Too hasty to have Salvage Radiation?

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Ned
New Member


Date Joined Sep 2016
Total Posts : 12
   Posted 10/5/2016 11:09 AM (GMT -6)   
Hi everyone.
My brother and best friend, Larry, informed me that he had prostate cancer over a year ago. He also told me that since it was in our family, that I was more likely to have it as well. His turned to be a very high gleason and stage 4. To shorten the story, I ended up with a very low grade and had my prostate removed on November 11, 2015.
I had some complications due to scar tissure, which were handled with a trip to the Hospital and a scope and laser procedure to remove scar tissue. I then used catheters for a few months to keep the scar tissue from reforming, or to make it form with a wide enough gap to allow urination.
My description of this procedure is penile torture. ( joking)

My first PSA was around 0.35 after that it continued to go down with a low of 0.19.

(Biopsy 10/5/2015
12 cores -2 out of 6 carcinoma - G6 10% - G6 2%
open Radical Prosectomy 11/11/2015 negative margins
Perineural invasion Present - Prostate wt 54.3g – stage PT2c
PSA 8/19/2015 3.31
Post-surgery .35, .23, .19, and now .29
Age 64 )

The last test, it went up to 0.29. I read an article on Salvage Radiation that recommended having it at a much lower PSA level.
I went to see a Radiation Oncologist, and we talked about doing Salvage Radiation to me.
Yesterday, I went to see my Urologist, and he wanted to tell me that if I did SR that it may not effect the outcome of my cancer. We had a fairly good discussion and during it he told me that the PSA bouncing around could possibly be cancer cells in my blood, and not extra prostate cells left in the bed. I have never heard of this.
I had a talk with my brother, and he told me that I might just want to wait and see what the PSA does.
Has anyone ever heard of this? I am re-considering having SR done so quickly. If I do wait and see, what would be the level that I should start moving back towards a SR treatment regimen again?
Thank you for your time. Ned
Biopsy 10/5/2015
12 cores -2 out of 6 carcinoma - G6 10% - G6 2%
open Radical Prosectomy 11/11/2015 negative margins
Perineural invasion Present - Prostate wt 54.3g – stage PT2c
PSA 8/19/2015 3.31
Post-surgery .35, .23, .19, and now .29
Age 64

JNF
Veteran Member


Date Joined Dec 2010
Total Posts : 3347
   Posted 10/5/2016 11:15 AM (GMT -6)   
Was your surgical pathology in agreement with the biopsy regarding the Gleason score? G6 won't spread and is generally thought that it doesn't become a higher score either. Thus, you were low risk going in and shouldn't have any problems. If you had some G7 I would be on alert as that can cause problems. I would be interested in seeing at least another PSA before getting too excited.
PSA 59 on 8-26-2010 age 60. Biopsy 9-8-2010 12/12 positive, 20-80% involved, PNI in 3 cores, G 3+3,3+4,and 4+3=G7, T2b.
Eligard and Jalyn started on 10-7-2010. IMRT to prostate and lymph nodes started on 11-8-2010, HDR Brachytherapy December 6 and 13, 2010.
PSA < .1 since February 2011

Tall Allen
Veteran Member


Date Joined Jul 2012
Total Posts : 8613
   Posted 10/5/2016 11:50 AM (GMT -6)   
I assume that your pathology Gleason score was still 3+3. If so, you cannot have metastases, and there must be a piece of cancerous prostate tissue still in there. PSA from benign tissue dissipates within a few months of surgery. What choice do you have but to get the rest of it with salvage radiation?

