Right now, she is one of only three doctors in Massachusetts who provide this treatment.
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In Massachusetts alone, there are more than 11, state-registered sex offenders, plus about 1, inmates serving time for sex crimes, and several hundred more sex offenders who have served out their sentences but are being held indefinitely in civil commitment facilities until they are deemed fit for release. Few ever are. Since opening her practice a decade ago, Sorrentino has become increasingly comfortable speaking about topics that make people squirm—deeply disturbing sexual fantasies, child molestation, prison.
The petite brunette sits in her office, which is decorated with aboriginal art and burgundy tufted leather chairs. Thirteen framed diplomas and certificates crowd the pale-blue wall behind her.
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She says that her decision to treat patients with deviant sexual disorders—clinically known as paraphiliacs—was likely influenced by her father, a neuroendocrinologist who wrote his Ph. A closer look reveals that he is, in fact, castrating a rat. References to male castration date back to Greek mythology, but castration as a treatment for sexual disorders has roots in the late 19th century, when Swiss doctors first began performing the surgery.
This method was used throughout the U. Deemed more humane than surgery, these medications were never considered a cure-all, and most had significant physical side effects, including feminization in men. Today, American doctors often prescribe antidepressants to paraphiliacs to help them suppress their compulsive tendencies.
Paraphiliacs also commonly participate in a rehabilitation program called the Good Lives Model, which can include one-on-one and group-therapy sessions that involve training in personal responsibility, sexual-impulse control, and empathy. The program also offers biofeedback methods that measure their reaction to sexual stimuli. Lupron is still a relatively new treatment, but psychiatric journals have deemed it promising—though not without significant risks. Sorrentino first witnessed the power of hormone therapies like Lupron when she took a forensic psychiatry clerkship at the Sexual Behaviours Clinic in Ottawa.
There are side effects, however. Patients on Lupron often experience hair loss, weight gain, and the development of breasts. Sorrentino regularly measures their sexual arousal levels and administers bone density scans, because suppression of testosterone can lead to osteoporosis in men. Yet they tell Sorrentino this is better than feeling unwanted urges. Participants will have 2 optional tumor biopsies during the study. Participants will join 1 of 2 groups.
Both groups will get:. Steroids by mouth or vein before each docetaxel infusion. Both groups first have ADT. One to 4 months after, they have:. Booster injections 2 weeks later and then every 3 weeks, for 6 boosters total. Participants will have a visit weeks after the last treatment. They will then have visits every 12 weeks. Participants will be followed for up to 15 years.
- 1 Introduction.
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This includes physical exams every year for 5 years. It will be given subcutaneously, 2x10 8 infectious units. It will be given subcutaneously, 1x10 9 infectious units. Drug: Docetaxel It is commercially available.
Patients getting PROSTVAC prior to chemotherapy will be evaluated for antigen specific responses after completing vaccine followed by 6cycles of chemotherapy. Evaluate immunologic response among immune subsets flow cytometry.
Evaluate antigen-specific immune responses and response scores at39 weeks in both groups and 1 year in both groups. Evaluate radiographic and biochemical time to progression in both groups. Evaluate changes in the tumor microenvironment with biopsies preand post 2 cycles of vaccine therapy; alone or combination when feasible. Evaluate Pharmacogenomic studies to evaluate drug metabolism andtransporters. Evaluate overall survival.
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Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies. Patients must have metastatic disease, defined as at least one lesion on bone scan or at least one lesion that are measurable per RECIST 1.
Patients who have metastatic disease by these criteria prior to ADT, but then have changes after ADT that diminish the size of these lesions or changes on bone scan are still eligible. Patients must have a performance status of 0 to 2 according to the ECOG criteria Patients must have adequate bone marrow, hepatic, and renal function with:.
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Hide glossary Glossary Study record managers: refer to the Data Element Definitions if submitting registration or results information. Search for terms x. Save this study. Warning You have reached the maximum number of saved studies Listing a study does not mean it has been evaluated by the U.
Federal Government. Read our disclaimer for details. Last Update Posted : September 16, Study Description. Background: Metastatic castrate-sensitive prostate cancer is cancer that has spread beyond the prostate area. Eligibility: Men ages 18 years and over with metastatic castrate-sensitive prostate cancer Design: Participants will be screened with: Physical exam Medical history Blood tests Possible CT, MRI, or bone scan: Participants lie in a machine.
Background: A phase III trial demonstrated that combining docetaxel and androgen deprivation therapy ADT significantly improved survival The potential to combine docetaxel with vaccine in mCSPC could improve upon the survival advantage that has been previously seen. Drug Information available for: Docetaxel. FDA Resources. Arms and Interventions.
It is a recombinant vaccinia virus vector vaccine containing the genes for human PSA and three co-stimulatory molecules B7.
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