For ADT, double blockage, Lupron and Casodex, should the Casodex dose be 50 mg. or 150 mg. daily? When on ADT, what labortory test level of DHT in my blood serum has to be achieved, so not to have to use Advodart?

The answers to your questions have not been proven in clinical trials. I can only tell you how we currently handle these issues. We generally use 50 mg of Casodex. I reserve 150 mg of Casodex for patients who are either at high risk for the development of hormone-resistant disease or who have stopped responding to 50 mg of Casodex. We monitor DHT monthly and add finasteride or Avodart if the DHT is above 10. With this approach, approximately 90% of the patients we treat reach a PSA of less than 0.01 ng/ml and usually do so within 90-120 days. However, it is important to point out that no randomized controlled trial has been done to show a survival benefit to this approach.

Ask Dr. Espinosa

Geo Espinosa, N.D., L.Ac, CNS, RH (AHG) is the Director of the Integrative Urological Center at New York University Langone Medical Center. Before joining NYU, Dr. Espinosa was a clinician, researcher and director of clinical trials at the Center for Holistic Urology at Columbia University Medical Center. He is a licensed naturopathic doctor, licensed acupuncturist, a Certified Nutrition Specialist and a Registered Herbalist. Dr. Espinosa is an author of the naturopathic entry in 1000 Cures for 200 ailments, by Harper Collins; March 2007 and “Prostate cancer – Nutrients that may slow its progression,” Food and Nutrients in Disease Management - Maryland: Cadmus Publishing, 2009.

Ask Dr. Myers

Medical oncologist and prostate cancer survivor, Dr Charles "Snuffy" Myers was a key player in creating AZT, Suranim, and Phenylacetate while working at the National Institute of Health. With over 250 research papers published, Myers is one of the leading developers of today's prostate cancer canon on both the research and treatment side of the test tube. Former Cancer Director at the University of Virginia, Myers opened the American Institute for Diseases of the Prostate in 2002 to provide men with the kind of comprehensive care that saved his own life. Dr. Myers has long been popular among prostate cancer patients as a speaker because of his ability to explain science and medicine in easy-to-understand language.

Ask Dr. Latini

Dr. Latini welcomes your questions about the psycho-social dimensions of Prostate Cancer, particularly those presented by Gay and Bisexual men. Dr. Latini is an assistant professor of urology at Baylor College of Medicine. Before joining Baylor, he spent six years in the Department of Urology at the University of California, San Francisco. Dr. Latini is a clinical health psychologist whose work concentrates on cancer survivorship and symptom management for persons living with genitourinary cancer.