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Interesting example of Rick K.(USA)-'Leibowitz protocol'~14 yrs.+
Apparently most men decide upon surgery for PCa, then radiations probably next highest choice and so, on.
Since there are dramatic new things happening in PCa advances like genetic, gene therapy, vaccines and other new approaches..that look like a real futures for treatments. Maybe using the Leibowitz protocol is more sane than some apparently believe, depending upon your original stats is a huge variable here, though.
Rick K. his case is interesting to me, maybe it is to others: diagnosed around 1996 with psa of 11.0 and two positive cores found and back then rated at Gleason 5 (2 + 3)...well today that is considered Gleason 6 I guess lower scores usually are not defined that low anymore? Anyway he took a huge leap of faith back then and wanted to remain 'intact', so did Dr. Leibowitz protocol of ADT3 (through a local doctor).
Lupron+ casodex (maybe higher doseage level) + proscar and only do it for 13 months, quit and stay only on proscar as maintenance therapy.
His manhood and normalcy came back to him in short amount of time (apparently this is huge consideration for most men...just read the posts after most guys have surgery). Well he went for years with no psa rises, so he even elected re-biopsies even at two times perhaps a few years apart (nothing found in those biopsies). He finally had some psa rise last year at 13 yrs. since diagnosis, now he still could elect to do: even surgery (harder to do now), radiations, cryo, hifu, and other stuff. What did he elect to do? Resumed ADT3 for a second round, which is in Dr. Leibowitz protocol, how long it works would vary alot...then later Rick could still chose various treatments. So, this may work similarly and especially for the lower stats presentations of PCa guys, and this is mentioned by Dr. Leibowitz on his website info, thingy.
Another interesting note, Dr. Fred Lee (inventor of cryo therapy) is a PCa patient himself, for many years now, he has been using emcyt (after failed radiation method) to control his PCa and with very good results which he even mentions in an article. How many people have you heard of using emcyt? Maybe it is a better control thing than we know of, it is in the estrogenic family.
Re: Interesting example of Rick K.(USA)-'Leibowitz protocol'~14 yrs.+
Rob,
Gleason 2+3= 5 might not even be diagnosed as PCa today, given the changes in pathology interpretation of the Gleason grades. At most it would likely be upgraded to GS 6 which is now ‘ entry level’ for prostate cancer, compared to 1996 whe it was mid-point.
The question that is raised in my mind by this example is Did Rick K need any therapy to start with?
On the information you have posted he would likely have been a candidate for Active Surveillance today and, as those studies demonstrate the majority of men in those studies do not show progression, at least over the period of the studies and between 20% and 25% of the men in the studies have negative secondary biopsies.
Coincidentally, of course, I was diagnosed in 1996, the same year as Rick.K. Unlike Rick I didn’t have the initial ADT3 therapy: like Rick I chose intermittent ADT (Zoladex) at year 12.
Re: Interesting example of Rick K.(USA)-'Leibowitz protocol'~14 yrs.+
I don't disagree with what you mentioned, but his psa was high at 11.0 which is a factor in that mix. Plus his PCa did seem to return, but about 13 yrs. later and now resuming ADT3 for 2nd round. Based on what happened in his case, I might presume it was good he did not do watchful waiting/surveilance.
But I agree that watchful waiting/surveilance is useful and sane in some cases(my brother is 5 yrs. at such now), and I supported you and did so years ago and still do, because that is a persons choice and option, maybe when one should change over from doing such is the hardest part to determine. What I think is more insane is surgery on indolent PCa patients whom want it all out(who doesn't) and don't realize at any stage there is no guarantees..we see some very low stats patients with recurrance...just hope they realized up front the 'no guarantee' and real side effects issues that can be permanent or devestating.
My own opinion: Question everything on PCa is always in the patients best interests, just because someone is a doc, does not mean they are an expert in the whole disease(let's include Leibowitz too). Ask about your lymphnode sampling or removal(s) prior to surgery and listen closely and compare to others and then see what Dr. Walsh would do. That might start a further educational process. I don't profess to know anything, I do see many reasons to question plenty.
