intermittant hormone therapyh

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intermittant hormone therapyh

by coelacanth on Thu Jun 11, 2009 12:00 AM

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I've been on hormone therapy for 14 years. Lupron and casodex for

12 years, the last 2 without the casodex. Three month shots up until

2007, now the yearly implant. Original diagnosis Gleason 7 and

2 bone lesions. No lymph  node involvement.

Now my urologist wants to stop the hormone treatment. Says in my case

it would be safe to do. Not so sure.

Looking for opinions.

Dave 

 

 

 

RE: intermittant hormone therapyh

by Chrystalluna on Thu Jun 11, 2009 12:00 AM

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My husband has stage 4 prostate cancer, bone and lymph node.  He started hormone therapy in May of 08.  He is on a clinical trial that they took him off the hormone therapy (both injections and pills) in December.  He started out with a PSA of 31 and it was down to 3.  It has been going up every month.  Once he reaches a PSA of 20, they will put him back on the hormone treatment.  They think by taking him off of it intermittently, he will respond to it longer.

RE: intermittant hormone therapyh

by Badmamazoo on Fri Jun 12, 2009 12:00 AM

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Chrystalluna,

There is not enough evidence as to whether that approach will extend the time that hormone therapy will be effective---hence the present clinical study. I don't believe it will hurt or benefit but the main plus is it gives a man some "breathing room" from the side effects. That is a method I will be favoring when I eventually go on hormone therapy.

Dave,

I can understand your feelings; your long-term success with hormonal therapy is the exception...listen, if I were you, I would contact an oncologist for a second opinion. You literally have a sleeping monster in you and the last thing you want to do is wake that monster up. 

 

Joe

 

  

 

RE: intermittant hormone therapyh

by Johnw100 on Fri Jun 12, 2009 12:00 AM

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It is probable that the effects of hormone therapy  can be permanent after 36 months of treatment..

RE: intermittant hormone therapyh

by Chrystalluna on Fri Jun 12, 2009 12:00 AM

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Joe;

I am confused.  Can you explain what you mean?

RE: intermittant hormone therapyh

by Chrystalluna on Fri Jun 12, 2009 12:00 AM

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Johnw- how do you mean?  Does it work, or only work for 3 years?  My doctors don't explain any of this.

RE: intermittant hormone therapyh

by jcr65566 on Fri Jun 12, 2009 12:00 AM

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On 6/12/2009 Chrystalluna wrote:

Johnw- how do you mean?  Does it work, or only work for 3 years?  My doctors don't explain any of this.

 

Hi Chrystalluna maybe this can help you

Androgen blockade therapy for men with advanced prostate cancer often yields only a temporary fix or respite, not a permanent cure. Now, researchers at Johns Hopkins have discovered critical differences in the hormone receptors on prostate cancer cells in patients who no longer respond to this therapy. The findings, reported in the Jan. 1 issue of Cancer Research, could lead to a way to track disease progression, as well as new targets to fight prostate cancer.

Prostate cancer cells rely on androgens, male hormones that include testosterone, to survive and grow, explains Jun Luo, Ph.D., an assistant professor at Johns Hopkins’ James Buchanan Brady Urological Institute. Since 1941, doctors have taken advantage of this dependency to battle prostate cancer by depriving patients of androgens, either by surgical castration or by means of injectible drugs or by means of estrogen. For most patients, androgen deprivation therapy causes tumors to shrink, sometimes dramatically. However, it’s never a cure—unless the patient is elderly and dies of some other condition before his prostate cancer becomes hormone refractory, eventually his PSA will rise, signalling that the cancer is resurging in a stronger form, now resistant to the standby treatment.

Seeking the reason why this therapy eventually fails, Luo and his colleagues at the Johns Hopkins University School of Medicine, the University of Washington and Puget Sound VA Medical Center looked to a key player: the androgen receptors on prostate cancer cells.

