Through the years there has been numerous legislative bills introduced to create an Office of men's Health. All eneded in a drawer somewhere. A few were introduced by female legislators. They all...
It is important to understand that treating men with artificial (exogenous) testosterone results in a reduction of netural(endogenous) testosterone. Therefore it is always preferable to aument the...
peanut307, From the start it is important to understand that not all prostate cells are androgen dependent. In a normal human prostate most prostate cells depend on androgen to survive and to...
Sankalp, In your fathers's case the immediate aplication of androgen deprivation makes sense. Hopefully he will experience a long remission. Androgen deprivation or suppression (known as ADT or HT)...
JackH, The median survival of all the drugs mentioned are expressed in months. The significance of PSA testing and early disease detection that would have caused death when treated effectively to...
JackH said: 2. BillyBob commented about mortality improvement in PC, which has been largely driven by the breakthroughs in both HT and chemo treatments over the last 20+ years, not be screening. The...
The best example of dedifferentiation comes from AS series in which men have to ultimately get some form of treatment for their cancers. In the past we discussed if is it possible that in a slow...
Hi ksk54, Just to tell you that you are doing the best to delay TX. If one is optimistic the PSA elevation is from residual benign tissue and your life-style, monitoring and medications are holding...
JackH, You need to tell the AAFP to change their website. The URL below and their recommendation about PCa screening with PSA:...
The USPSTF guideline recommendation resulted from the amount (estimated) of over treatment that has happened and is said to be happening here in the US. How is the over treatment figure calculated?...
JackH, Are you aware that the AAFP follows the USPSTF guideline about testing for PCa with PSA? The recommendation is to not test with PSA unless there are symptoms. How can that help those of us who...
If the intent here is to improve patient education why use the USPSTF data (which recommends against screening with PSA for prostate cancer? Nowhere in the USPSTF information there is mention of the...
RandyJoe, As reported your result is less than 0.05 which is the lower limit of detection of the PSA assay used for your test. It is undetectable by that PSA assay. If other assays are used with a...
Hi Galileo,Dr. Almeida is now practicing at the same location. He does the C-11 acetate PET. The information is: open Sans", sans-serif; color: rgb(102, 102, 102); text-transform: none; text-indent:...
Hi Peter, If Jerry would decide to stop his present course of ADT and experience a PSA surge don't you think it is important to know that intermittent ADT has yielded similar results as continuos...
Allen, If the correct time of adjunct ADT to RT remains unknown to effect a "cure" why would a randomized trial involving adjunct IADT to RT be available? On the other hand, IADT has been tried on RT...
Bob,The problem with this gentleman is that his testosterone is still low. He needs to get it tested. Hopefully in time that level will rebound. The longer the period of ADT the higher the risk that...
Allen, One of Jerry's options if he stops adjuvant ADT at this point and there is biochemical failure is to restart ADT to prevent progression. There have been a couple of trials that demostrated...
Hi Jerry, You are right that in cases with high risk/high grade disease as yours there is little research supported by RCTs to give you a guideline on how long to stay on ADT . That said,...
The intention here is not starting an argument about the mechanism of androgen deprivation on prostate cancer cells. First it is important to know that not all prostate cells are androgen dependent....
Hi Steve, There is evidence that 5-alpha reductase inhibitors (Proscar, Avodart) reduce the incidence of PCa by some 25% and although not FDA approved for the disease they have a place in the...
SC, Good going. Keep up the good work! Redwing, ask for a 25-Hydroxy D test. The CPT code is 82306 and the normal range is 30-100 ng/ml. The prefered range is over 50 ng/ml Best regards. RalphV...
In 1975 male life expectancy was 68.6 years. In 2011 male life expectancy was 76.3 years. This difference alone (7.7 years) has to create a difference in the populations involved. As you all well...
Tony, This morning when I looked at the HW board there were two posts from you. The second post that contained your words dangerous and appropriate prompted my response. That second post has now...
Tony, In what do you base your conclusion? Find a post of mine in which I have negated the potential value of AS in preventing overtreatment. Find one here or anywhere else in the past 22 years of...
It is well known that there is a variation between diagnostic pathology and surgical pathology. Many studies during the last 20 years have shown such difference. The reason I posted the Stattin et al...
