Plan of Attack

This begins with 3 months of treatment with Casodex. 1 - 50mg tablet a day. For me a 30 tablet bottle of this drug costs $385.00 and 6 of them are needed for the entire treatment. That comes to $2310.00 for my total treatment. Fortunately I have medical prescription insurance which reduces the out of pocket cost here to $30.00. As discussed previously, the Casodex effectively places keys in all of the locks in the prostate so that none of the manufactured androgens can enter. This starves the hormone sensitive cancer cells.

At the end of ten days an intravenous injection of Lupron is administered. One injection (22.5mg) is good for three months. This compound costs $1500 for each injection. Two injections will be needed for the six month program. This results in a temporary surge in testosterone. However, since the Casodex has already placed keys in the receptors none of this unwanted compound reaches the cancer cells. The Lupron then tricks the pituitary gland into thinking that the hypothalamus is not sending out signals to manufacture LH and FSH so production of these androgens ceases and the feedback loop to manufacture testosterone is broken. This starves hormone sensitive cancer cells. The combination of Casodex to block the key entry points and the Lupron to trick the pituitary into not making LH and FSH continues for a total of six months. This combination is called "Total Androgen Ablation" or "Blockade."

After three months of Total Androgen Ablation, 3-Dimensional Radiation Therapy is administered for 8 - 9 weeks or 42 - 45 sessions depending on the extent of the patient's condition. Here a complex computer program based on a CAT Scan of the prostate delivers an external beam of radiation from a Linear Accelerator or a Microtron, which is mathematically computed to integrate my exact condition with regard to the biological specifics of my cancer and the geometry of my prostate.

Damage to other organs is minimized and side effects should be minimized also Since the IMRT program targets specific areas only. Approximately 11,000 patients have been put through this program at the hospital of my choice since it began about 5 years ago. It is also used for brain cancer and other cancers as well.

The final three months of treatment consists of concurrent applications of the Total Androgen Ablation and the IMRT.


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