Avodart and Proscar

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Avodart and Proscar

Proscar (finasteride) and Avodart (dutasteride) are prescriptions pills FDA approved to treat enlarged prostate, or BPH  They are in a class of drugs call "5 Alpha Reductase Inhibitors".  They are not FDA approved to treat prostate cancer (in fact the FDA made a ruling about this in 2012) , or prevent prostate cancer, but they have been shown in some studies have an effect on both prevention, and treatment.  PCRI's Executive Director, Dr Mark Scholz wrote more about this in 2014 - Avodart & Proscar, and in 2011 - Avodart & Proscar for Men on Active Surveillance.   Proscar and Avodart also:

Dr Charles Snuffy Myers also uses this as part of his clinical practice:

See his short videos - 


Avodart for BPH + Active Surveillance


Proscar Vs Avodart

Avodart in Depth

Avodart + Active Surveillance

Avodart + PSA-Only Recurrent PCa

Proscar/Avodart + High Grade PCa

Weigh the risks and benefits for yourself.  Discuss with your physician(s).

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Active Surveillance

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Active Surveillance


Active Surveillance is a very reasonable option for most men with low risk prostate cancer.  Still, it can be challenging to fully understand what your risk category is (very low - low - intermediate - high), and challenging to consider NOT treating prostate cancer if you've been diagnosed with it.  Here are some resources that should help you:


article - Newly Diagnosed: Understanding Your Risk


article - Q & A with Dr Laurence Klotz (Leading AS Expert)


VIDEOS - Dr Mark Scholz & Prostate Oncology Specialists


BOOK - Invasion of the Prostate Snatchers by Mark Scholz, MD

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C11 Choline PET @ Mayo in MN/ C11 Acetate in AZ

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C11 Choline PET @ Mayo in MN/ C11 Acetate in AZ

Here's the info on the C11 Choline PET Scan (for RECURRENT prostate cancer) at Mayo Clinic in Rochester, MN.  

1) Slide Presentation from 2012 Conference, Dr Eugene Kwon. Here you will find the Power Points from a lengthy presentation at our Los Angeles conference last September. If you read the text below the PPt's, you will find the phone # for Dianne Mann at Mayo, and some other information that is helpful.

2) Short Video from 2011 Conference, Dr Eugene Kwon


Questions to ask Mayo Clinic:

  • Do I need to make an appointment with a Mayo Clinic physician first?

  • Is there a wait for the C11 Choline PET? (as of April 2014, there is a 2 month wait)

  • What is the likelihood insurance will pay for my PET scan?  (have your insurance card handy)



Here is information on the C11 Acetate PET Scan with Dr Fabio Almeida at Arizona Molecular Imaging


1) Video of slide presentation from June 2014 Dr Fabio Almeida


2) AMI website & presentation from Sept 2013


Questions to ask Arizona Molecular Imaging:

  • What will the cost of the PET Scan be (currently no ins coverage)?

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Almeida trial

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Almeida trial


Dr Fabio Almeida's center in Tucson, AZ

T

his is the first site to open for this interesting clinical trial using both Zytiga (abiraterone) and Xofigo (radium 223).  

All men will receive Zytiga + prednisone.  Some men will receive Xofigo, some will receive placebo instead of Xofigo.

Clinic visits are every 4-weeks for six months during treatment.  

 

Basic Eligibility Criteria for this trial:

  • Castrate resistant (Testosterone less than 50 w/ rising PSA)

  • 2 or more bone metastases

  • NO lung, liver, or other soft tissue metastases

  • NO previous chemo

  • NO previous Zytiga (abiraterone)

  • NO previous Xofigo or Samarium

  • Little or no cancer pain

  • NO atrial fibrillation, Crohn's disease, or ulcerative colitis


Location:

Arizona Molecular Imaging
Tucson, AZ

Contact: 

Elisa Blackwell 602.331.1771

**

Other locations to follow - View this link at ClinicalTrials.gov **

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Insurance and Financial Help

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Insurance and Financial Help


The PCRI does not specialize in helping with insurance issues and financial help.  But we clearly understand the need, and have these resources to share with you.  We have found these to be valid resources, and helpful over the years.  It still can take some work and research to find the right one for you.  


The Advocacy Connector
Search online for resources by state, disease type, and by type of resource.  Hundreds of organizations listed.

The Patient Advocate Foundation
Get help with insurance questions and issues, Healthcare reform questions, financial support for the needy, and much more.  Chat online, look through resources, or ask for a Case Worker to assist in your situation.

SHIP Talk

If you have Medicare, this website gives you access to actual Counselors who can walk you through any issue related to Medicare - from billing, to choosing a plan, to understanding your benefits.  You can chat online, find a physical location to visit, or call them directly.

Patient Access Network Foundation

Apply for help paying for drugs if you have insurance, but not enough insurance.  You must fit ELIGIBILITY CRITERIA.  You will need to search the site as programs change regularly, and assistance is only available when there are funds.  
This is subject to change, but currently there are programs for: 

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Shared Decision Making

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Shared Decision Making

Shared Decision Making is a concept where patients and families are part of the treatment decision process.  They work with the physician - together.  It is an important concept that is being accepted, encouraged, and even promoted.  It is an important part of Patient-Centric Healthcare.  

Here are a couple of articles that support this essential partnership between doctor and patient:

Shared Decision Making - The Pinnacle of Patient-Centered Care, 2012 New England Journal of Medicine

Shared Decision Making to Improve Care and Reduce Costs, 2013 New England Journal of Medicine

Also, The Mayo Clinic has an entire set of patient videos discussing "Shared Decision Making" - CLICK HERE to view 

Jan Manarite from PCRI gave a talk on this subject in Chicago, July 2014  - CLICK HERE to view

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Radiation Dosage and Safety

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Radiation Dosage and Safety

unfinished...

Many people ask about the safety of radiation in imaging, such as bone scans, CT scans, and PET scans.  PET scans give higher amount of radiation than CT or T99 bone scans.  Read more here - Naturally-occurring "background" radiation exposure.  (MRI and ultrasound do not use radiation, so may be alternatives in some cases.)  

Radiation dosage is usually measured using "millisieverts", or mSv.  
Some estimates say the average person in the U.S. receives about 3 mSv per year from naturally occurring radioactive materials in the environment.  Read more here - Naturally-occurring "background" radiation exposure.  

Men also ask about the safety of radiation treatment for prostate cancer.  

Radiation Treatment dosage is measured using Gray's, or Gy, which is the measurement of the 'absorbed dose' of radiation.  Since different types of body tissue absorb radiation doses at a higher or lower rate, Gy is used in prostate cancer radiation dosage measurements.

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