Should Men with a Rising PSA After Surgery Add Taxotere to Their Hormone Therapy?

A total of 413 relapsing prostate cancer patients whose PSA doubling time was less than nine (9) months and whose PSA was over 1.0 were evaluated.  Half of the men were treated with Lupron and the other half received Lupron and Taxotere (docetaxel®).  The study information is preliminary after only 2.5 years of follow-up but a statistical trend toward an improvement in cure rates was observed in men treated with Taxotere (docetaxel®) and Lupron.

The preceding abstract was presented at the 2015 meeting of the American Society of Clinical Oncology (ASCO) by Dr. Michael J. Morris of the Memorial Sloan Kettering Cancer Center in New York.

Food for Thought; Our Help in Weakness.

God always provides!
Food for thought. God always provides! Photo from BJ Gabrielsen’s yard

When we as individuals put our faith in Jesus Christ’s sacrifice for the payment of our sin debt to God, and asked Him to come into our lives, we received a special gift, namely the presence of the Holy Spirit Himself.  John 14:16-17 (NewAmerican Standard version) expresses it this way.  “And I will ask the Father, and He will give you another Helper, that He may be with you forever; that is, the Spirit of truth, whom the world cannot receive, because it does not behold Him or know Him, but you know Him because He abides with you, and will be in you.”  This Helper will stand alongside us in any trials we may face.

We men often face life’s issues (e.g. prostate cancer or other crises) with a stiff upper lip, trusting our own ingenuity and skills to get us through.  In choosing to follow the Lord, however, we agree to adopt a totally different mindset.  We’re weaker than we could have imagined but through the Holy Spirit, we are stronger than we dare to hope.  Whether our struggle is physical, emotional or spiritual, we can rely on the Holy Spirit to intervene with God and help us.  The apostle Paul gives us a perfect example of what this looks like.  While dealing with pain from a physical condition, Paul prayed that the Lord would take away what Paul referred to as a “thorn in the flesh”.  Instead of removing it, God said His power would be manifested or “perfected in weakness.”  (2 Corinthians 12:9).  Too many Christians operate under the misconception that “God helps those who help themselves” or that God helps us only when we have gone as far as we can go.  In reality, His Spirit doesn’t add to our strength, like some kind of spiritual steroid.  Instead, when we admit we are powerless to help ourselves, the Holy Spirit gives us the strength we need to face any challenge with absolute confidence in God.

If you are not sure of your relationship with God and His Son Jesus Christ, and therefore may not possess the Holy Spirit’s presence and power in your life, please see the website section entitled “How to Enter Into a Personal Relationship with God.”  Portions of the above were taken from the InTouch devotional dated October 8th, 2015 by Dr. Charles Stanley.

 

Don’t Let Yourself Go! The Benefits of Exercise During Hormone Therapy

Old fishing boats, Placida, S.W. Florida; Photo: BJ Gabrielsen
Old fishing boats, Placida, S.W. Florida; Photo: BJ Gabrielsen

A recent article written by researchers from the University of Southern California was published in the August 2015 issue of Prostate Insights from the Prostate Cancer Research Institute.  The article discussed how exercise may help with treatment-related side effects of hormone therapy (ADT) and what types of exercise were most effective.  Two of the primary side effects of ADT are the loss of muscle mass and increase in body fat within 3-12 months of starting treatment.  These effects, termed sarcopenic obesity, also contribute to insulin resistance and greater risk of diabetes.  Prevention of muscle loss was observed with exercise programs that were at least three (3) months in duration and involved resistance exercise rather than aerobic exercise although both were recommended.  Resistance exercise utilizes weights (machines or free weights), while aerobic exercise such as walking, cycling or swimming, elevates heart rate.  Weight exercises should be done two (2) or three (3) times per week targeting the major muscle groups beginning at moderate intensity and progressing to more vigorous intensity with limited rest periods.  For example, a chest press exercise which involves more muscle mass is preferred over a biceps curl exercise.  In addition, the exercises should start at light weight and high repetitions (>12) and slowly progress throughout the weeks to heavier weight and less (around 8) repetitions.  Minimal rest sessions of less than one minute should be taken between sets as a way of keeping the heart rate elevated in a manner similar to aerobic training.  It was also found that performing either aerobic or resistance exercise at least twice a week reduced fatigue, another side effect of ADT.  In summary, regular exercise incorporating resistance and aerobic training should be carried out 2-3 times per week.  Resistance exercise should focus on large muscle groups (e.g. chest press, leg press and leg curl) combined with dynamic movements e.g. squats, lunges. Also, remember to discuss starting any rigorous exercise program with your physician.

