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TY,
In most cases active surveilance is an option but not in yours. You are young, have a high PSA, high percentage of cancer in your prostate and a mid to high Gleason Score. If the center you are at is part of clinical trial programs then they are probably a good place to get treated. Find out what you can on the clinical trial.
I haven't heard of a clinical trial using a "chemo" drug for initial treatment so ask what drug you would be on. They will give you a complete description of the trial if you ask. They just can't tell you if you are getting the drug or the placebo since the doctors won't know either (in most clinical trials).
P.S. - get a binder to keep all your papers in, have someone with you during all the appointments, join a PC support/information group and learn all you can about prostate cancer treatments
I have great admiration for anyone who joins clinical trials. Without them advancement of knowledge would likely be even slower than it is at present. BUT.....I think it is also very important for these brave people to have a clear understadning of any risks and or benefits that might be involved.
Frank has raised one of the key points - that in a blinded randomized trial such as this one, no one knows who gets the drugs and who gets a placebo. This is done so that comparisons can be made. If the study you are considering is the one I found, it would probably not be difficult to distinguish between the two groups (usually termed cohorts) in the study because the conseqences of the drugs being used can be quite severe and certainly noticeable and would not be felt by the men on the placebo.
I see that this is a Phase III trial, so tha means that some basic work has been done in Stages I and II - and those presumably indicate some potential benefit. I think you need to ask for the details of the outcomes of those studies - both beneficial and negative - so you can arrive at a balanced decision for yourself.
There are a number of other issues you might like to consider before making a final decision on your choice of therapy. I don't know if you have been to the DIAGNOSIS page of the site, but the various steps of obtaining as accurate a diagnosis as is possible are set out there. It is, in my opinion, well worth considering taking a number of those steps and those on the following pages of the site. IT may take a little time to gather the addtional information, but as Dr Stephen Strum, a well known oncologist, never ceases to repeat "Assess Status Before Determining Strategy."
Good luck whatever path you take
Terry in Australia
Ty,
I would like to join Terry in expressing admiration for those choosing to participate in clinical trials. I, like you, had a GS8 tumor but chose the path of proton radiation. Docetaxel (trade name Taxotere) is normally given as a one hour infusion every 3 weeks for a specified period of time as a cancer treatment. As part of my treatment I was given the option of receiving a reduced strength docetaxel (about 15%--my oncologist called it "Taxotere Lite") each week for one hour for a 9 weeks during my radiation. I am telling you this because if your trial uses this reduced strength it is well tolerated. Yes, some of my hair fell out and I lost my appetite but it was nothing like the terrible side effects of full strength chemo...I was retired at the time, but had I still been working in my office job, I would have had the energy to continue working while receiving this form of chemo.
Not all trials require bravery. I am on a large international trial where I was randomized to 6 months or 2 years of LHRH with radiation (I was getting the radiation for recurrence anyways). I got the 6 months and I get the advantage that the cancer center will monitor me more closely than a patient not on a clinical trial.
Just returned from the 2nd opinion yesterday and spoke with 2 doctors about the trial. If I qualify the two arms are either you get the Chemo for 5 1/2 months then to the Robotic surgery or you go straight to the surgery. Because I believe that I should have it removed at my age, it could be a win win (bad choice of words) state the Oncologist.
Ty,
The drug may not be really be a chemo drug. There are going to be a lot of trials using drugs like Aberaterone for early stage cancer that have only been tested on men with late stage metastatic disease. These type of drugs have mild side effects compared to the old line chemo drugs.
It does seem that you will be on a win/win trial. It was the same with me; I didn't know if, or for how long, I wanted hormone treatment with the radiation but I knew I needed the radiation salvage treatment so if I got hormone treatment thrown in all the better.
This is the trial that I copied and pasted. Let me know your thoughts please.
Surgery With or Without Docetaxel and Leuprolide or Goserelin in Treating Patients With High-Risk Localized Prostate Cancer
Official Title: Randomized Phase III Study of Neo-Adjuvant Docetaxel and Androgen Deprivation Prior to Radical Prostatectomy Versus Immediate Radical Prostatectomy in Patients With High-Risk, Clinically Localized Prostate Cancer
Summary
RATIONALE: Drugs used in chemotherapy, such as docetaxel, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Androgens can cause the growth of prostate cancer cells. Antihormone therapy, such as goserelin and leuprolide, may stop the adrenal glands from making androgens. Giving docetaxel and leuprolide or goserelin before surgery may make the tumor smaller and reduce the amount of normal tissue that needs to be removed. It is not yet known whether giving docetaxel and leuprolide or goserelin before surgery is more effective than surgery alone in treating patients with prostate cancer. PURPOSE: This randomized phase III trial is studying docetaxel and leuprolide or goserelin to see how well they work when given before surgery compared with surgery alone in treating patients with high-risk localized prostate cancer.