I think what your urologist means when he says that the cancer is already in your bloodstream is that it may have already metastasized - very tiny cancer cells would be everywhere. In that case, salvage radiation to the prostate bed would be futile. But that would not be possible if your pathology Gleason score were only 3+3.
Allen - not an MD
•PSA=7.3, prostate volume=55cc, 8/17 cores G6 5-35% involvement
SBRT 9 yr onc. resultsSBRT 7 yr QOL results
•treated 10/2010 at age 57 at UCLA,PSA now: 0.2,no lasting urinary, rectal or sexual SEs
my PC blog

Octorobo
Regular Member


Date Joined May 2009
Total Posts : 380
   Posted 10/5/2016 11:56 AM (GMT -6)   
Ned
Something is going on. Need to go see good RO and soon. Your PSA stinks for someone who has had prostate removed.
Diagnosis in August 2007
Age 57
PSA 4.1 Gleason 3+4=7
Robotic Surgery - 10/2007
GS 3+4=7, Stage T3a N0 MX, Margins-, EPE +, PIN+, Nodes-
Post- Surgery PSA .005, Jan. 2015 .06
SRT ended 5/15/15. 35 treatments 70 Gy's 8/1/'15 PSA <.006 11/1/2015 <.006
5/2016 <.006

Ned
New Member


Date Joined Sep 2016
Total Posts : 12
   Posted 10/6/2016 8:06 AM (GMT -6)   
JNF,
you are correct, the Gleason score remained the same 3 + 3. I was just reading the pathology and 15% of the prostate was found to be cancerous.

Tall Allen,
I just didn't understand how the cells would be in my blood stream, and that it had not gone on to metastasize. The Dr. stated that the cells in my blood stream would be bouncing around and affecting the PSA reading. He also stated that in my case, normally they would not recommend Salvage Radiation. Due to the history of my brother, who had an exceptionally agressive form of Prostate Cancer, I was wanting to get every chance to get rid of the cancer, such as if some small cells were left behind. I am going to check and see if my insurance would cover it if I wanted to get a second opinion - consult from MD Anderson Center.

I am going to read a bunch more on this forum, but I have been relying on my brother's research and knowledge to get answers. I need to understand more on my own. Any help would be appreciated.
Thank everyone for their replies and consideration. Ned.
Biopsy 10/5/2015
12 cores -2 out of 6 carcinoma - G6 10% - G6 2%
open Radical Prosectomy 11/11/2015 negative margins
Perineural invasion Present - Prostate wt 54.3g – stage PT2c
PSA 8/19/2015 3.31
Post-surgery .35, .23, .19, and now .29
Post-surgery, Gleason 3 +3 on pathology of specimen
Age 64

halbert
Veteran Member


Date Joined Dec 2014
Total Posts : 3058
   Posted 10/6/2016 8:14 AM (GMT -6)   
Ned, I like your instinct to get a second opinion at MDA, they are a top-notch PC spot. You definitely have an odd situation.
Age at Diagnosis: 56
Biopsy: 3 of 12, G3+3, all on LT side, 20%, 5%, 3%
Clinical Stage T2C
Bone Scan, CT scan negative for spread
RALP on 2/17/15, BJC St. Louis, Dr. Figenshau
58.5g, G3+4, 20%, 4 quadrants involved
PSA 3/10/15: 0.10
5/18/15: <.04
8/24/15: <.04
11/30/15: <.04
2/29/16: <0.04
8/30/16: <0.04
My Story: www.healingwell.com/community/default.aspx?f=35&m=3300024

JNF
Veteran Member


Date Joined Dec 2010
Total Posts : 3347
   Posted 10/6/2016 8:56 AM (GMT -6)   
PCa is very blood borne. It is common for men to have PCa cells in their blood stream. That does not mean they will develop mets. Only the more aggressive cells of G4 and 5 can locate and grow outside of the prostate. So, you can have some cells left behind as TA says, you can have some circulating as your doc suggests, and you can have both.

As TA says, SRT should mop up what was left behind and stop this. But if you are continuing to be G6 then what may be left shouldn't hurt you and you may find you live with a PSA level that is detectable, but stable. Kind of like a low risk man on AS that never progresses. I think the real risk is that some prostate tissue was left behind and from that more PCa could develop to cause a future problem. SRT should alleviate that.
PSA 59 on 8-26-2010 age 60. Biopsy 9-8-2010 12/12 positive, 20-80% involved, PNI in 3 cores, G 3+3,3+4,and 4+3=G7, T2b.
Eligard and Jalyn started on 10-7-2010. IMRT to prostate and lymph nodes started on 11-8-2010, HDR Brachytherapy December 6 and 13, 2010.
PSA < .1 since February 2011

George_
Regular Member


Date Joined Apr 2016
Total Posts : 395
   Posted 10/6/2016 10:03 AM (GMT -6)   
Tall Allen said...
What choice do you have but to get the rest of it with salvage radiation?

I agree with that and do not see what you will gain from waiting. Salvage radiation, in your case to the prostate bed, will be more successful if started very early.

Mr. Tendulkar published the following probabilities for success:
71% if PSA value between 0.01 to 0.2 ng/mL
63% if PSA value between 0.21 to 0.50 ng/mL
54% if PSA value between 0.51 to 1.0 ng/mL
43% if PSA value between 1.01 to 2.0 ng/mL
37% if PSA value greater 2.0 ng/mL

George

Tall Allen
Veteran Member


Date Joined Jul 2012
Total Posts : 8613
   Posted 10/6/2016 12:34 PM (GMT -6)   
I agree with JNF. After surgery, there are often a lot of cancer cells in the bloodstream, but they are not necessarily cells capable of metastasizing. Eventually those non-viable cells die off and are filtered out. Low grade prostate cancer cells must be within prostatic tissue to survive. Only metastatic cells can survive without prostate tissue to grow in (which is what makes them lethal). If you want to know more about this:

Can invasive procedures spread prostate cancer?

I said...
Cancer cells may be released into systemic circulation by surgery. A study of circulating epithelial tumor cells in breast cancer patients found that the serum-detected cell numbers did increase in some patients following surgery, and the increase was sustained in some, indicating viability. A study of bladder cancer circulating tumor cells using CellSearch® found an increase following transurethral bladder resection. Eschwège et al. found increased numbers of prostate epithelial cells in the serum after surgery, but found no association with metastatic progression or survival. To my knowledge, there has not yet been a study specifically of circulating tumor cells pre- and post-prostatectomy.


But there may be cancerous tissue left behind that can progress to the point where it does metastasize.

I said...
Another difficulty arises where the surgeon must detach the prostate from the urethra, which runs right down the middle. The surgeon scrapes prostate tissue away from the urethra, and cuts it as far away as he can from the bladder neck on top, and the urethral sphincter, on the bottom. He then joins the two ends together, which is called an anastomosis. This procedure may leave cancerous tissue behind. In a recent CT/MRI study of post-prostatectomy tissue, 76% of recurrences after surgery were found to occur at the anastomosis. How many of those were from cancerous tissue that was left behind, and how many from contamination of the surgical blade?

Allen - not an MD
•PSA=7.3, prostate volume=55cc, 8/17 cores G6 5-35% involvement
SBRT 9 yr onc. resultsSBRT 7 yr QOL results
•treated 10/2010 at age 57 at UCLA,PSA now: 0.2,no lasting urinary, rectal or sexual SEs
my PC blog

Post Edited (Tall Allen) : 10/6/2016 12:39:03 PM (GMT-6)


Break60
Veteran Member


Date Joined Jun 2013
Total Posts : 1744
   Posted 10/7/2016 6:47 AM (GMT -6)   
If you're truly Gleason 6 as confirmed by post RP pathology, with no positive margins, EPE or SVI then PCa was left behind elsewhere as noted by TA. So I don't understand your Uro's reticence about SRT. At the same time, I'm not sure that SRT is necessary if G6 doesn't metastasize. Maybe TA can address this. I believe that I've read cases where G6 did metastasize and don't remember why.
Bob
DOB January 1944 (now age 72)
PSA: 8/12 2.7; 5/13, 6.6 (actually double due to finasteride)
7/13 Bx GS 4+4=8 (Bostwick); GS 4+5=9 (Epstein); 2 of 6 cores, 10%, 40%; stage Pt1c
8/13 bone scan negative
9/13 ORRP at John Hopkins, GS 4+5=9, BLSVIs+, margin+ (4mm,G7), EPE, 10 Nodes resected (clear); stage upgraded to pt3bN0M0
PSA: 11/13 0.1; 2/14 0.2; 5/14 0.3
6/14 SRT by IMRT/IGRT, 68.2 grays/38 sessions to prostate bed, ADT (6 months Lupron)
PSA: 9/14 to 8/15: <.1, <.1, .1, .3, .7, 1.2
7/15 CT-PET f-18 bone scan negative
9/15 MRI, CT-PET scans find iliac lymph nodes suspicious for PCa; organs and soft tissue clear
9/15 IMRT/D.A.R.T. 75 grays/50 sessions to all pelvic lymph nodes
9/15-11/16: ADT3 (Lupron, Casodex, Avodart) plus Metformin, Cabergoline, Estradiol patch, Prolia , Vitamin D, calcium
6/16: CT scan, FDG 18 Pet scan, ultrasound, negative for Pca
PSA: 11/15 .084; 3/16 .034; 6/16 .028; 9/16 .045

Tall Allen
Veteran Member


Date Joined Jul 2012
Total Posts : 8613
   Posted 10/7/2016 10:31 AM (GMT -6)   
Bob-

Here are two statements:

(1) Metastases are never associated with a GS 6 found at pathology
(2) GS 6 can never lead to metastases

The first statement is true. The second statement is false. See the difference?
Allen - not an MD
•PSA=7.3, prostate volume=55cc, 8/17 cores G6 5-35% involvement
SBRT 9 yr onc. resultsSBRT 7 yr QOL results
•treated 10/2010 at age 57 at UCLA,PSA now: 0.2,no lasting urinary, rectal or sexual SEs
my PC blog

Ned
New Member


Date Joined Sep 2016
Total Posts : 12
   Posted 10/7/2016 10:48 AM (GMT -6)   
To Halbert,
JNF,
George_,
Tall Allen,
Break60,
and all the others who have read, and or commented on this post- Thank you so much for your input. I was having a bit of a problem understanding how certain things could be one way, and then appear as another.
I have had a consult with a good Radiation Oncologist, and they are submitting my case to the insurance company for approval for a CT scan that will give them a base of where my prostate base is. After that is approved and done, the computer will lay out a plan of radiation, which the RO will check and make sure it is like he wants it. After that procedure is approved by insurance, I will start radiation therapy to remove any cells that were left behind on or around the base.
Just being able to ask questions on this forum is a very great tool. I know that you all are not practicing physicians, but the amount of information that you impart to others is invaluable in someone like me who is unsure after talking to different Physicians.
Thank you all again,
Ned

PeterDisAbelard.
Forum Moderator


Date Joined Jul 2012
Total Posts : 5616
   Posted 10/7/2016 1:00 PM (GMT -6)   
Bob,

To add my misunderstanding to what the Tall one is saying, Gleason 6 disease can turn into* a more-aggressive type with a higher Gleason score and that more-aggressive disease can metastasize. But it won't ever metastasize before it changes to Gleason 7 or higher. That means that if there are metastases present then there will be Gleason 7+ cancer present (even if it used to be Gleason 6).

His statement one -- that "Metastases are never associated with a GS 6 found at pathology" -- looks backward in time and is true. Before metastases can form there must be GS 7 or higher that can be found by a pathology. But his statement two -- that "GS 6 can never lead to metastases" -- looks forward in time to falsely deny the possibility that GS 6 will lead to metastasis by the intermediate step of changing to a higher Gleason disease.

We frequently hear the statement "Gleason 6 never metastasizes" which, in a very narrow sense is true for the same reason that "A virgin will never give birth" is true, but it is prudent to remember that a man with Gleason 6 disease can still occasionally get screwed if he doesn't take care.

*One of the more technically dense and indecipherable threads we have had on this forum dealt with whether Gleason 6 disease turns into higher Gleason disease or whether the man simply develops Gleason 7 disease at more or less the same locations. From a patient's point of view it doesn't seem to make much difference but, thankfully, however it happens it doesn't happen that often.
63 Slow PSA rise 2007-2012: 1.4=>8
4 bxs 2010-2012: 1&2 neg, 3 pos 1/14 6(3+3) 3-4% (2nd opn. 7(3+4)), 4 neg
DaVinci 6/14/12. "some" nerve sparing on left
Path: pT3a pN0 R1 GS9(4+5) Pos margins on rt
24 mo ADT3 7/12 - 7/14
Adj IMRT 66.6 Gy 10/17/12-12/13/12
8/2012-3/2015: Incont., Trimix, VED, PSA<0.015.
AUS & IPP installed 3/5/2015
Forum Moderator - Not a medical professional

Post Edited (PeterDisAbelard.) : 10/7/2016 1:05:04 PM (GMT-6)


Tall Allen
Veteran Member


Date Joined Jul 2012
Total Posts : 8613
   Posted 10/7/2016 1:06 PM (GMT -6)   
PDA said...
We frequently hear the statement "Gleason 6 never metastasizes" which, in a very narrow sense is true for the same reason that "A virgin will never give birth" is true, but it is prudent to remember that a man with Gleason 6 disease can still occasionally get screwed if he doesn't take care.


LOL! I am definitely stealing that line!

sheepguy
Veteran Member


Date Joined Nov 2010
Total Posts : 746
   Posted 10/7/2016 5:12 PM (GMT -6)   
So..since metastasis is never associated with pathological G6 and G6 can lead to metastasis then G6 can lead to pathological G7 if something happens to it....like what ? Similar to sex with a virgin?

How does one "take care" that this "somethiing " doesn't happen ?

sheepguy
Veteran Member


Date Joined Nov 2010
Total Posts : 746
   Posted 10/7/2016 5:13 PM (GMT -6)   
The "virgin" being the G6.

Break60
Veteran Member


Date Joined Jun 2013
Total Posts : 1744
   Posted 10/7/2016 5:30 PM (GMT -6)   
There's no way to "take care". If you have high risk PCa and its not detected by bx or scan, so you don't treat it, and it later progresses what else can you do but treat it then or "overtreat it" when it's only determined to be Gleason 6?
That's the dilemma surrounding AS and imperfect detection methodology.
Bob
DOB January 1944 (now age 72)
PSA: 8/12 2.7; 5/13, 6.6 (actually double due to finasteride)
7/13 Bx GS 4+4=8 (Bostwick); GS 4+5=9 (Epstein); 2 of 6 cores, 10%, 40%; stage Pt1c
8/13 bone scan negative
9/13 ORRP at John Hopkins, GS 4+5=9, BLSVIs+, margin+ (4mm,G7), EPE, 10 Nodes resected (clear); stage upgraded to pt3bN0M0
PSA: 11/13 0.1; 2/14 0.2; 5/14 0.3
6/14 SRT by IMRT/IGRT, 68.2 grays/38 sessions to prostate bed, ADT (6 months Lupron)
PSA: 9/14 to 8/15: <.1, <.1, .1, .3, .7, 1.2
7/15 CT-PET f-18 bone scan negative
9/15 MRI, CT-PET scans find iliac lymph nodes suspicious for PCa; organs and soft tissue clear
9/15 IMRT/D.A.R.T. 75 grays/50 sessions to all pelvic lymph nodes
9/15-11/16: ADT3 (Lupron, Casodex, Avodart) plus Metformin, Cabergoline, Estradiol patch, Prolia , Vitamin D, calcium
6/16: CT scan, FDG 18 Pet scan, ultrasound, negative for Pca
PSA: 11/15 .084; 3/16 .034; 6/16 .028; 9/16 .045

sheepguy
Veteran Member


Date Joined Nov 2010
Total Posts : 746
   Posted 10/7/2016 5:50 PM (GMT -6)   
The analogy to a virgin is not a good one...unless it is true a G6 can turn into a G7. That would be like the virgin turning into a sheep if it got pregnant.

PeterDisAbelard.
Forum Moderator


Date Joined Jul 2012
Total Posts : 5616
   Posted 10/7/2016 10:16 PM (GMT -6)   
Sheepguy,

Actually, it does happen that men diagnosed as Gleason 6 "turn into" Gleason 7s. Happens all the time. Something like one quarter of men receiving surgery with biopsy diagnoses of Gleason 6 disease will be upgraded to Gleason 7 or above in their post-surgical pathology reports. Men on AS will be upgraded from one biopsy to the next, although less often.

I'm a bit vague on my sheep-farming terminology but my understanding is that her first pregnancy turns a "gimmer" into a "ewe", particularly in Scotland and the north of England.

When I spoke of "taking care" I was mostly suggesting that men remember the "Active" part of "Active Surveillance." Gleason 6 disease is low risk, not no risk, but if a man diagnosed with Gleason 6 disease follows the guidelines of a successful AS program then his chances of catching the disease after it starts to move but before it metastasizes are really quite good.

I'm not sure what the term "true Gleason 6" means.
63 Slow PSA rise 2007-2012: 1.4=>8
4 bxs 2010-2012: 1&2 neg, 3 pos 1/14 6(3+3) 3-4% (2nd opn. 7(3+4)), 4 neg
DaVinci 6/14/12. "some" nerve sparing on left
Path: pT3a pN0 R1 GS9(4+5) Pos margins on rt
24 mo ADT3 7/12 - 7/14
Adj IMRT 66.6 Gy 10/17/12-12/13/12
8/2012-3/2015: Incont., Trimix, VED, PSA<0.015.
AUS & IPP installed 3/5/2015
Forum Moderator - Not a medical professional

celebrate life
Veteran Member


Date Joined Dec 2014
Total Posts : 2066
   Posted 10/8/2016 12:10 AM (GMT -6)   
Perhaps a."true G 6" is analogous to the Virgin Mary turning into a ram. At any rate Sheepguy, best to just keep your knees together.
DH 52 @dx
Dx:PC w/ext. mets to bones & nodes 11/2010
PSA:1983 G 9 stage 4
Docetaxel, Zytiga 2012 Smarium, Xtandi 2013 xofigo 2014
Cabazitaxel, Zytiga rerun
Ongoing:xgeva + Lupron
RT sacrum X 10
PSA 1/15 100
2/15 liver mets
DRibbles trial 3/15 PSA:259
6/15:Psa 900 End study
docetaxil PSA 7/15:1054 9/15:921;12/15:1008 retry xtandi
12/15:880 1/16:665 3/16:1316 ascites Start mitoxantrone 8/16:792

George_
Regular Member


Date Joined Apr 2016
Total Posts : 395
   Posted 10/8/2016 2:59 AM (GMT -6)   
There are studies that researched metastatic patients and reported the Gleason score of the included individuals.

Azzam - SBRT: An Opportunity to Improve Quality of Life for Oligometastatic Prostate Cancer
reports in table 1 that they included patients with Gleason score 6 to 10.

Berkovic – SBRT for patients with limited PCa metastases
reports also in table 1 that patients with Gleason score 5 to 10 were included.

Finally Messing - Immediate versus deferred ADT in patients with node-positive PCa …..
reports in the full text that he included quite a number of patients with Gleason 6.

So patients with Gleason 6 can also develop metastases.

George

Tall Allen
Veteran Member


Date Joined Jul 2012
Total Posts : 8613
   Posted 10/8/2016 11:37 AM (GMT -6)   
No, George - none of your references show that. You have to understand that there is a difference between a biopsy Gleason score and a pathology Gleason score. Biopsy scores are often upgraded at pathology (about a third of the time). To prove that true Gleason 6 never metastasizes, researchers looked at pathology Gleason scores only.
Allen - not an MD
•PSA=7.3, prostate volume=55cc, 8/17 cores G6 5-35% involvement
SBRT 9 yr onc. resultsSBRT 7 yr QOL results
•treated 10/2010 at age 57 at UCLA,PSA now: 0.2,no lasting urinary, rectal or sexual SEs
my PC blog

sheepguy
Veteran Member


Date Joined Nov 2010
Total Posts : 746
   Posted 10/8/2016 12:25 PM (GMT -6)   
For all practical purposes then, you can only be confident of not getting metastasis is to have RP and a gleason 6 . But that gleason 6 does not turn into gleason 7 as I understand it. Of course, neither does a biopsy G6...the G7 was simply missed and the biopsy G6 is still a G6

Ned
New Member


Date Joined Sep 2016
Total Posts : 12
   Posted 10/8/2016 6:05 PM (GMT -6)   
To all who have commented on this post,

I really do appreciate all your input. I have learned and am learning how to read and scan research documents. I have learned so much just by reading your replies and questions among our members. My Radiation Oncologists "operator" (?) called me Friday. Come to think of it I think she called herself a Radiation Tech or something like that. My first CT scan is this Monday at 11:30am.

I went to the store today to buy weapons of mass defecation, (laxatives and enemas), LOL. They want me to be empty in my bowels and then to be hydrated for the scan to accurately map the area to be radiated. This Monday is just a location scan. After that they will request from the insurance company for the radiation treatment, which will consist of 39 treatments of five days a week for eight weeks less one day.

I am going on this journey with a lot more information than most men with my problem usually have, and I want to thank you again for all your time and comments. I hope I can help someone, as you have helped me,
Ned
Biopsy 10/5/2015
12 cores -2 out of 6 carcinoma - G6 10% - G6 2%
open Radical Prosectomy 11/11/2015 negative margins
Perineural invasion Present - Prostate wt 54.3g – stage PT2c
PSA 8/19/2015 3.31
Post-surgery .35, .23, .19, and now .29
Post-surgery, Gleason 3 +3 on pathology of specimen
Age 64

PeterDisAbelard.
Forum Moderator


Date Joined Jul 2012
Total Posts : 5616
   Posted 10/8/2016 8:50 PM (GMT -6)   
Ned,

I'm not sure we've mentioned it here but most of us on this forum who have had that sort of radiation have had a fairly easy time of it, although there are a few notable exceptions. Most guys come through with fatigue and hemorrhoid flareups as their most significant side effects. The fatigue is generally not particularly debilitating. In my case it mostly involved falling asleep watching television in the evenings. As for the 'rhoids, there are a number of treatments your RO can suggest that will generally get them under control straight away.

But, while it is never acutely horrible, it can get to be something of a grind after a few weeks. What helped me in that regard was to put 39 20oz bottles of diet Gatorade knock-off in the trunk of my car before the first session. I would drink one in transit each time I drove myself to the cancer center. I worked out the proper level in the bottle for each stoplight along the way to pace myself to arrive with a nicely full but not bursting bladder. As well as being handy, the dwindling number of bottles in the trunk provided a visual confirmation that I was making progress and the treatments wouldn't last forever.

Good luck.
63 Slow PSA rise 2007-2012: 1.4=>8
4 bxs 2010-2012: 1&2 neg, 3 pos 1/14 6(3+3) 3-4% (2nd opn. 7(3+4)), 4 neg
DaVinci 6/14/12. "some" nerve sparing on left
Path: pT3a pN0 R1 GS9(4+5) Pos margins on rt
24 mo ADT3 7/12 - 7/14
Adj IMRT 66.6 Gy 10/17/12-12/13/12
8/2012-3/2015: Incont., Trimix, VED, PSA<0.015.
AUS & IPP installed 3/5/2015
Forum Moderator - Not a medical professional
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