E-LETTER #5 - GO TO INDEX FOR EARLIER LETTERS   YANA - YOU ARE NOT ALONE NOW PROSTATE CANCER SUPPORT SITE

Prostate men need enlightening, not frightening December 13, 2011 Food Effects and Zytiga Abiraterone acetate was approved by the FDA on April 28, 2011 for the treatment of metastatic prostate cancer. It is now marketed - at least in the US - as Zytiga. Trials are still being run in other countries - Australia for example, where they are still recruiting. There have been some excellent reports of good results, although not all results were good, and there seems little doubt that Zytiga will become an important weapon in the arsenal in the fight to manage our shared disease. There is one aspect of Zytiga that everyone should be aware of and that is what is sometimes termed the "food effect", which in the case of Zytiga is said to be greater than any other marketed drug. The package insert (which regrettably is not read by everyone) states very clearly "No food should be consumed for at least two hours before the dose of ZYTIGA is taken and for at least one hour after the dose of ZYTIGA is taken. The tablets should be swallowed whole with water. The Zytiga website goes on to say Taking Zytiga with food may cause more of the medicine to be absorbed by the body than is needed and this may cause side effects. Just how much the dose is increased depends on what is being eaten and when The dose can increase fivefold with a low-fat meal and tenfold with a high-fat meal. If a man takes the standard dose – four tablets totalling 1,000 mg daily after fasting for two hours, then gets hungry and, rather than fast for one more hour, eats a meal, he could get up to 10 times the intended dose. For this reason it is probably best to take the dose first thing In the morning and then wait an hour to eat. There is an article on this issue at WebMD Food and Oral Cancer Drugs: A Case of Mislabeling? Chuck Maack and his new site Chuck Maack always ribs me because we are both Platinum Yana Members - more than fifteen years from diagnosis - he was in fact diagnosed four years before me, almost 20 years ago. He is also just a bit older than I am, all of which makes him feel that he's got the edge over me. Chuck has been on Internet Forums and Mailing Lists for many years now and his advice is down to earth and simple. Here he is for example dealing two widely held beliefs - that ADT (Androgen Deprivation Therapy) has dreadful side effects and always, fails after two years: My personal opinion is that you should get over your concern about androgen deprivation therapy (ADT). Think about this - and this relates to the physician telling you that you could get another 15 years - I have been on/off/on/off and only recently back on androgen deprivation therapy FOR THE PAST 15 YEARS! I still LIVE! ADT is NOT the horrendous treatment that some claim it to be, and many of those who claim so never even had the treatment themselves - they rather echo someone else's comments who may have experienced some of the side effects that can occur, but that person likely had no idea how he could have relieved whatever side effects he is complaining about. Chuck has collected information on all manners of prostate related issues and has for some time developing digests, which he terms Observations, on what he feels are the most relevant sources of good information about these issues. He now has his own website The Prostate Advocate. I think it is worth adding Chuck's site to your Bookmarks - plenty of useful reading there. Ultrasensitive PSA I have always been somewhat concerned about Ultra-Sensitive PSA Tests and even more so by the so-called "third generation" tests because what is measure by these is so small that a relatively small error or the "background noise" generated by other organs can assuredly lead to elevated results which might not be associated with disease progression. A study published earlier this month highlights. The conclusions of the study are: Agreement between prostate specific antigen doubling time calculated using ultrasensitive vs traditional prostate specific antigen values is poor. Ultrasensitive prostate specific antigen doubling time is often significantly more rapid than traditional prostate specific antigen doubling time, potentially overestimating the risk of clinical recurrence. Until the significance of ultrasensitive prostate specific antigen doubling time is better characterized, the decision to proceed with salvage therapy should not be based on prostate specific antigen doubling time calculated using ultrasensitive prostate specific antigen values. This study is discussed on The "New" Prostate Cancer Infolink YANA-3 I had a very good response to the call for help I made in the last E-Letter to re-develop parts of the site, particularly the automation of the contributions and updates. We have gone a long way towards identifying aims and achieving them and especial thanks go to Mark Freedkin who has already done a great deal of work. Hopefully, despite the impact of the Holidays, we'll have a system up for testing before the end of January. If any of you are due to send in an update, please just take a few minutes to go to UP DATE YOUR STORY and send it in. We'd like the site to be as updated as possible before transferring to the new system. Useful Links - including a FaceBook one Subscribe to this E-Letter Choosing A Treatment YANA Experiences Index If you want to see the latest stories and updates, click on the Updates link on this page Survivors Talk About Prostate Cancer YANA Forum Prostate Primer A Primer on Prostate Cancer: The Empowered Patient's Guide by Stephen Strum MD and Donna Pogliano has been published in e-book (Kindle) form. In my opinion, this book is one of the very best for those who want to understand the technical aspects of this complex disease of ours. It is always worth checking on sites like AbeBooks for cheap second hand editions of this and other prostate cancer related books.

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