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  1. Triple-hormonal blockade/Androgen Deprivation Therapy (ADT3) is the prescribing of an LHRH agonist or GnRH antagonist to shut down testosterone production plus an antiandrogen to block testosterone access to the cancer cell nucleus; and a 5Alpha Reductase inhibitor (5-ARI) to prevent any testosterone that might access the cancer cell nucleus from converting to dihydrotestosterone(DHT). LHRH agonists include Lupron, Eligard, Trelstar and Zoladex. Firmagon is a GnRH antagonist. Antiandrogens include Casodex(bicalutamide). 5-ARIs are either Avodart (dutasteride) or Proscar (finasteride). For more than 15 years there have been a number of doctors (including Snuffy Myers and Stephen Strum) who have believed strongly in including a 5-ARI as part of Androgen Deprivation Therapy. The “Therapy Assessed by Rising PSA” (TARP) study was initiated in 2007 to test whether adding a 5-ARI to an anti-androgen would prevent prostate cancer progression in men with non-metastatic castration-resistant prostate cancer. Mike Scott on the “New” Prostate Cancer InfoLink in an article headed “TARP trial shows limited benefits from 5-ARI + an anti-androgen in CRPC” summed up the results of this Trial: “Is there a numerical difference in median Time to Disease Progression between the two study arms? Yes, there is. Do we know whether this difference is clinically meaningful after 8 years? No, we don’t. Can we tell you that there is absolutely no point in adding a 5-ARI to an anti-androgen and an LHRH agonist in the treatment of non-metastatic CRPC? No, we can’t. Can we tell you that you should add a 5-ARI to an anti-androgen and an LHRH agonist in the treatment of non-metastatic CRPC? Nope, we can’t tell you that either!”
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