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What is the thought process for this?
Prostate Cancer | Last Active: Jan 29 10:45am | Replies (17)Comment receiving replies
hmmm
My experience, my perspective....
Attached is my clinical history.
After I completed triplet therapy in May 18 with my last 90 day Lupron shot, by October my T had recovered to 300+, by Feb 19 400+ and when we measured before starting doublet therapy in April 2023, 600+. And ye, my PFS was nearly five years. So, if T is the fuel and a danger when breaking from treatment, why did I go nearly five years before activity?
I am at 16 months post doublet therapy now. PSA has remained stable at .03, T is 400+, we'll measure in December. Again, why if T is the fuel...
When I asked my medical team, shrugged their shoulders, gave me the deer in the headlight look and said, you're not complaining, right! There is science and art when it comes to medicine.
Don't mind me, I may be a statistical outlier.
Kevin
As to ADT and done density. I didn't take any type of strengthening agents, but I do a lot of resistance training, Bone density scans are normal.
Replies to "hmmm My experience, my perspective.... Attached is my clinical history. After I completed triplet therapy in..."
@kujhawk1978
Your story and the issues are really all about "the thought process" that almost every medical procedure involves but seems a little more forward with the current PC therapies.
Radiation is an attempt to kill the cancer but it's not always 100% successful, which is why it is used in combination with ADT. OK maybe it's seldom successful and that's why it's used with ADT. But hey, it *might* sometimes really be successful! Maybe the ADT helps it be successful. And if and when it is successful then T isn't the fuel anymore because there's no more malignancy to fuel! But it's hard to know if it's successful.
And so the practice recommendations are to err on the side of caution. Even if the treatment is 100% successful today, if you were susceptible before it could recur de novo tomorrow. This is where the "art" comes in, trying to outguess the future.
Doctors are supposed to know this all but it's complex and statistical and in practicing their practice (!) doctors seldom have time to work it all through for themselves and aren't in the business of educating all patients on the mathematics of statistics so they simplify and shrug and appeal to "art".
How much of an outlier are you to be on the good side of this story? That's kind of the question I came to this group to try to understand. I still haven't run across anything like a clear answer but it seems doctors aren't handing out blue ribbons even in the best of cases, LOL.
My friend has been on ADT for a year, with a scheduled six more months to go, his PSA has been some miniscule number since right after the radiation, seemed modest and limited at the start - but I haven't heard him mention any bone density drugs, I will ask about it. He has stayed mildly active if rather less than before the ADT but he seems to suffer pretty much every possible side-effect, so I'm curious how much he's discussed it with his doctors.
Thanks.
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I agree about the science and art distinction. It seems most people prefer one over the other. My perspective is that a marriage of the two might be helpful, with neither dominating. Each has valuable insights to share with the other and their progeny might look like a cure…