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He covers the dangers of high dose DES but emphasises that most of the problems are overcome when DES is delivered in what he terms a parentral route - by injection or absorbed through skin patches.
I managed to persuade my oncologist, against all his objections, to agree to my using DES after I suggested that he check on some of the studies published since his graduation on the subject since those were more positive possibly than the older studies - for the reasons mentioned by Bob. I wouldn't suggest this approach to anyone unless they have a good relationship with their oncologist!!
I have chsoen not to start with the DES right now, as set out in my latest update, but will almost certainly head down that route in the fullness of time.
Re: How strange can HT therapies and results get? Just as strange as the disease-No Rules applies
Interesting too Terry that studies showed the i.v. method to be useful in like 70% of all patients testing it in any PCa scenario. I did not realize that DES orally like I used is way less on the general hrpca and HT naivee cells at 24-28% effective. So, I could be very fortunate in my case for such long duration, with highly aggressive/risk stats from day one.
Dr. Myers considered DES somewhat a carcinogen, but that was found in females using estrogen drugs. I like Myers alot, just not sure he has enough evidence to prove this idea as a real risk in men with PCa, might be correct though. I do know my results and side effects over all the years, was real and tangible...as a patient results is huge, less side effects also huge, saving your bones in PCa likely priceless (for as long as that can happen).
My main point is that in PCa, not everyone responds to drugs the same, and you cannot possibly know with ut most certainty how you will do on a drug, until you try it on your own case. This can be seen in other patient histories, so something to consider if you have uncurative scenario.
With Zytiga now available without having to do chemo prior (as it was mandated before), will open up more useage among patients, for many it may work and may work better than Keto (even though Dr. Myers questioned that in his 2009 video, as to is it known to be better, we kind of assume it is).
I suspect MDV3100 (super casodex) to join in this same approval next year, and by pass the failing on chemo program they currently have in the Early Access Program being used by patients right now. Thus Zytiga will find a new competitor. I would welcome trying MDV3100 if I get the chance it binds to AR receptor better than anything invented, the odds of it working are high.
Re: How strange can HT therapies and results get? Just as strange as the disease-No Rules applies
Terry
I will see if I can get a copy of Chodak's book.
Why is a good relationship so important for DES therapy?
Terry and Bob
Can you help me locate any recent DES studies that may be helpful?
Bob
I don't mean to be such a pest, but can you provide me more detail on the 2003 study you cited,e.g.,Vol.No., specific publication date, full title, author's
name(s)?
Re: How strange can HT therapies and results get? Just as strange as the disease-No Rules applies
Don,
I only mentioned the good relationship because it can be difficult to persuade some of the medical deities to even consider something that they KNOW is not correct. Medical beliefs are often not based on medical facts:-)
I don't think there are any new DES studies because the medical belief is that it is too dangerous and no better than other ADT drugs. Of course the dangers of heart related consequences idintified for low dose DES do not seem to be any greater than similar risks identified many years afte the adoption of the 'safer' ADT drugs, but......well that would clash with medical beliefs.
I'm posting one of the old study abstracts to start you on your hunt:
Low-dose oestrogen in the treatment of advanced prostate cancer
Br J Urol 1996 Dec;78(6):921-7; discussion 927-8 Related Articles, Books,
Experience with low-dose oestrogen in the treatment of advanced prostate cancer: a personal view.
Bishop MC.
Nottingham University Hospitals, UK.
OBJECTIVE: To re-evaluate the treatment of advanced prostatic carcinoma with diethylstilboestrol (DES) in low dosage in relation to the degree of suppression of plasma testosterone.
PATIENTS AND METHODS: The study comprised 106 patients with advanced carcinoma of the prostate (89 with T3/4 M1 and 17 with T3/4 N0/1 M0) who were treated with 1 mg/day of DES. The response was assessed clinically and by the change in plasma prostate specific antigen, prostatic and phosphatase and alkaline phosphatase, and plasma testosterone was monitored regularly. In a few patients it was possible to reduce the dose to 0.5 mg/day DES; in others, the initial response was not sustained and they were treated with an increased dose of DES or bilateral orchidectomy.
RESULTS: Seventy patients (Group 1) showed a sustained response to 1 mg/day of DES (0.5 mg/day in three) and 50 remained in remission at a mean of 21 months of treatment. Of the 36 patients offered secondary treatment, 12 (Group 2) responded with a second remission. Only 27% of patients had mean testosterone levels in the castrate range (0-2 nmol/L) but most in Group 1 had mean levels of < 10 nmol/L, whilst in 10 of the 12 patients in Group 2, the level was > 10 nmol/L. Overall times to progression and death were comparable with the results of conventional monotherapy or combination treatment and complication rates were acceptable.
CONCLUSION: Low-dose oestrogen therapy (1 mg/day of DES) is cheap, effective and caused few side-effects, none of which was life-threatening. In many patients, only minimal suppression of the plasma testosterone was required and the response appeared to be qualitative, although there was considerable variation in the threshold of response. A randomized trial of oestrogen, in a minimal dose adjusted to the requirements of the individual patient, against conventional hormone treatment now seems justified.
Re: How strange can HT therapies and results get? Just as strange as the disease-No Rules applies
I thought I posted that link prior:
http://ffyates.com/prostate/des.pdf (nov. 2003 J. Urology)
(old stuff: Complete remission w/DES: Journal of Urology 1955, 153 (6): 1944-5 (maybe at www.ncbi.nlm.nih.gov/pubmed/7752364 )
www.jurology.com/article/S0022-5347(05)62916-3/abstract (in my old notes??)
Dr. Premoli on estrogen patches & DES: www.pcainaz.com/Pages?ETE_eng.pdf
*docs make alot of money on LHRH drugs like Lupron and don't generally bother to go and look over all these 2nd line drugs, but might, but also oncologist do look at most everything for PCa control in their patients. Rarely will any hospital endorse using these drugs: eulexin, nilandron, avodart, proscar, ketoconazole, DES, emcyt, estradiol patches or gels, leukine,thalidomide, and some others. They do heavily endorse Lupron (mostly), sometimes casodex, definitively chemo drugs (very profittable too).
Watch some of Snuffy Myers videos on 2nd line hormone therapies, very enlightening as to what can be achieved in patients and himself with PCa still doing excellent around yr. 10-12??? now.
