Compiler Update-- reprieve

The subject says it all, but here are the details I conveyed to loved ones. The drug I referred to is avodart. I did hear this masks your PSA so I need to check on that. Read on..

Yesterday I got my latest PSA result and again it was very disappointing, but totally expected. In fact, it was exactly what I had predicted. Today I had my consultation with Dr. Lam. He is the partner of Dr. Scholz.They are both experts and they strongly recommend that their patients consult with both of them at different times. Their philosophy is that in this way you get two expert opinions.

I fully expected that I would be filling a few prescriptions and starting the next phase of nasty treatment today. It turns out that is not the case: I have a reprieve. My PSA is still quite low, although doubling at a very fast pace. He has prescribed one drug for me to try. They have found that this drug works for awhile. It is generally given after a year on the medications I thought I would be on. The latest treatments involve giving those medications for a year and then taking some time off them (due to the severe side effects) if the prostate cancer responds well to the drugs. During the time off, this other drug is given and they find it extends the "drug vacation." So, we will actually try it now and see if it gives me a vacation from starting the new regimen.

I will retest my PSA in 2 months and we will see what is happening. So, overall that is good news here. It means I can start the new semester unencumbered by the drugs, their side effects, the medications given to prevent side effects, side effects of those medications, etc.

Another good news item is that the results of my bone density was phenomenal. The z-score was 2.5, which puts me in the top 1/2 of 1%. One of the drugs I was going to have to take was fosamax, because the drugs I was going to start manage to wreck your bones at a high rate. Well, apparently my reserve is good enough in that area for many years. So, even when I start the next phase (and we are just in a delaying pattern), I can dispense with fosamax.

Also, I was concerned about the bone scan, which shows problems in my upper right shoulder joint and surrounding areas. I consulted with a local medical oncologist and he did not think it was cancer but was just a bit of wear and tear. I really expected the California doctor to order more tests (this was suggested on the report). But he agreed with my local doctor that this was not a problem area.

So, this was a good day today.

Mel

You are using the Avodart after the Lupron (Eligard). Right?

Any SE?

This is an interesting idea about starting out just with the avodart

Mel

THANKS VERY MUCH FOR THAT LINK. Your article sure explained a LOT.

Isn't it an interesting idea, however, to do avodart before starting HT and hopefully delaying that start!

Do you happen to know about the SE of avodart?

Mel

Excellent questions. The 5 sounded like a max but better to do before then.

Scholz's main thrust is to get started BEFORE there is observable bone mets. He claims if we start before then, the median is 10 years before we have to try something else. I think with bone mets (without symptoms) you are looking at 18 months (this is what Myers says) and mets with symptoms Myers says 8 months.

Scholz was pushing me to start right away, so yes I was surprised that Lam did not parrot this same advice. It was indeed a true "second opinion." Hussain's office called and they are still checking with her and she will get back to me next week (that delay typefies my dealings with her -- frustrating!).

David, this is hardly an indefinite delay. With my PSADT, it will be 2-5 months. But with the new semester starting in January, it is a relief. Like you, I don't want to do HT. But, in my case, it sure looks like it's just a matter of months.

Mel