The Plan of Attack
The Treatment Program:
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
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
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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