Opinion by Don Cooley
In one of the discussion groups a man made some statements of what is "standard" in the treatment of prostate cancer. His information was limited to the little knowledge he had an yet he spoke as if it was gospel. I replied with the following:
You make a too generalized statement.
I have used the well known name drugs but any drug that fit into that category would be used.
1. There is no standard treatment for those initially diagnosed with prostate cancer. A lot would depend on the diagnosis. It can be Watchful Waiting, Supplements, herbals, diet, Radiation (several types), Cryo, Surgery (several types) and hormonal ablation therapy (several kinds including castration). Could even include chemotherapy. And even doing nothing - not even WW.
2. The available treatments for someone who has failed his localized treatment and thought the disease is still localized (rarely) can be radiation to the prostate (several kinds), Cryo, surgery, and hormonal ablation therapy (several kinds including castration).
3. The available treatments for someone who has failed his localized treatment with known mets can be all of number 2 above to debulk (except hormonal - if thought useful - debatable). Add chemotherapy (many different kinds) and/or DES, Bisphosphonates,
4. If a patient has become HRPC, remove Casodex, use HDK, DES, and move on to various combinations of Chemo therapy along with or without Lupron, Bisphosphonates
Radiation - there are many ways that radiation can be done - almost as many ways as there are radiation oncologists doing them. The key is to get as much radiation to the Gland as possible without causing serious side effects. It is believe that it needs to be 8000 cGy (photon) or greater and yet few will give this amount. Than there are combinations of different radiation treatments and different beams used. There is no standard radiation treatment. There are some recommendations by various organizations and these are just that - recommendations. If radiation is done with care - there is almost a different radiation for every patient.
Hormonal Ablation Therapy - again there is no standard and it depends on who it is being done by - a urologists or a Medical Oncologists. It can be Lupron, Casodex, Proscar/Avodart or any combination of the three or any single of the three. In addition it can be any dose of Casodex. DES, castration, HDK all would be included in here.
Surgery can range from two or three ways to open up the body to remove the gland through laparoscopic including robotic.
Cryo can be to freeze the whole gland or any part thereof.
Chemotherapy can include drugs - many combinations, vaccines and other similar things would be included in this group.
WW ways can be numerous from doing nothing to taking supplements, herbal concoctions, diet, etc.
Finally any combination of the above at any place along the way would be acceptable.
And I have probably left out some. But there is nothing standard about the treatment for prostate cancer. Then you add to this certain drugs like NSAID's, etc. that are known to have an effect on prostate cancer. And you come up with an unlimited numbers of combinations depending on the disease at any one time.
Perhaps the only standard is there is no standard!
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Information You Should Read
Stanford Univ. video on PCa
The Prostate - What, Where
The Prostate Biopsy
How To Tell a "Physician Artist"
The Doctors Appointment
Insignificant Cancer
Vocabulary, Glossary, etc.
Tables, Tests, Markers etc.
Gleason Info and Partin Tables
PSA - What it is and means
Locally Advanced Cancer
BPH
Prostatitis
Other Diagnostic Tools
Veterans Information
