Hallo Forum, da habe ich doch heute im Amerikanischen p2p-Forum im Dialog zwischen Dr. Strum und einem Schotten aus Edinburgh nachstehenden Beitrag gelesen.
Die zum Thema markanten Dinge habe ich rot eingefügt.
Strums Hinweis auf Prolactin und das Medikament Dostinex habe ich blau herausgehoben.
Gruss Ludwig
##################
From: Stephen B. Strum MD, FACP
Medical Oncologist Specializing in Prostate Cancer
To:
Worktime for Response: 9:30 AM to 10:05 AM
-----Original Message-----
From: p2p-bounces@prostatepointers.org
[mailto2p-bounces@prostatepointers.org] On Behalf Of Forbes Craig
Sent: Tuesday, November 14, 2006 4:37 PM
To: 'p2p'
Subject: [P2P] ADT2 Advice Please
**********
Material posted here is intended for educational purposes only, and
must not be considered a substitute for informed medical advice from
your own physician.
**********
Hi, Many thanks for the service you provide.
I live in Scotland and am being treated by the NHS (National Health
Service)in Edinburgh.
I contacted P2P before and Dr Strum gave a very comprehensive response which
is attached below. He also asked me to keep in touch. In summary Dr Strum
agreed that Zoladex was the most suitable treatment but suggested a number
of other tests that could be carried out to aid analysis and monitor
progress. I tried hard to get this done but got no response from my medical
team. I also failed to get a second opinion from Dr Oliver in London.
I even managed to get a consultation in France
(Ich habe es sogar geschafft einen Termin in Frankreich zu bekommen)
under reciprocal health arrangements easier than get any response from the NHS in the UK.
I discovered that in France men are screened for PC from age 40 and the consultant was horrified that my first PSA test was at age 60.
(Ich habe in Frankreich herausgefunden, dass ein Sreening für Männer auf Prostatakrebs ab 40 stattfindet, und der konsultierte Arzt war entsetzt, dass mein erster PSA-Test mit 60 erfolgte)
In my condition they agreed with the Zoladex treatment I was receiving and said PSA was the only checks required.
In summary my history is:
6 March 2006 DRE Firm
10 April 2006 PSA 216
19 April 2006 DRE Hard
19 April 2006 Biopsy, Gleason 5+4 = 9
16 May 2006 CT Bone Scan - clear
22 May 2006 started Casodex for 3 weeks
29 May 2006 Zoladex implant, first of 12 weekly shots.
19 June 2006 MRI scan - 4 x 3.6 cm metastasis lying just medial to the
right sacro iliac joint.>>
I would have also added Avodart at 0.5mg per day &
checked a fasting prolactin level to see if Dostinex should be also added.
Moreover, a Pyrilinks-D (Dpd) & aminoterminal procollagen propeptides of
type 1 collagen (PINP) tests are important since these are associated with
bone breakdown and metastases. In a non-socialized medicine world you would
also have a 18F-Fluoride PET/CT study since you almost certainly have bone
metastases or if not, then lymph node metastases. For the latter, a CT is
not the best test (although with a PSA of 216, & a Gleason score of 9, there
is enough tumor volume that even a CT should be abnormal. In fact, the MRI
scan you allude to above sounds like either a soft tissue conglomeration of
nodes or a bone metastasis that has grown to involve soft tissue.
26 June 2006 PSA 4.2 (Excellent news!)
10 August 2006 PSA 1.1 (Fantastic!)
17 August 2006 2nd Zoladex implant
2 November 2006 PSA 4.8 (Totally unexpected)
9 November 2006 3rd Zoladex implant
13 November 2006 Consultation with oncologist. He recommends that I
start Casodex to compliment the Zoladex and check PSA in 8 weeks.
Die zum Thema markanten Dinge habe ich rot eingefügt.
Strums Hinweis auf Prolactin und das Medikament Dostinex habe ich blau herausgehoben.
Gruss Ludwig
##################
From: Stephen B. Strum MD, FACP
Medical Oncologist Specializing in Prostate Cancer
To:
Worktime for Response: 9:30 AM to 10:05 AM
-----Original Message-----
From: p2p-bounces@prostatepointers.org
[mailto2p-bounces@prostatepointers.org] On Behalf Of Forbes Craig
Sent: Tuesday, November 14, 2006 4:37 PM
To: 'p2p'
Subject: [P2P] ADT2 Advice Please
**********
Material posted here is intended for educational purposes only, and
must not be considered a substitute for informed medical advice from
your own physician.
**********
Hi, Many thanks for the service you provide.
I live in Scotland and am being treated by the NHS (National Health
Service)in Edinburgh.
I contacted P2P before and Dr Strum gave a very comprehensive response which
is attached below. He also asked me to keep in touch. In summary Dr Strum
agreed that Zoladex was the most suitable treatment but suggested a number
of other tests that could be carried out to aid analysis and monitor
progress. I tried hard to get this done but got no response from my medical
team. I also failed to get a second opinion from Dr Oliver in London.
I even managed to get a consultation in France
(Ich habe es sogar geschafft einen Termin in Frankreich zu bekommen)
under reciprocal health arrangements easier than get any response from the NHS in the UK.
I discovered that in France men are screened for PC from age 40 and the consultant was horrified that my first PSA test was at age 60.
(Ich habe in Frankreich herausgefunden, dass ein Sreening für Männer auf Prostatakrebs ab 40 stattfindet, und der konsultierte Arzt war entsetzt, dass mein erster PSA-Test mit 60 erfolgte)
In my condition they agreed with the Zoladex treatment I was receiving and said PSA was the only checks required.
In summary my history is:
6 March 2006 DRE Firm
10 April 2006 PSA 216
19 April 2006 DRE Hard
19 April 2006 Biopsy, Gleason 5+4 = 9
16 May 2006 CT Bone Scan - clear
22 May 2006 started Casodex for 3 weeks
29 May 2006 Zoladex implant, first of 12 weekly shots.
19 June 2006 MRI scan - 4 x 3.6 cm metastasis lying just medial to the
right sacro iliac joint.>>
checked a fasting prolactin level to see if Dostinex should be also added.
Moreover, a Pyrilinks-D (Dpd) & aminoterminal procollagen propeptides of
type 1 collagen (PINP) tests are important since these are associated with
bone breakdown and metastases. In a non-socialized medicine world you would
also have a 18F-Fluoride PET/CT study since you almost certainly have bone
metastases or if not, then lymph node metastases. For the latter, a CT is
not the best test (although with a PSA of 216, & a Gleason score of 9, there
is enough tumor volume that even a CT should be abnormal. In fact, the MRI
scan you allude to above sounds like either a soft tissue conglomeration of
nodes or a bone metastasis that has grown to involve soft tissue.
26 June 2006 PSA 4.2 (Excellent news!)
10 August 2006 PSA 1.1 (Fantastic!)
17 August 2006 2nd Zoladex implant
2 November 2006 PSA 4.8 (Totally unexpected)
9 November 2006 3rd Zoladex implant
13 November 2006 Consultation with oncologist. He recommends that I
start Casodex to compliment the Zoladex and check PSA in 8 weeks.
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