Just in from AS patient Phil Segal, of Toronto, from Prostate Cancer Support Canada:
"I agree with Dr Booth (savvy Canadian). At what cost both economically and physically does Enza contribute
"This is a powerful drug. We were disputing the value of 5ARI’s such as finasteride and dutasteride for men on AS.
"I would think Enzalutamide is more “powerful” than either of the above
"As someone who has been on AS for a long time my preference would be to see advances in genetic/genomic testing which would ease the anxiety burden by offering analysis as to likelihood of PCa advancement. I think that would do way more to keep most men on AS than an offer of hormonal drugs to allay progression."
a main theme here is anxiety related to gleason 3+3 . If taking an AR inhibitor (daralutamide maybe has fewer side effects) relieves this anxiety why not let men use the shared decision process and choose to take something then do AS. Dr J Epstein is good enough to do a second opinion on pathology but not good enough to listen to about 3+3. Shared decision is at play here.
Good point Dr. M. This could relieve the anxiety for some men. Loads of men are on "anxious surveillance." When do they become anxious? Is is acceptable? (We'll have some new numbers on how many get anxious and why after the ASCO presentation in February.) But I wonder if the potential side effects from the drug are worth it and whether anxiety relief actually will be worth a tradeoff. Like Excedrin asked in its ads, Why trade a headache for an upset stomach?
Excellent point we hear about major side effect on zoom all the time. Big pharma sees another large market im afraid
Just in from AS patient Phil Segal, of Toronto, from Prostate Cancer Support Canada:
"I agree with Dr Booth (savvy Canadian). At what cost both economically and physically does Enza contribute
"This is a powerful drug. We were disputing the value of 5ARI’s such as finasteride and dutasteride for men on AS.
"I would think Enzalutamide is more “powerful” than either of the above
"As someone who has been on AS for a long time my preference would be to see advances in genetic/genomic testing which would ease the anxiety burden by offering analysis as to likelihood of PCa advancement. I think that would do way more to keep most men on AS than an offer of hormonal drugs to allay progression."
a main theme here is anxiety related to gleason 3+3 . If taking an AR inhibitor (daralutamide maybe has fewer side effects) relieves this anxiety why not let men use the shared decision process and choose to take something then do AS. Dr J Epstein is good enough to do a second opinion on pathology but not good enough to listen to about 3+3. Shared decision is at play here.
Good point Dr. M. This could relieve the anxiety for some men. Loads of men are on "anxious surveillance." When do they become anxious? Is is acceptable? (We'll have some new numbers on how many get anxious and why after the ASCO presentation in February.) But I wonder if the potential side effects from the drug are worth it and whether anxiety relief actually will be worth a tradeoff. Like Excedrin asked in its ads, Why trade a headache for an upset stomach?