AR-V7: A Genetic Test to Determine Effectiveness of Enzalutamide and Abiraterone.

When prostate cancer becomes “hormone resistant” or refractory, anti-androgen drugs such as enzalutamide (Xtandi®) and abiraterone (Zytiga®) are often prescribed.  But not all patients respond equally. Some 30 percent of men with advanced prostate cancer have an abnormal version of a prostate cancer protein that connects with testosterone.  The protein is missing a key connector that binds to abiraterone and enzalutamide.  The abnormal protein is caused by a genetic variant called AR-V7.  Most patients who test positive for AR-V7 get limited or no benefit from abiraterone or enzalutamide.  Researchers at Johns Hopkins in Baltimore have invented  a test for the genetic variant, AR-V7.  However the test is available for research purposes only at this time.  More information can be found in the linked article and in a blog published on this website on May 7th, 2015.

 

Don’t Miss a New Blog Post; Sign Up for Automatic Email Delivery.

Blood moon taken September 28th; Photo by Arnold Dalene
Blood moon taken September 28th; Photo by Arnold Dalene

While not every blog may be applicable to your specific condition and interest, you can get them delivered automatically to your e mail address.  Just go to the lower right hand corner of the Godandprostate home page and enter your e mail address.

Taking Charge of Your Prostate Cancer Recovery; Old Model Revised.

The following is from the October 7th Prostatesnatchers, as written by Ralph Blum and urinary oncologist, Dr. Mark Scholz.  I urge the readers to subscribe to their periodic e mail posts.

In the old model of prostate cancer care, you were rushed into radical treatment–usually surgery or radiation–often without fully understanding all your options, or the risks and side effects involved. The entire process was focused on the tumor; minimal attention was given to you as a person, and little effort was made to explore the benefits of healthy lifestyle choices, immune-enhancing treatments, reasonable delays, and emotional support.  

The emerging new model of prostate cancer care recognizes the important role you can, and should, play in your recovery. The emerging model comprehends that simply attacking the cancer is not enough. Greg Anderson, who after surviving “terminal” lung cancer founded the Cancer Recovery Foundation, has said that “Retaining a medical team without doing everything you can to help yourself is like attempting to walk on one stilt.” So what do you need to know in order to take charge of your recovery?

There are three common misconceptions about prostate cancer: a) The assumption that the disease is as dangerous as other cancers; b) The assumption that the urologist who did your biopsy may be a prostate cancer expert; and, c) The assumption that a quick treatment decision is necessary before the cancer spreads.

First of all, prostate cancer is unique among cancers because the mortality rate is so low. Around two hundred thousand men in the U.S. alone are diagnosed with the disease every year, and less than 15% will eventually die from it, usually over a decade down the line, while a majority of men who have the far more common low-risk, slow-growing prostate cancer can anticipate living a normal life span, or dying of something else.

Your local urologist has a busy medical practice that involves treating multiple problems like impotence, infections, incontinence, and kidney stones. He also does biopsies. But the average urologist may perform fewer than five prostate removals (prostatectomies) a year–far too few to be considered proficient. He may be a talented doctor, but he may be an unlikely prostate cancer expert.  So once you have your biopsy results, it is best to consult a prostate cancer specialist, either at a major medical center, or at a high-volume prostate cancer clinic.

As for the third misconception, it is essential, before committing to any form of treatment, that you  do your own research, and are convinced the treatment you choose is the right one for you.  Do not let anyone rush you into making a bad decision. Once your category of prostate cancer is identified (Low, Intermediate, or High Risk), get on the Internet and learn about every treatment option–including no treatment whatsoever–for your type of disease.  If you are over 70, and have low-risk disease, my advice to you is to find a doctor who has experience monitoring an active surveillance protocol.

Your role in your recovery, however, doesn’t end with choosing your treatment. The emphasis on lifestyle changes has been one of the most significant shifts in cancer care in the last decade.  A study at UCSF showed that improving your nutrition, reducing stress and getting more exercise, can lower PSA levels.  According to a relatively new field of health psychology called “illness representation,” your beliefs and expectations also impact the outcome of your disease. So take charge of your recovery, and have faith in your choice of treatment. (Added note from this website: Make sure you have a personal relationship with God and then place your faith in His hands.)