zufus said...
One the best questions every poised, totally controversial still to this day, even some arguements that infer or say that, it makes no freakin difference in longevity, then others within abstracts like Bolla studies easily showing significant survival longevity outcomes, BUT not identical results in all patients. Logically it seems to work in holding back PCa cells, how long and how perfect is the next question, perhaps. I kind of followed Bolla concepts in my own very high risk PCa stats scenario from 2002, did 2 yrs. of ADT3 (Lupron+casodex+proscar), then because I hated the side effects and had 8 consecutive miniscule rises within 8 months (monthly testing I did on my own accord) started questioning everything in this jungle.
Decided (Lupron) it was failing and I knew what that means for the patient going down the road. Switched to estrogenic drug (you know the one the uro-doc says will kill you with blood clots-LOL). Lowered psa within 14 days, stabilized so well I went off for 1 yr. holiday, resumed thereafter and gone intermittent off and on now for a total of almost 8 yrs. (no side effects, no weight gain, no memory loss, no bone losses any more....occassional tenderness in boob area no biggie-LOL). Way better control and quality of life and costs almost nothing, no patents on this man made compounded drug (DES). But remember it is junk and old school and worthless (didn't Dr. Fred Lee use something similar-LOL). Hey this is PCa, no rules just right in this jungle. (humor intended)
You might enjoy a history lesson of PCa and what has been used (1940 on up) and what happened along the way. Typically there is no ONE WAY only to fight PCa using drugs, many ways can be effective and contrary to the cultural trend of Lupron being #1 is worth challenging that sort of brainwashing mentality. Dr. Fred Lee found with PCa like 30 yrs. ago now, found with uncureable scenario within 2 yrs., never took Lupron or LHRH drugs, he did take the drug emcyt (an estrogenic) for many, many years and he is still alive and working today...I have a weblink available of his journey. Here is a weblink worth reading:
www.pcainaz.com/Pages/ETE_eng.pdf (Kudos to Dr. Premoli and Ralph V.)
www.hrpca.org (various treatment options used in PCa scenarios-'proven treatments')
Dr. Premoli in Argentina using estradiol patches on patches (another estrogenic method), getting excellent results in uncureable scenario patients, this is more than 10 yrs. of his studies on this, the USA Journals would not publish his findings. Dr. Labrie (Canada) is the founder of biclutamide (casodex types) to fight PCa and much success was done for decades using this form of HT and still is used today. Another doc in Canada found that Ketoconazole (a fungus treatment drug, nothing at all related to PCa), actually worked in failing patients or hrpca scenarios and so it is used sometimes when Lupron or other drugs fail. This is also a very cheap drug and targets the exact same enzyme that Zytiga and TAK-700 targets, called CYP17....the newer drugs may outperform Keto but the cost comparisons are staggering. 'Is it all about the money' (you may wish to look into that)
Part of the dilemna of PCa: we are still in somewhat of the dark ages in knowing when and what to use on a specific patient...why?....clues: 24+ variant types of PCa known of now (some go unclassified by pathologists), different Gleason grades in patients and sometimes missed entirely by biopsies (gland can have multiple Gleason grades happening, I know factually as I had 7,8,9's and 2 sets found like that in my 12/12 biopsies), ploidy DNA anaylsis testings (usually not done in pathology enough) has 3 different classifications (within those the more that the cells morph from diploid status-i.e. equal pairs of DNA strands, the worse your prognosis or effectiveness on HT therapies). PCa can morph or become refractive in patients (varies hugely) and not understood enough as to how and why, even arguements that using HT therapies may induce refractiveness to happen sooner in some cases? Then the root cause of your PCa, which is from a genetic issue is the underlying cause, specialized pathology can test for many of these genes with accuracy (but is not usually being done), some have targeted therapies upon those genes that could be hugely significant in your particular longevity. (genes like P53, BCL-2, HER-1, and many others)-See pathology Dr. Bonkhoff.
Hope this gives you more incite into all this, it is imperfect science happening at all levels and some docs will tell you such and others will have you believe it is just so simplistic and only they have all the answers, so don't hire someone else they hope. Results in patients varies plenty, the reasons above are likely the answer of why that is as it really is. Robert Young coined the term "Jungle" when referring to PCa, a great analogy. I call this the Twilight Zone, to unreal to believe it is reality. Complex stuff on steriods!
Hmmmm......a very well worded answer, but I'm not sure if it cleared or muddied the water.........the bottom line is that HT directly affects the progress/spreading of PC, unfortunately to what extent and how long to administer the treatment varies according to many experts and studies.