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Casodex as a Recurrent Cancer Treatment Option

Terry and I had a brief exchange of ideas on the above named subject in this section several weeks ago. My research results and the decision-making process leading to the rejection of this option appear in the last three entries of my ongoing journal. For those of you who may be interested in how this turned out, see:
http://protondon.blogspot.com/

Re: Casodex as a Recurrent Cancer Treatment Option

Don, I have followed your story for quite some time and am sorry that you're having to contend with the possible failure of your PBRT treatment. I know you've been a huge booster of it since your time at UFPTI.

In any event, in my ongoing reading I came across the below article that I would offer for your consideration --

"Dutasteride as a second-line treatment for men failing first-line treatment for localized prostate cancer"

http://prostatecancerinfolink.net/2012/11/29/16779/


Let me know what you and your medical team think. It seems to offer a promising, relatively risk-free interlude before you'd have to embark on anything like traditional hormone therapy.

Re: Casodex as a Recurrent Cancer Treatment Option

R. Scott:
You are absolutely right; I was a major advocate of PBT following treatment, and I used my journal to promote this option every chance I got. I remain a believer, but as you may well imagine, my credibility has been seriously compromised. From some of your other comments on this forum I see you advocate PBT based on personal experience. Keep up the good work.
I reviewed the article you referenced. It looked very, very promising. I then googled dutasteride and focused on side effects and the comments of patients who used it for their BPH. Whether the disadvantages and risks involved outweigh the effectiveness seems questionable. At this point I will keep it on my radar screen and bring the question up with various practitioners as I interact with them over the next few months.
Thank you so much for the thoughtful response. It is just the kind of feedback I am looking for.
Best wishes Don O.

Re: Casodex as a Recurrent Cancer Treatment Option

G'day Don,

I don't have any experience with Casodex, but my interest in this story is to do with dutasteride.

You wrote :
"I then googled dutasteride and focused on side effects and the comments of patients who used it for their BPH. Whether the disadvantages and risks involved outweigh the effectiveness seems questionable."

As someone who has been having daily dutasteride for 23 months with very little noticeable side effects (except for a 60% reduction in PSA), I am wondering what "disadvantages and risks" you are concerned about.

My use of dutasteride is officially to control BPH, but I am also a believer in dutasteride as a drug that may slow down prostate cancer cell growth.

If you believe Dr. Patrick Walsh, dutasteride causes higher grade cancers and has no redeeming features. He was able to convince the FDA that dutasteride was not a valid cancer treatment. At the other end of the scale, Mark Scholz thinks that finasteride and dutasteride are useful to “treat prostate cancer after it has been diagnosed”.

I am committed to the idea of taking dutasteride indefinitely to maintain the best possible urinary function and with the hope that it will also inhibit the growth of my small volume prostate cancer and keep it small.

Don, you can read some other comments about my use of dutasteride in my YANA story.

yananow.org/display_story.php?id=131

All the best from Brian Watts in Australia.

Re: Casodex as a Recurrent Cancer Treatment Option

Brian:
Thank you so much for your input. I read your YANA story. Like you I am inclined to place a somewhat higher value on quality of life rather than longevity. You are to be commended for participating in your own treatment, developing a successful strategy and sticking with it.
My casual, limited research into dutasteride produced the following results:
One drug company warned "may cause serious side effects including a higher chance of a more serious form of prostate cancer." Other more common side effects included impotence and enlarged or painful breasts.
User comments icluded the following:
"reduction of sex drive and erectile problems"
"total impotence and loss of libido"
"my body hair all disappeared"
I promise you this: The more good things I hear or read about dutasteride, the more likely I am to raise this issue with my oncologist when I see him next.
Thanks again for your thoughtful response.

Re: Casodex as a Recurrent Cancer Treatment Option

Just to add my two cents worth (that's about 3 US cents I think!)

There was a tremendous row in the PCa world about the higher chance of a more serious form of prostate cancer developing from using dutasteride following the publishing of the results of the long term study looking at this.

The essence of the disagreement was that the study seemed to show that
a) dutasteride reduced the incidence of PCa BUT
b) in the fewer cases reported, there was a greater number of tumours with a higher Gleason Score.

BUT........ many well informed PCa professionals weighed in and disagreed with the findings of the study. Dr Gleason (he of the Gleason grading system) went so far as to say that due to changes in the cellular structure brought about by the drug, the grading system should not be used in assessing material from men who had been on dutasteride. This being the case, it was not possible to say if the 'more serious form of cancer' was in fact more serious after all or merely a misinterpretation of the biopsy samples.

Of course I thought (but did not say) that if the grading system could not be used for distinguishing higher grades, it shouldn't be used for lower grades either.....which in my simplistic way made me wonder if it had in fact reduced the incidence of the disease, or just the number of cell groups labelled as adenocarcinoma.

Just my odd look at things.

All the best

terry

Re: Casodex as a Recurrent Cancer Treatment Option

More proof Terry that if rules do exist they are vague and ambiguous.

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