Dr. Myers. I am a 69 yr old white male. I was diagnosed with Prostate cancer in Feb 2008. My prostate is 1& 1/2 times normal size. My biopsy revealed a gleason score of 8. I elected to take the Lupron shots and have IMRT. My oncologist told me to stay with the Lupron shots for 3 years. If the ADT therapy fails my Doc said there was no alternative therapy. 16 months out my PSA is 0.2. I am awaiting more psa results this week.

There are so many things wrong with this that it is hard to know where to start. First, there is no reason to recommend three years of continuous Lupron. There is no credible evidence that treatment of that duration offers any advantage. On the downside, continuous hormonal therapy can increase the risk of heart attack, stroke or diabetes unless patients are very carefully monitored and treated aggressively if problems develop. Then, sixteen months out from IMRT and on continuous Lupron, the PSA should be undetectable. I am very concerned about the implications of your PSA of 0.2 ng/ml. Finally, it is really nuts to say that there are no treatment options after Lupron fails! There is second line hormonal therapy and there is chemotherapy. To be specific, there is Casodex, ketoconazole, estrogen, taxotere and mitoxanthrone just off the top of my head. I think you need to get a second opinion to understand how these issues might be tailored to your care.

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.