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  1. Jim Marshall (not a doctor) said ... Cardiovascular If you know the term 'cardiovascular', you probably know two major things - heart attack and stroke. A fuller list includes: Abnormal heart rhythms, or arrhythmias Aorta disease and Marfan syndrome Congenital heart disease Coronary artery disease (narrowing of the arteries) Deep vein thrombosis and pulmonary embolism Heart attack Heart failure Heart muscle disease (cardiomyopathy) Heart valve disease Pericardial disease Peripheral vascular disease Rheumatic heart disease Stroke Vascular disease (blood vessel disease) Risk factors Risk factors for cardiovascular disease that you can change: Tobacco smoking Not enough physical activity Poor diet Excessive alcohol consumption. Risk factors your doctor can find: High blood pressure High blood cholesterol Being overweight or obese Having diabetes People with diabetes have twice the risk of developing cardiovascular disease. The rate of stroke can be up to five times greater, and prevalence of heart attack up to ten times greater, for people with diabetes. There are other special conditions your doctor may identify. For instance, for me personally, unless I work at it, I find myself with low salt levels which gives a much higher heart attack risk. Hormone therapy (androgen deprivation therapy, ADT) It is a fact of life for men with prostate cancer that is know to be, or thought to be, out of the prostate, that in many treatments your doctor may recommend hormone therapy. Simply, prostate cancer will use testosterone as a food. Hormone therapy stops your body producing testosterone.Your treatment may include just one period of hormone therapy with radiation. For many men in this group, however, the prescription is hormone therapy for the whole of your life. Types of hormone therapy in this study Hormone therapy mostly used with radiation, or to live long, fits into two groups: Firmagon Firmagon (degarelix) is the only member of the GnRH antagonists currently available (as of 8 December 2019). The rest GnRH agonists include: Zoladex (Goserelin), Lupron (leuprorelin), Eligard (leuprolide), Lucrin (leuprorelin acetate), Suprefact/Suprecor (buserelin), Synarel (nafarelin), histrelin (Supprelin), Suprelorin/Ovuplant (deslorelin), Triptorelin (diphereline) The choice if you are at risk of cardiovascular disease. Simply, the authors find Firmagon (degarelix) to be a better choice if you have cardiovascular risk. Most important is that the authors worry that specialist doctors might not be finding out from your GP if you do have cardiovascular risk before starting hormone therapy. Problems with Firmagon (degarelix) Convenience for patient. A Firmagon injection must be given every 28 days. Other ADT formulations offer, besides every 28 days, 84 days, 168 days, and even longer. Convenience for doctor. Mixing the Firmagon injection takes about 15 minutes. Injecting takes several minutes, and there are special rules. Some other ADT formulations are much more straight forward. Pain. Where the injection goes in. For me pain does not start until day 2. Flu-like symptoms. I know this is a rare symptom because for the past 4 years I have been on Firmagon I have had the opportunity to talk to many men on this drug, and only one man has reported this - me! On days 2, 3 and sometimes longer, I feel crook! Oh well - life wasn't meant to be easy! ... end Jim Int J Clin Pract. 2019 Nov 22:e13449. doi: 10.1111/ijcp.13449. [Epub ahead of print] Cardiovascular Risk with Androgen Deprivation Therapy. Rosenberg MT1.In LibraryGet PDF Author information Abstract BACKGROUND: From the primary care perspective, many urologists and oncologists appear to be ignoring an FDA warning to assess patients' cardiovascular (CV) risk before instituting androgen deprivation therapy (ADT) with gonadotropin-releasing hormone (GnRH) agonists. A growing body of data suggests an association between androgen deprivation therapy (ADT) and CV/cardiometabolic risk, particularly for GnRH agonists. METHODOLOGY: The author examined available evidence regarding CV side effects with GnRH agonists and antagonists to determine what urologists, medical oncologists, primary care physicians (PCPs), and patients need to know about these risks. RESULTS: Data are inconclusive and somewhat conflicting - both low testosterone and testosterone replacement have been associated with elevated CV risk, for example. But the distinction between GnRH agonists and antagonists is becoming clearer, as agonists appear to be more strongly linked with CV risk, perhaps due to the transient testosterone surge they cause upon administration. Moreover, adverse CV events associated with GnRH agonists can emerge relatively quickly, within weeks to months. Conversely, two studies show that GnRH antagonists may significantly reduce CV risk compared to GnRH agonists. CONCLUSIONS: Both GnRH agonists and antagonists carry some degree of CV risk. Although the risk appears to be lower with GnRH antagonists, urologists and oncologists should communicate with PCPs to determine patients' baseline CV risk levels before implementing ADT with either type of agent. © 2019 John Wiley & Sons Ltd. KEYWORDS: GnRH antagonists; androgen deprivation therapy (ADT); cardiovascular risk; gonadotropin-hormone releasing (GnRH) agonists; myocardial infarction; prostate cancer; stroke PMID: 31755635
  2. There are five Thursdays in this month. Each Thursday I aim to present one of the YouTube videos from the PCRI. Hormone therapy, also called androgen deprivation therapy (ADT) keeps most of us alive by robbing the body (and the prostate cancer) of androgens. The main androgen is testosterone. When our bodies are without testosterone, some men experience hot flashes (also called hot flushes). The experience varies from man to man. Some men have no hot flashes. Others have their life very affected. Personally, my hot flashes were mild at first, and gradually faded to undetectable over a few years. In this video, PCRI’s Executive Director, Mark Scholz, MD, discusses various methods for managing hot flashes that occur in men who are undergoing hormone therapy for prostate cancer: And a reminder that we have a few videos of our own on the JimJimJimJim channel: https://www.youtube.com/jimjimjimjim/videos The Prostate Cancer Research Institute (PCRI) is an important source of information for about prostate cancer for patients, families, and the medical community. As part of their mission to empower men and their caregivers they make YouTube videos.
