Proponents of Prostasol argue that Nattokinase accompanying Prostasol will protect against deep-vein thrombosis (DVT), yet, if such protection is necessary, the manufacturers of Prostasol are encouraging its use as a herbal treatment and not acknowledging the presence of DES and not cautioning against the possibility of DVT.

Personally, I would avoid the use of Prostasol and certainly not recommend patients consider adding this product to their treatment considerations.

“From the comments, it is clear folks did not really appreciate the full impact of this study. This was not about salvage radiation, which is a whole different issue. This is about adjuvant radiation given shortly after surgery to those with high risk disease. I am neither a radiation oncologist nor a surgeon, but to me the results are stunning. Radiation given shortly after surgery dramatically and significantly reduced the risk of bone metastases. This is huge. It means that in these men, the cancer cells that ultimately would cause bone mets were still in the pelvis and sensitive to radiation! By the time you are talking about salvage radiation, that opportunity is gone and those cancer cells are already out at the bone site in those with high risk disease. Salvage radiation, on the other hand, only really works well for those with indolent, slow growing disease: PSA doubling time greater than 9 months, Gleason score 7 or less. Bottom line is that surgery followed by adjuvant radiation therapy will offer many men with high-risk disease a chance at being disease free long-term - perhaps even cured.

“I would point out that the same issues hold for adjuvant hormonal therapy after surgery rather than waiting to give hormonal therapy when metastatic disease appears.”

I switched urologists before I finally decided on the doctor who did the surgery. I did not like having to deal with his rude staff and he said it would take 6 weeks to schedule my surgery. If a person does not feel comfortable with the doctor they have, I would consider that a red flag. Sometimes you have to go with your gut instinct with doctors.

Feuerstein is unapologetic. In his story he notes that he panned Introgen back in December with the following: “Introgen is a terrible company. Advexin is junk. The drug doesn’t work. The data are manipulated and false. Management misleads.”

Such are the trials of bringing new biotechnology to the healthcare market in the modern world. Is Advexin a valuable drug? Clearly you would need to ask people wiser than we are!

Thanks, Clark

Arthur replied:

Dear Clark: Denosumab is not a bisphosphonate. Denosumab is a fully human monoclonal antibody that specifically targets the receptor activator of nuclear factor kappa B ligand (“RANK-L”), a key mediator of the cells responsible for bone breakdown. However, since Arthur has seen only a small amount of adverse effects data related to the use of denosumab yet (and none in a cancer condition), he cannot tell you whether it has any of the same risks for ONJ as the bisphosphonates. Until full publication of the safety data from clinical trials, it may be difficult to know precisely what some of the less common side effects of denosumab might be.

Arthur responded as follows:

This situation is very much one for individual discussion between you and your physician. You have signs of potentially aggressive disease; your PSA is still low; but you have a short PSA doubling time. It seems to Arthur that the key issues here are (a) whether the hormone therapy has dropped your PSA to zero and, if it has, then (b) how long can the hormone therapy keep your PSA down at zero. There are two things to ask your physician that might be helpful. The first is whether, if your PSA is maintained at zero, he thinks intermittent homrone therapy might be a possibility. The second is whether he would even consider referring you for radiation therapy. Arthur thinks it is only proper to inform you that radiation therapy may not be appropriate in someone of your age, but that also depends on all sorts of other health information that you have not provided. Radiotherapy might be appropriate in a “young” 83-year-old with a 10-year life expectancy, for example. Having said all that, the first thing you need to know from your physician is what your PSA is now — after the initial few months of hormone therapy.

And would I go to him for surgery if I needed it? NO! But that’s because I wouldn’t want to have to ask one of my friends to operate on me. And I know other people just as good (some maybe even better) who I would be happy to go to.