Using a large database, the researchers searched for variations of the nucleic acid RNA that prostate cells use to create androgen receptors, eventually identifying seven RNA sequences different from the "normal" androgen receptor already known to scientists. When they looked for these sequences in cells isolated from 124 prostate cancer patients, they found over-production of these outlaw variants in prostate cancer cells taken from patients whose disease had become resistant to androgen deprivation therapy. One variation—known as AR-V7, was also prevalent in a select group of patients who had never taken hormone therapy, but whose cancer aggressively regrew after surgery to remove their tumors.

To see how androgen receptors made from AR-V7 differ from others, the researchers forced lab-grown prostate cancer cells to produce only the AR-V7 sequence. Unlike cells with other androgen receptors, those with only AR-V7 receptors acted as if they were continually receiving androgens—turning on at least 20 genes that rely on androgens for activation—even though no androgens were present.

The results suggest that hormone therapy might encourage prostate cancer cells to overproduce the AR-V7 receptors over time, leading them to survive and grow aggressively even without androgens, explains Luo. In some patients, he adds, AR-V7 receptors might already be prevalent even without hormone therapy, predisposing them to an already-aggressive form of prostate cancer that won’t respond as well to hormone deprivation therapy.

"We may eventually be able to develop an assay to test for this androgen receptor variant, giving us a way to test which patients are good candidates for hormone deprivation therapy and providing a way to monitor disease progression in patients already on this therapy," Luo says.

Examining the differences between AR-V7 and other androgen receptor variants may also provide researchers with new ideas to develop prostate cancer-fighting pharmaceuticals, he adds.

Other researchers who contributed to this study include Rong Hu, Thomas A. Dunn, Shuanzeng Wei, Sumit Isharwal, Robert W. Veltri, Elizabeth Humphreys, Misop Han, Alan W. Partin, William B. Isaacs and G. Steven Bova, all of the Johns Hopkins University School of Medicine; and Robert L. Vessella of the University of Washington and Puget Sound VA Medical Center.

This research was funded by a grant from the David H. Koch Foundation.

Edited by J. Strax.

Related

Although this diagram at nature.com of Androgen-receptor signaling in prostate cancer does not include the newly discovered androgen receptor types, it does show how hormone-dependent androgen signaling takes place through dihydrotestosterone stimulation of the androgen receptor and how hormone-refractory prostate cancer cells survive through stimulation of multiple signaling pathways.

Researchers Identify Molecular Cause of Drug-Resistant Prostate Cancer

Researchers Identify Molecular Cause of Drug-Resistant Prostate Cancer

December 21, 2003.

http://www.psa-rising.com/mednews/tx/36-hormonal/62-ar-v7-ho

all the bess Ray

RE: intermittant hormone therapyh

by Johnw100 on Sat Jun 13, 2009 12:00 AM

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On 6/12/2009 Chrystalluna wrote:

Johnw- how do you mean?  Does it work, or only work for 3 years?  My doctors don't explain any of this.

The effect of hormone therapy is reduction of testosterone  to very low levels which reduces the growth of prostate cancer.

Generally speaking, If  for whatever reason hormone (Lupron)  is discontinued after say 12 monthsof use,  testosterone levels will  gradually increase again to more normal levels.  This is usually what happens when intermittent therapy is used.

The longer a patient remains on hormone treatment the greater the chance is that the testosterone reduction will be permanent. eg if someone uses hormones for say 36 months or more then stops the Lupron, it is probable that their testosterone levels will not increase to their previous normal levels.

 

 

 

RE: intermittant hormone therapyh

by Chrystalluna on Mon Jun 15, 2009 12:00 AM

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Ray and John-

Thank you!  Now I get it!.

All my best to both of you!

Chrystalluna

RE: intermittant hormone therapyh

by PaulG76 on Tue Jul 07, 2009 12:00 AM

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When you go on a trial, is there a chance you could be on a placebo? My Dad has PSA of 1000, and just started hormone therapy (fingers crossed it comes down!)....we are thinking of looking into a trial, but don't want to do this is there is a 50/50 chance that the patients could get a placebo....what is the trial you are on?
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