Tony, In the Results section of the study: "Results Among Swedish men with clinically localized Gleason 6 prostate cancer approximately 50% had adverse pathology at radical prostatectomy. Of the men...
The cited study tried to predict these adverse pathologies for men BEFORE surgery. These men all qualified for AS protocols before surgery but the surgical pathology was different from the...
RCS, This is the actual text: "Overall 2,235 (50%) men had adverse pathology at RP, with a slight change over time from 50% in 2007 to 54% in 2011 (p = 0.20). On univariable analysis predictors of...
We can argue about PSA testing until the cows come home. It is easy to say that GS6 is harmless but as it stands in today's world we need more than words… In a recent issue of the Journal of Urology...
Hello Jerry, One important issue I forgot to mention in the previous post is the fact that even when DHT in serum is at low levels (as determined by test) research has demonstrated that intratumoral...
Hi Jerry, The use of Proscar or Avodart to treat prostate cancer is not a recognized label use for these products. In spite of this, they are used in hormone suppression protocols when maximal...
Robert, Mr. Faloon (the author of the LEF article) was critical of the study because an overdose of estradiol inhibition. The reality is that Finkelstein JS et al tried to identify the physical...
The mechanism by which Ketoconazole can affect androgen production is related to its capacity to inhibit the CPY17 enzyme. This enzyme is intrinsically associated to the syntesis of androgen. Because...
The question of Proscar (finasteride) reducing PSA by 50% needs an explanation. Finasteride was developed by Merck to treat prostate enlargement (BPH). Since BPH and PCa are two diseases that could...
Finasteride is a lighter form of androgen deprivation treatment. It was marketed to treat prostate enlargement by inhibiting the conversion of testosterone (T) to dihydrotestosterone (DHT). When used...
JohnT, A somewhat pessimistic view of this issue in my opinion. You fail to explain the 40%+ reduction in PCa mortality and an equivalent reduction in BCa mortality. This reduction in spite of longer...
There are many ways to interpret the survival benefit of the currently available drugs for prostate cancer. Understanding what median survival represents is vital. The best interpretation was...
Hi Bob, Actually prostate cancer mets to the lung are very common. The reason is that the blood drainage from the prostate goes directly to the heart and from there to the lung. Fortunately although...
Both Proscar and Avodart in clinical trials showed to reduce prostate cancer by about 25%. In the Proscar trial (PCPT) the incidence of high grade PCa was slightly higher (0.5%) in the treatment arm...
David, It all depends on the lower detection limit of the assay used to measure PSA. Different assays have different lower detection limits. If the lower detection limit of the assay is <0.03 then a...
Hi PhilC, Maybe I am interpreting your profile wrong. According to the profile your last shot of Lupron was 5/28/13. That depot would be exhausted by or around 8/28/13. I assumed you also stopped...
Hi PhilC, Tall Allen gave you a good representation of your current situation. Slow down! You are currently 8 months down the road from aggressive treatment and as your testosterone rebounds the...
Hi John, Your surgical pathology provides both positive and negative aspects. Lower GS 6; negative SVs and negative LNs are positives. On the negative side you report positive margin. PNI can be...
Hi Doug, I am guessing you do not have a PSA level after the surgery. That result will dictate how successful has the treatment been. It will be nice to have a baseline testosterone anyway and...
Peter, Years ago while searching for an answer to the cause of PCa I ran across AW Meikle's research efforts with steroidal hormones and their relation to PCa. Then like now some said that high T...
Mel, Those results are normal in most blood ranges I have seen reported. See for example: http://www.mayomedicallaboratories.com/test-updates/attachment.php?id=27704 That said it is common to be...
Doug, It is not easy to find an answer to your question in the medical literature. In the past I tried to answer the question. What follows is a long answer after a search of what is available (that...
Hi Tony, I have seen that video before but I went to your site and saw it again. The AUA might not be against testing below the age of 55 or above the age of 69, but their guidelines do not recommend...
Hi Tony, Drs. Vickers and Carlsson are two of the authors of the studies mentioned in this thread. Their 2013 video at the 2013 AUA Annual meeting presented a general view of the differences between...