Prostate Cancer in China

[Guest guest]

Dear TCM group,

 

I am copying this post from another medical group with the permission of the

sender. If anyone has any suggestions they would be much appreciated. I will

post relevant responses to the message owner. A couple of questions from me:

Is castration for prostate cancer a frequent treatment in China? For how

long has the practice been going on ? [in the west it was " discovered " in

the early 1940's]. My response to the patient queries are below the main

text. Many thanks for your input. Sammy.

 

 

~~~~~~~~~~~~~~~~

 

Dear Doctors,

 

I am writing this for my dearest father who lives in China. He was diagnosed

almost six years ago with metastasis PC. For the first four years after his

initial treatment (orchiectomy) he was feeling great but things started to

get worse since last year. Currently he has mets to his urethral tract,

penis and several bone sites. The doctors he has are not very helpful. We

regret not being knowledgeable in the past but we think actions need to be

taken immediately now. Being his only daughter and so far away from him I am

deeply saddened and feeling helpless. I hope you could provide us some

guidance in controlling of his disease progression even at this late stage.

 

Current age-73

09/15/98- DX at age of 68 through biopsy, bPSA 35, bone scan-5 hot

spots, DX-D2

09/22/98 Orchiectomy, TURP to relieve urinating difficulty

ERBT to prostate bed from 10/98 to 02/99

Flutamine for about a month but stopped because of liver

toxicity

04/99-PSA-1.2 (Lab A)

09/99-PSA 0.7

7/00-PSA 0.8

07/01-PSA 0.015 (Lab B)

07/02-PSA 0.14

07/03-PSA 1.4

10/03-PSA 2.6- difficult to urinate

12/03-PSA 5.4

DX-scar tissues built up in urethral tract (major mistake!)

TX-E-beam remove the scar (we think it is a major mistake) but did biopsy on

the tissues, GS (5+4)

01/07/04-Starting Casodex 50mg/day

02/-PSA 2.41

03/-PSA 2.18

04/-PSA 2.50

05/-PSA 2.80-minor pains in the hip

06/-PSA 3.08

06/14/04 urethral tract ultrasound found spread to urethral tract and penis.

Unable to urinate

06/22/04 Tx-urinal diversion

07/24/04-PSA 4.12, AKP 131

Stopped Casodex, Start Proscar and Mobic (Celebrex is not available in

China)

08/03/04-MRI Pelvic confirmed PC spread to seminal vessel and urethral

tract.

08/04/04-BS (ECT), 7 hot spots in bones

Overall health is good besides borderline diabetes.

 

Questions:

 

1. Is he hormone-refractory?

2. In Dr. Myers' paper on PCRInsights Vol 5. No 2 " Androgen

Resistance Part I " he commented that the T level on the prostate issue is

only reduced to 75% for surgical castration patient. Does that mean that

Lupron does a better job than surgical castration? Is there any benefit to

use Lupron in surgical castration patients?

3. What should we do next? Some doctors suggest use SR89 but we

are worried that it is not going to control the progression.

4. Should we try second -line hormone therapies? We thought

about HDK but are worried about the side effect especially the liver

toxicity.

5. Should we consider chemo at this point? Which protocol is

the best and has the minimal side effect? My father is worried about taking

Eymct because he read a book that says that the disease progresses much

faster once you stop taking it. Most of the doctors in China do not believe

in Chemo for treating PC patients. They said that Chemo is not effective.

6. Are there any other things we should do?

 

Your help will be appreciated very much.

 

Yingqiu

-a heart aching daughter

 

 

~~~~~~~~~~~~~~~~

 

Greetings Yxxx,

 

Sorry to learn of your father's difficulties.

 

I hope the P2P doctors reply with advice on testosterone supplementation /

replacement, as this is a valid option for your father at this time.

 

Although I am not medically trained I take a great interest in this illness.

You can see my web page at: www.prostateman.org. Yxxx, I should be very

grateful if you would allow me to copy your post to the P2P to another

medical group. I will ensure the personal details are made anonymous and if

I get any relevant replies, I will pass them to you.

 

Sincerely,

 

GA " Sammy " Bates

BA., BSc., MSc., PGCE.

 

PS. Here is my 'lay' response to your questions.

 

> 1. Is he hormone-refractory?

 

I believe so. A rising PSA over several months indicates this.

 

> 2. In Dr. Myers' paper on PCRInsights Vol 5. No 2 " Androgen

> Resistance Part I " he commented that the T level on the prostate issue is

> only reduced to 75% for surgical castration patient. Does that mean that

> Lupron does a better job than surgical castration? Is there any benefit to

> use Lupron in surgical castration patients?

 

As your father has been castrated it is a moot point surely? Academically

speaking Lupron+Casodex may do a better job for a time, BUT HRPC emerges

eventually, regardless of the type of castration - chemical or physical.

Hence HRPC is the issue to address.

 

> 3. What should we do next? Some doctors suggest use SR89 but we

> are worried that it is not going to control the progression.

 

Typically Sr89 will control bone metastases for a few months. Overall the

treatment may weaken your father because the radiation affects the blood.

What is his overall health like?

 

> 4. Should we try second -line hormone therapies? We thought

> about HDK but are worried about the side effect especially the liver

> toxicity.

 

This is a possibility. Strum will mention details if he replies. In the UK

(from where I write) there is NOT a lot of enthusiasm for HDK for prostate

cancer, thus relatively little is know of the 'ins and outs'.

 

> 5. Should we consider chemo at this point? Which protocol is

> the best and has the minimal side effect? My father is worried about

taking > Eymct because he read a book that says that the disease progresses

much

> faster once you stop taking it. Most of the doctors in China do not

believe > in Chemo for treating PC patients. They said that Chemo is not

effective.

 

There is a chemo protocol using platinum with minimum side effects. A member

of another group (in the UK) will be reporting back eventually. You may like

to join that group and ask further questions about it. Subscribe by sending

an email to ProstateCancerSupport-

 

> 6. Are there any other things we should do?

 

I believe testosterone is a valid option as mentioned. You could also

consider asking your father to take a supplement called coriolus versicolor

(CV) in the west and known as yun zhi in pinyin (cloud mushroom). Start at

1-2 gm per day and build up to 5 gm x3 per day over a few weeks. This

supplement has been shown to improve well-being for patients undergoing

radiotherapy or chemotherapy, improving stamina and immune function.

http://www.mycologyresearch.com/ (I have no financial interest)

 

Sammy.