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From: Alan Meyer on 20 Sep 2008 23:10
The following URL was posted to the Yahoo prostate cancer support
group:

http://www.medicalnewstoday.com/articles/122127.php

It reports the results of a new randomized trial in Germany of
intermittent vs. continuous hormone therapy, and also
references a study on the same topic reported in the U.S
in 2006.

If the report is accurate, and if I'm reading it correctly,
it appears that there is no difference in progression or
in overall survival between the two strategies.

If that's right, then those who have agonized about whether
to choose intermittent or continuous ADT can stop second
guessing themselves. The outcome would likely have been
the same whichever choice they made. However the German
professor who reported the results said that people who
choose intermittent therapy should only do it if they get
to a PSA below 4.0 on their first ADT period.

Alan
From: Steve Jordan on 23 Sep 2008 16:02
On September 20, Alan Meyer wrote:

> The following URL was posted to the Yahoo prostate cancer support
> group:
>
> http://www.medicalnewstoday.com/articles/122127.php
>
> It reports the results of a new randomized trial in Germany of
> intermittent vs. continuous hormone therapy, and also
> references a study on the same topic reported in the U.S
> in 2006.

It is not new. No one to my knowledge, not even the originators of IADT
(Intermittent Androgen Deprivation Therapy) has said that IADT itself
prolongs either PCa-specific or overall survival.

The nearest they (Scholz, Lam, Strum et al.) have come is to present a
study a year ago in The Oncologist that support the proposition that
survival is dependent upon PSA nadir. See "Prostate-cancer-specific
survival and clinical progression-free survival in men with prostate
cancer treated intermittently with testosterone-inactivating
pharmaceuticals." And the related studies referenced there. Pub Med ID
17905106. Pub Med is a service of the US National Library of Medicine at
www.pubmed.gov

Fundamentally, the purpose of IADT is to relieve the SEs of ADT for an
off-period of time, a "vacation."

> However the German
> professor who reported the results said that people who
> choose intermittent therapy should only do it if they get
> to a PSA below 4.0 on their first ADT period.

Maybe that's how they do in in Europe, but I'll never permit my PSA to
rise to that point so long as I have any control. Strum et al. Recommend
at least a year of undetectable PSA while on ADT, defined as =/< 0.05 ng/mL.

Regards,

Steve J




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