Keep your hope upbeat mainly because there are still options in this that you can still do, ask your doc also if you could try 2-mg of DES(maybe 1-mg every 12 hours?), but with coumadin for additional safety (it would show up within like 7-14 days in a PSA test if it is working, trust me on knowing that. If it didn't show either a stabilization or lower psa, then it is becoming ineffective and you need to look at other options. Also, if DES is ineffective in a Hrpca setting, so too is Lupron or LHRH drugs (how ineffective is the real question).
See other drugs possible at: (see www.hrpca.org )-Jevtana(newer chemo), Abiraterone(Zytiga), Leukine, Ketoconazole, Revlimid, Taxotere-Chemo+2nd drug combos, are some of the options. There are even Novel and more obscure options in PCa, if you wished to look into such. Off the wall but you could try like Nilandron, Eulexin, or casodex, sometimes because the way the AR receptor changes or morphs, these drugs can be effective again...need to monitor psa often and closely in so doing (in some cases this could feed PCa, psa test would help confirm that quickly). Strange that happens, but is does.
The comment from you uro-doc you mentioned, what a nice bed side manner? This is not the uro-docs world, he is a fish out of water, this is why people see oncologists whom study the biology of the disease.
Consider getting Mark Moyad's new book: Beyond Hormone Therapy (Options for Prostate Cancer Patients)....covers even a bunch of drugs in the pipeline now, and the Phase III clinical trial drugs that seem worthwhile(you could be a canidate for some), some have "compassionate useage" labelled in his book...which means one can apply for using that option to get it without FDA approval. Plus makes you aware of what is coming, still good to know.
There are alot of possible protocols to look at and, likely do. If you could afford it, a trip to see Dr. Scholz in California might be worthwhile or write to P2P (www.prostate-pointers.org )= Patient to Physchian and see if DR. Strum or DR. Barken, Scholz et al might provide some free advice answers, checkout their archives and search other patients with there replies is another idea. You can also contact Dr. Barken as a coach www.pcref.org another idea.
If you have not seen PCRI videos by oncologists suggest you see them and all of Dr. Myers videos, just to get a glimpse of the things he has experience with in other patients. Have seen other patients, jump into Keto or other things and get results, some people have gotten 2-3 years out of Keto, monitor side effects, and same for abby-Zytiga.
The more bizzare to us options, either expense or less known: Sandostatin-IV or injection (not certain if effective in Hrpca at this juncture), also the Radiopharmaceutical drugs 'IF' one has bone pains from mets related disease these seek out some of those cancer cells and kills them=pain relief: Samarium-153 & Strontium-89 or (Radium-223 phase 4 now), Samarium is found the best right now. Are you using Zometa or D3 vitamin or Fosamax for bone density assistance? You might wish to find a 2nd opinion oncologist doc? As you can see I am Full of it....ideas that is. 
Keep on rockin in that band you are in too.
Post Edited (zufus) : 6/25/2011 7:48:39 PM (GMT-6)