goals and benefits of these studies, and they don't intend to lessen anyone's chances for living a long, quality, life.

IMHO, go with it!
Posted 3/31/2015 3:56 AM (GMT 0)
There are some negative aspects of a study to consider as well. We are thrilled that Gary was chosen for his pilot study, but I suggest you research it thoroughly and consider the following: what phase of the trial, the funding, and how much travel is involved and how often you have to get to where it's being done. Also, the what Dr is doing the surgery. You are comfortable with your current. What if you aren't with the study Doc..all I'm saying is do your own research and don't just rely on what your Dr says.
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