Preface | Detection | Diagnosis | Evaluation | Treatment

	DIAGNOSIS: To properly diagnose condition of the gland a transrectal ultrasound, utilizing the most advanced equipment preferably by a doppler color enhanced unit which can obtain a superior image, enhancing the hypoechoic echogenicity in suspicious tumor areas that permits a needle GUIDED biopsy rather than multiple random biopsies should be undertaken. Should a positive biopsy result further confirmation of the extent of the disease by CT scan, and/or MRI in conjunction with an imaging enhancing agent such as CYT356 should be undertaken. Further blood tests such as PSA2 and RTPCR will more clearly define the extent of the disease. Additional data should be obtained for the patient's personal records. A ploidy analysis to determine the aggressiveness of the disease, the dimensions of the gland to help determine the presence of BPH which along with Prostatitis can create a rise in the PSA unrelated to PC. Once the diagnosis has confirmed the presence of the disease, treatment should be commenced with CHT Combination Hormonal Therapy. Mono Therapy, the administration of only one of the two LHRH without the anti- androgen medication can cause a tumor flare that would increase the volume of the disease and provide an exacerbation of the disease. In all cases both the gland size and tumor volume are reduced, making secondary therapy, if needed, much more effective. Low stage disease should be treated with a minimum of six months of CHT followed by a reevaluation to determine that the disease is confined to the gland and therefore the patient is a proper candidate for secondary localized therapy. More extensive disease should be treated with a minimum year of CHT before another reevaluation and metastatic disease two years. PSA should be monitored at regular intervals. The ignorant conclusion that an LHRH Agonist alone suffices because under normal conditions the testes produce 95% of the body's hormones indicates that the physician is ignorant of the endocrinological changes that take place in the body when a foreign substance is introduced. Monotherapy when administered can cause a severe tumor flare and an exacerbation of the disease. When mono therapy or the introduction of the LHRH Agonists without the administration of an Antiandrogen medication a day to a week before starting the LHRH occurs, the adrenal androgens are routed through the hyperthalmus to the pituitary gland where, by a 5 alpha reductase alteration they are converted to the powerful Di Hydro Testosterone (DHT) which elevates the hormone production from this source to 50%, a ten times increase from the body's normal conversion. When properly administered, the PSA count should be rapidly reduced to undetectable levels which only indicates that the disease activity has been halted. Continued CHT administration will reduce the gland and tumor volume and on reevaluation may permit secondary therapy such as Cryosurgery. Whatever the choice of therapy, it should always be preceded by a minimum of 6 months of CHT.
	Evaluation

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