Need some info from the group

Walt,
I have read where hormone refractory prostate cancer (HRPC) patients where incorrectly declared with HRPC because the androgen deprevation was not acheiving it's goal of lowering the testosterone and/or dihydrotestosterone levels to efficient levels preventing the cell mestasis. At least in the Myers book he references examples of patients who came to him that were HRPC but he was able to re-invoke remission. While there are several different ways to do it, he focussed on the Lupron/Eligard/Zoladex variations for the LHRH end of it. He said one might work better than the other depending on the patient. In addition he varied the levels of Casodex and combined either Avodart or Proscar, for a triple androgen blockade. Along with some other agents he was able to get the testosterone levels lower and the PSA's dropped. I ran this by my guy and he agreed that the levels need to be monitored if there was rising PSA to determine if another combination might have a stronger effect. That stated the levels that Myers would like to achieve is 10-30ng/dL for testosterone and dihydrotestosterone should be <5ng/dL. Lupron/Eligard/Zoladex do not always lower the DHT and that Proscar was his drug of choice to knock it down.

Tony