  3. This video today is about weight training for men on hormone therapy for prostate cancer. Hormone therapy is also called 'Androgen Deprivation Therapy' (ADT) because it robs a man of androgens. The main androgen is testosterone. Androgens fuel prostate cancer. And a reminder that we have a few videos of our own on the JimJimJimJim channel: https://www.youtube.com/jimjimjimjim/videos The Prostate Cancer Research Institute (PCRI) is an important source of information for about prostate cancer for patients, families, and the medical community. As part of their mission to empower men and their caregivers they make YouTube videos.
  4. Prostate Cancer Hormone Therapy Study Have you received hormone therapy treatment for prostate cancer? If so, you may be eligible to join an American Cancer Society funded study to test a program designed to help people with changes to memory, thinking and concentration following hormone therapy for treatment of prostate cancer. This study is done completely over the phone and internet and involves a brief screening to determine eligibility, 3 assessments/interviews, and 8 weeks of home-based computer use. For more information, please contact Lisa Wu at +1 (212) 824-7805 or lisa.wu@mssm.edu This study is approved by the Mount Sinai Institutional Review Board (GCO# 10-1352 approved through 6 April 2015) Dr Lisa Wu is an Instructor in the Department of Oncological Sciences in the Icahn School of Medicine at Mount Sina, New York, one of the leading medical schools in the United States. For a number of years Lisa's work has focused on research into quality of life issues around cancer patients experiencing cognitive difficulties after treatment. Lisa already has a number of men from Australia participating in this study. She is wanting to recruit more Australian men who have had hormone therapy treatment. Given the time difference, sending an email to Lisa is probably the easiest way to make initial contact.
  5. This video is about a treatment for men who already have prostate cancer. It is about adding an occasional testosterone boost to regular drug therapy to treat prostate cancer. Dr Sam Denmeade reports on encouraging trials of this approach. It is 56 minutes long and has Closed Captions (Cc) for the hard of hearing. Thanks to Rick Davis of the Answer Cancer Foundation for allowing us to post this video. Access the whole presentation, including introductions, questions and answers, at: https://www.ancan.org/bat-presentation The questions and answers begin at about 1hour 4minutes.
  6. Treatment of metastatic prostate cancer has changed recently. In the past doctors used to use hormone therapy (ADT) at first, then wait until the disease was very progressed before giving chemotherapy with Taxotere (Docetaxel). The reason for the change? Professor Christopher Sweeney reported on a trial he led (CHAARTED). In CHAARTED, the researchers (an international team of medical oncologists) showed that starting BOTH chemotherapy and ADT at the beginning of treatment gave men a longer life. Yesterday (Sunday, 4 Sep 2016), members of your Executive Committee were invited to be the audience for an video interview of Christopher Sweeney and his Australian colleague, Professor Gavin Marx, by Anthony Lowe, PCFA CEO. Tony Maxwell, Alan Barlee and Nev Black and I were able to attend. (Paul Hobson had to miss out because of treatment.) Being able to question world leaders in advanced prostate cancer treatment was a privilege, and we were able to ask several questions men have raised with us in the past. I have been offered first cut of the video footage. I hope to be able to produce two YouTube videos - one the expert interview, the other on key questions men ask about chemo. Watch this space!
  7. US oncologist, Dr Snuffy Myers, has made a 10 minute video in which he talks about Metformin and Prostate Cancer. When Dr Mark Moyad spoke to one of our monthly teleconferences, he mentioned the possible benefits of metformin for prostate cancer patients
  8. In short Jim had 4 years of continuous hormone therapy: 8 months before radiation; 4 months during radiation; and 3 years after the end of radiation. Hormone therapy is also called ADT (androgen deprivation therapy). After 3 years of undetectable PSA, Jim took a break from hormone therapy. This break lasted 2 years, but the PSA started rising again, so Jim is now on hormone therapy again. In detail Click on this sentence to see Jim's full story. If you know how to post on the website, why not post your own story? Or Click on this sentence to be helped to write your own story.
  9. A Youtube video from the Mini Medical School for the Public series from the University of California San Francisco Patients with advanced prostate cancer are currently treated with combinations and sequences of immunotherapies, hormonal approaches and chemotherapy. Professor Charles Ryan, a medical oncologist at the University of California San Francisco covers the clinical and biological factors that drive treatment choice and sequence by physicians, and highlights how prostate cancer therapies are emblematic of the progress that is being made against cancer in general. Further, he addresses the challenges faced by patients and doctors and the research being done to address them. http://youtu.be/kQ4im2WQ75E [Although the talk was given in June 2014, most of it is still current as at October 2015]
  10. An interesting article about a presentation on hormone therapy made by Australian researchers to this year's American Society of Clinical Oncology (ASCO) Annual Meeting. Click on this link to read it.
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