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With a Gleason 9 PCa, four years ago I had EBRT which, with ADT since, brought my PSA down from 62.3 to 0.3. As so often happens, it began to rise slowly a couple of years ago and was at 1.9 at the end of January. At this point it became apparent to me that the EBRT (through scatter effect) had caused three very small bladder tumours close to the prostate. My oncologist is non-committal on this view of mine (I think because bladder cancer occurs in only about 1-2% of EBRT treated cases and there just isn't enough evidence out there about cause and effect).
Anyway, to my point abour killing cats. I'm being treated with Gemcis (Cisplatin and Gemcitabine) over four three weekly cycles to deal with the bladder cancer as a pre-treatment before a possible radical cystectomy. Already, after two cycles, my PSA has come down to 0.7, which has bought me a couple of years. I assume it will drop some more over the next six weeks.
So chemotherapy may not be a regular treatment for prostate cancer that has not become hormone refractory (mine hasn't by the Phoenix definition), but at least in my case it seems to be having an unexpected and beneficial effect.
I write this to give hope to others who may think their options are limited to the usual treatments. They aren't. You may be able to find someone prepared to try "off-label" use of an approved chemo drug set, such as Gemcis, which on my evidence anyway is doing better than what the usual (approved)chemo for hormone refractory PCa is expected to do.
If you want to try another drug "off-label" try Aldara skin cream on pre-cancerous skin lesions. It is an immune system modifyer that causes the body to attack types of early skin cancer. When I was using it my PSA went from 7 to 2. This was before I had a confirmed case of PC so my doctor assumed that I couldn't have PC since my PSA went back down so low. I think what might have happened is that the Aldara caused my body to also attack the PC. Unfortunately it is not a lasting effect because once the skin cancer is gone it doesn't work anymore but I think Aldara given at the right time might really help in completely killing off a case of PC when used with other treatments like radiation and hormone treatment.