Mark A. Moyad - Promoting Wellness Beyond Hormone Therapy: Options for Prostate Cancer Patients, Second Edition

Promoting Wellness

Beyond Hormone

Therapy

OPTIONS FOR PROSTATE CANCER PATIENTS

MARK A. MOYAD, MD, MPH

SECOND EDITION

This book is dedicated to my dad and doctor, Robert Moyad. He taught me what it means to put patients first and what it means to be a good husband and father.

It is also dedicated to the individualsEpstein, Jenkins, Pokempner, and Thompsonwho invest in the dream and allow me to make a difference one starfish at a time.

Another group that deserves credit are all of the oncologists, urologists, and other healthcare professionals from around the world whom I consulted with during the preparation of this book. I cannot thank you enough for your passion and dedication to your patients, your overall guidance, your objective critiques of the manuscript, and your friendship.

And finally, this book is dedicated to the advocates, advocacy groups, healthcare professionals, patients, and their families who have battled and are still fighting prostate cancer.

Second edition 2013 Mark A. Moyad

All rights reserved. No portion of this book may be reproduced in any manner without the express written consent of the publisher, except in the case of brief excerpts in critical reviews or articles.

All inquiries should be addressed to:

Spry Publishing LLC

2500 South State Street

Ann Arbor, MI 48104

www.sprypub.com

877-722-2264

E-book ISBN: 9781938170409

Disclaimer: Spry Publishing LLC does not assume responsibility for the contents or opinions expressed herein. Although every precaution is taken to ensure that information is accurate as of the date of publication, differences of opinion exist. The opinions expressed herein are those of the author and do not necessarily reflect the views of the publisher. The information contained in this book is not intended to replace professional advisement of a patients doctor prior to beginning or changing the patients course of treatment.

10 9 8 7 6 5 4 3 2 1

CONTENTS

WELCOME to the second edition of a unique educational book for individuals dealing with advanced prostate cancer, those with a rising PSA after being on hormone or androgen deprivation therapy (ADT). This book is intended to complement Promoting Wellness for Prostate Cancer Patients, which is currently available and has been circulated around the world for almost a decade. Hormone refractory prostate cancer (HRPC), or as were calling it Beyond Hormonal Therapy, is a stage of the disease that currently has so many options that it needed its own separate book. Most prostate cancer resources focus on the needs of individuals with localized prostate cancer, leaving a void of information for those men needing further treatment. Our primary goal with this book is to empower you with information and suggestions to assist you in communicating with your doctor and other healthcare professionals while dealing with your cancer. Through that informed communication, you and your physician will select the treatment options that best suit your individual needs.

Section one is a quick review. We start , weve focused on those coming in the near future, several months away as opposed to several years away.

Use this book to help you develop questions and understand state-of-the-art treatments. We want this book to give you and the individuals who love and support you the extra knowledge to hit this disease with anything and everything out there. Always remember, in dealing with your health, knowledge and action equal power!

will help you anticipate and mitigate the potential side effects of the various treatments. Understanding and alleviating those effects will improve your comfort during treatment. Well consider lifestyle changes, nutritional options, supplements, and prescription medications to give you a variety of choices.

In , well review diet, supplements, and alternative medicinal therapies that can enhance your well-being, both during treatment and in general.

As you reach the end of the book, hopefully youll have a new wealth of knowledge to consider and discuss with your healthcare providers in setting up the best care plan for your situation. This is the most optimistic time for men with hormone-refractory prostate cancer, with new treatments testing all the time. In the two short years since the first edition was published, there were three new life-extending drugs to add to our second edition! Just remember, especially in dealing with cancer, combining knowledge and action really equals power!

Mark A. Moyad, MD, MPH

Jenkins/Pokempner Director of

Preventive & Alternative Medicine

University of Michigan Medical Center

Department of Urology

The impact of support and advocacy groups on men and their families can be life changing. These groups are some of the most up-to-date resources patients can use for awareness, education, research, clinical trials, drug access, insurance issues, and political advocacy for prostate cancer research.

ADVOCACY AND SUPPORT ORGANIZATIONS

Alliance for Prostate Cancer Prevention www.apcap.org

American Cancer Society www.cancer.org

American Society of Clinical Oncology www.asco.org

American Urological Association www.auanet.org

CancerCare www.cancercare.org

Chemotherapy Care www.chemocare.com

Clinical Trials Recruiting, Ongoing & Completed www.clinicaltrials.gov

Foundation for Cancer Research and Education www.cancer-foundation.org

HRPCa.org. www.hrpca.org

MaleCare www.malecare.org

Man to Man, local groups of the American Cancer Society www.cancer.org

Malecare Advanced Prostate Cancer Program www.advancedprostatecancer.net

National Alliance of State Prostate Cancer Coalitions www.naspcc.org

National Comprehensive Cancer Network www.nccn.org

Patient Advocates for Advanced Cancer Treatments www.paactusa.org

Prostate Cancer Foundation www.pcf.org

Prostate Cancer Info Link http://prostatecancerinfolink.net

Prostate Cancer Research and Education Foundation www.pcref.org

Prostate Cancer Research Institute www.prostate-cancer.org

Prostate Conditions Education Council www.prostateconditions.org

Prostate Forum www.prostateforum.com

Prostate Health Education Network, Inc. (PHEN) www.prostatehealthed.org

The Prostate Net www.prostate.net

Us TOO International Prostate Cancer Education and Support Network www.ustoo.org

ZeroThe Project to End Prostate Cancer www.zerocancer.org

When a patient is confronted with prostate cancer that is advancing, certain important questions come to mind almost immediately. It seemed to make the most sense to put those questions on the table first and provide some general answers before we get into more depth in upcoming chapters.

Men most commonly are considered to have hormone-refractory prostate cancer when their prostate specific antigen level, or PSA, starts to rise while on hormone therapy (also called androgen deprivation therapy [ADT] or luteinizing hormone-releasing hormone therapy [LHRH]). However, a small number of men are diagnosed with an advanced stage of prostate cancer prior to receiving any treatment. They are offered ADT the moment the physician finds prostate cancer well beyond the prostatefor example, in the bones.

Over the years, several names have been given to the advanced cancer condition involving a rising PSA after hormone therapy, but in reality all of the names represent somewhat similar stages of prostate cancer. You may hear any of the terms below used: