lymph node involvement

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livinadream
Veteran Member


Date Joined Apr 2008
Total Posts : 1382
   Posted 4/17/2008 5:24 AM (GMT -6)   
As you can read from my signature during my surgery I also had a lymph node disection which came back positive with a gleason 8. Is there any one in the forum that has any data as to how long you can expect Lupron to work before the cancer returns. Doctors tell me I should be able to see two to three good years before refractory.
My PSA at diagnosis was 16.3
age 46 (current)
My gleason score from prostate was 4+5=9 and from the lymph nodes was 4+4=8
I had 44 IMRT's
Casodex
Currently on Lupron
I go to The Cancer Treatment Center of America
Married with two kids


Roger G
Regular Member


Date Joined Apr 2008
Total Posts : 150
   Posted 4/17/2008 8:21 AM (GMT -6)   
My father had four good year, but I know others that have had alot more. It's really a function of your body and it's chemistry.

Do then also have you scheduled for radiation treatment?

Don't start counting the mintes while watching the clock, enjoy them with your wife and kids.


Age: 43 (2008)
DRE Small Ridge on prostate, PSA 1.5
07/2007: Diagnosed cancer, T2c, Gleason 3+4=7
09/2007: Laparoscopic prostectomy @ Hamilton General, 4 hrs.
              Both nerve bundles spared
              Pathology Report: Tumor confined w/in prostate
              T2c, Gleason is 3+3=6
              Went home with JP drain
10/2007: Made return trip to hospital.  All urine was comming out JP drain.
10/2007: Catheter removed. Next to no leakage
11/2007: 1st PSA <.003 :)
              ED: Started Viagra, no response yet.
12/2007: Had confidence to go padless!!!!!
12/2007: ED:  Stopped Viagra as it's causing hemroid problems.
01/2008: 2nd PSA <.003 :)
              ED: next to no response.
04/2008: 3nd PSA <.003 :)
              ED: next to no response.  Changed the Viagra prescription.
 


Doting Daughter
Veteran Member


Date Joined Aug 2007
Total Posts : 1064
   Posted 4/17/2008 8:24 AM (GMT -6)   
Have you read Dr. Snuffy Meyer's book yet?  He has a number of patients that have been on HT for years!!!  2-3 seems really low.  I would also inquire to your doctor about the below study. 

Addition of radiation therapy to androgen ablation improves outcome for subclinically node-positive prostate cancer.

Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA.
OBJECTIVES: To determine the outcome for node-positive prostate cancer treated by early androgen ablation with or without prostatic radiation. METHODS: Two hundred fifty-five men with lymphadenectomy-proven pelvic nodal metastases treated with early androgen ablation alone (n = 183) or with combined ablation and radiation (n = 72) between 1984 and 1998 were retrospectively reviewed for disease outcome and survival. Post-treatment disease status was based on the prostate-specific antigen levels or on the clinical and radiographic status for patients treated before 1987. Univariate and multivariate statistics were used to determine the prognostic factors and assess the influence of radiation treatment. RESULTS: With a median follow-up of 9.4 years, the 5, 10, and 13-year overall survival rate for those treated with early ablation alone was 83%, 46%, and 21%, respectively. The freedom from relapse or rising prostate-specific antigen rate for these patients was 41%, 25%, and 19% at 5, 10, and 13 years, respectively. Distant metastasis and local recurrence occurred with a 10-year actuarial incidence of 44% and 51%, respectively. With a median follow-up of 6.2 years, the 5 and 10-year overall survival rate for those treated with radiation and ablation was 92% and 67%, respectively. The freedom from relapse or rising prostate-specific antigen rate in these men was 91% and 80% at 5 and 10 years, respectively. The superior outcome for combined ablation and radiation was substantial and statistically significant in the univariate and multivariate analyses. CONCLUSIONS: Early androgen ablation alone has little curative potential for node-positive prostate cancer. The addition of prostatic radiation to ablation resulted in substantial and significant improvement in disease control and patient survival.




Father's Information
DX July 15, 2007
Age 62 (now 63)
PSA 5.5
Original Gleason 3+4=7 
Post Surgery Gleason- 4+3=7
DaVinci Surgery Aug 31, 2007
Focally Positive Right Margin
One positive node
Bone Scan/CT Negative (Sept. 10, 2007)
T3a N1 M0
Oct. 17 PSA 0.07
Nov. 13 PSA 0.05
Casodex adm. Nov 07
Lupron beg. Dec 03, 2007 2 yr
Radiation started March 03, 2008 8 weeks 5x a week
5 weeks of radiation down!!!
 
 

Post Edited (Doting Daughter) : 4/17/2008 8:29:44 AM (GMT-6)


Doting Daughter
Veteran Member


Date Joined Aug 2007
Total Posts : 1064
   Posted 4/17/2008 8:33 AM (GMT -6)   

Initial Hormone Therapy plus Radiation Improves Survival with Prostate Cancer Spread to Lymph Nodes

CancerConsultants.com | 08.01.2006

According to an article recently published in the Journal of Urology, the addition of initial hormone therapy to radiation therapy improves long-term survival compared to radiation therapy and delayed hormone therapy among patients with early prostate cancer that has spread to the lymph nodes.

The prostate is a walnut-sized gland that is located between the bladder and rectum in males. Standard treatment for prostate cancer is determined by the extent of spread of the cancer; a patient's age and willingness to tolerate side effects; the aggressiveness of the cancer; and prior therapies.

Treatment options for patients whose cancer has not spread to distant sites include radiation therapy, surgery, watchful waiting (delaying treatment until disease progression), and hormone therapy. Researchers continue to compare different therapeutic approaches and associated outcomes as the optimal treatment for these patients has yet to be clearly established.

Hormone therapy—also called androgen deprivation therapy, androgen ablation, or endocrine therapy—refers to treatment that blocks the body’s formation of the male hormone testosterone. Testosterone is responsible for stimulating prostate cancer cells to grow. Hormone therapy may be achieved with drugs that block the formation of testosterone or with the surgical removal of the testicles, a procedure called an orchiectomy.

Researchers from Sweden recently reported long-term follow-up of a clinical trial comparing initial hormone therapy (orchiectomy) plus radiation therapy to radiation therapy alone in the treatment of men with prostate cancer. This trial included 91 patients with prostate cancer that had not spread to distant sites. Some patients, however, had cancer spread to nearby lymph nodes (N+). Patients were either treated with initial hormone therapy/radiation therapy or initial radiation therapy followed by hormone therapy when their cancer progressed.

  • At 14 to 19 years follow-up, 36% of patients treated with initial hormone therapy plus radiation therapy died from prostate cancer, compared with 57% of patients treated with radiation therapy only.
  • The difference in survival mainly occurred among patients whose cancer had spread to lymph nodes; there was no significant difference in survival rates between the two treatment groups among patients whose cancer did not spread to lymph nodes.

The researchers concluded that initial treatment with hormone therapy plus radiation therapy appears to improve long-term survival compared with initial radiation therapy followed by hormone therapy once the cancer progresses among patients with prostate cancer that has spread to the lymph nodes. However, it is important for all patients to discuss their individual risks and benefits of their treatment choices with their physician.

Reference: Granfors T, Modig H, Damber J, Tomic R. Long-Term Followup of a Randomized Study of Locally Advanced Prostate Cancer Treated with Combined Orchiectomy and External Radiotherapy versus Radiotherapy Alone. Journal of Urology. 2006;176:544-547.


Copyright 2006 CancerConsultants.com


Father's Information
DX July 15, 2007
Age 62 (now 63)
PSA 5.5
Original Gleason 3+4=7 
Post Surgery Gleason- 4+3=7
DaVinci Surgery Aug 31, 2007
Focally Positive Right Margin
One positive node
Bone Scan/CT Negative (Sept. 10, 2007)
T3a N1 M0
Oct. 17 PSA 0.07
Nov. 13 PSA 0.05
Casodex adm. Nov 07
Lupron beg. Dec 03, 2007 2 yr
Radiation started March 03, 2008 8 weeks 5x a week
5 weeks of radiation down!!!
 
 


livinadream
Veteran Member


Date Joined Apr 2008
Total Posts : 1382
   Posted 4/17/2008 9:37 AM (GMT -6)   
thanks for all the responses. It is obvious this group really cares. I am doing a hope and inspiration seminar this weekend and I am going to shout the praises of Healing Well.
My PSA at diagnosis was 16.3
age 46 (current)
My gleason score from prostate was 4+5=9 and from the lymph nodes was 4+4=8
I had 44 IMRT's
Casodex
Currently on Lupron
I go to The Cancer Treatment Center of America
Married with two kids


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 4/17/2008 10:44 AM (GMT -6)   
Hi Dale,
When I greeted you here, I was speaking from the heart and my own experiences. "Welcome to the best site on the web for patient to patient interaction" is what I said. That is not part of our greetings, but rather it was from me. The folks here have helped me to no end, and it continues.

Chayna and Roger are right. You have no reason to not believe that your treatments won't help you for an extended period. I can already tell you have the other three componants that are necessary for a great quality of life for a long time ~ Faith, Hope and Love. I always capitalize those words when I use them. I started doing it in my blog and just laugh when I do it and someone notices. But the truth is, these folks do care. This site and its members are blessed.

Tony
Age 45 (44 when Dx)
Pre-op PSA was 19.8
Surgery on Feb 16, 2007
Post-Op Pathology: Gleason 4+3=7, positive margins, Stage pT3b (Stage III)
HT began in May, '07 with Lupron and Casodex 50mg
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (1/08): <0.1
I will continue HT until May '09. 
Years in Remission (3/23/07): 1
Visit my Journey at:
 
STAY POSITIVE!
 
Prostate Cancer Forum Moderator


livinadream
Veteran Member


Date Joined Apr 2008
Total Posts : 1382
   Posted 4/17/2008 11:35 AM (GMT -6)   

thanks Tony. I still remember waking up from surgery and the doctor telling me it had spread outside the prostate and we have to attack it different. He was positive as was I. I had to get myself educated as to what gleason scores meant. I also made it a point to spread the message of hope as often as possible. I am working on starting a support group here in my hometown. We may have cancer, but we are all blessed as well.

how are your treatments going? You can email me if you would like dchildress@livinadream.com

 


My PSA at diagnosis was 16.3
age 46 (current)
My gleason score from prostate was 4+5=9 and from the lymph nodes was 4+4=8
I had 44 IMRT's
Casodex
Currently on Lupron
I go to The Cancer Treatment Center of America
Married with two kids


Frank1205
Regular Member


Date Joined Feb 2008
Total Posts : 308
   Posted 4/17/2008 12:53 PM (GMT -6)   

Hi Dale,

Nice to see another post by you.  I learn something after each one of your posts.  There is so much excellent information on this site and good friends to share it with.

Take care and God Bless

Frank

 


Diagnosed 01-08-08 @ 53 years old 
DRE normal - High PSA for 5 or more years
2004 Biospy negative - 2008 Biopsy positive (01-08-08)
10 cores, 1 positive and at 1% of that one core
Current PSA 6 - Bone and Ct scans negative
clinicalg Staged at T1C - Gleason 3+3 = 6
Robotic Da Vinci performed March 27th, 2008
University of Chicago,5 hour surgery , 3 hour recovery
Unexpected Cardiac issues appear and disappear?
Hospital stay 30 hours - Catheter out in 7 days  normaly expected leakage - Erectile funtion back on line 9 days 
Post Pathology T2C, Gleason 7, 10 % of both portions of prostate, Seminal vessels clear, fat tissue clear,Tumor on bottom of prostate, 1 positve margin  going to meet with oncologist to discuss treatment options if any at this time.
 


livinadream
Veteran Member


Date Joined Apr 2008
Total Posts : 1382
   Posted 4/17/2008 12:59 PM (GMT -6)   
Thank you so much for the kind words. I try to be a face of hope as we stare down this enemy called cancer. So many people are so devasted with the diagnosis that they cannot find the strength to fight, so it is up to the rest of us to be their hope.
God has given me a peace and serentity to go forward, and for that I feel blessed. I am glad the forum hasn't got tired of me yet.
My PSA at diagnosis was 16.3
age 46 (current)
My gleason score from prostate was 4+5=9 and from the lymph nodes was 4+4=8
I had 44 IMRT's
Casodex
Currently on Lupron
I go to The Cancer Treatment Center of America
Married with two kids

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