By PCRI Helpline Staff

Has anyone ever beaten this disease? What are my chances of beating this disease?

If you are going to “get “ a cancer, Prostate cancer is the best cancer to “get”. It “typically” is a slow growing cancer; allowing you plenty of time to research how to best “beat” this disease. However, there are aggressive cancers and that is why you need to discern which you have. This is where not ignoring PSA is important. Yes, “beating” prostate cancer is possible.

I just want to get it out!

We need to change this mindset of “just get it out”. This way of thinking almost always leads to prostatectomy - which more times than not, is not the best treatment. There is not a guarantee that you will “get it out”. So coming to terms and educating yourself about your cancer is imperative to having a healthy, happy, “relaxed” mindset and life!

What is the the best treatment for prostate cancer?

As is almost always the case in any treatment selection, you need to ascertain what type of prostate cancer you have. Then, and only then, can you choose the best treatment. There are many questions that need to be asked and pertinent information that must be obtained in order for you to have the best answer to this question! The good news is that both can be achieved!

Does Testosterone give you cancer?

A bit of a complicated question- see short answer below. Read Jeffrey Turner, MD’s complete article in November 2015 Insights. There is no concrete evidence whatsoever that testosterone causes prostate cancer though it is clear that testosterone can stimulate existing prostate cancer cells to grow. The take home message, therefore, is that men who appear to have been cured of prostate cancer can indeed consider taking testosterone without concern that it will induce new tumors. This is a very different scenario from patients who have existing cancers, especially those who have aggressive, widespread, and castrate-resistant disease. Potentially such individuals with existing cancers could be harmed by taking testosterone.

Why does my doctor want to put me on Lupron and Casodex BEFORE doing radiation?

As a man ages, his prostate size increases. Therefore, if he has a “larger” prostate; it is advisable to “shrink” the prostate. Lupron (hormone therapy) achieves reduction of the prostate size. This is desirable so that the radiation area can be reduced and beams better focused. When taking a hormone drug (Lupron), there is a possibility of a “PSA Flair”. Casodex is used in order to block this Lupron flair.

After being diagnosed with Prostate Cancer, how do you know if you are a good candidate for “Active Surveillance”?

First, you need to understand your biopsy report. Within the report there is something called a “Gleason Score”. If your Gleason score is 6, you typically would be a good candidate for Active Surveillance. When your score is a 7 or higher, more “components” need to be assessed.

After initial PC treatment, when/how soon should secondary treatment be started if there is a PSA rise?

A prostate cancer relapse is signaled by a PSA rise after treatment. The term - “biochemical failure” - which means you are “relapsed” - following radiation. The use of Nadir (lowest PSA score after treatment) plus 2 (+2ng/ml) is typically used and is a determinant of patient outcomes and therefore, it is used to decide when treatment should be started. (Phoenix Definition) The rate that the PSA doubles typically dictates “which” treatments can be used.

How long can someone be on Lupron before “resistance” sets in?

The time period varies among men. In some patients, hormone therapy may slow disease progression for more than a decade; in others, it may keep cancer in check only for a few months. Eventually, prostate cancer cells begin to resist the treatment. A new oral medication called ARAMIS is being evaluated in men who have rising PSA levels on Lupron and whose bone scans remain clear. For more information, visit: https://clinicaltrials.gov/show/NCT02200614

 

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