I do not recall who made the comment about getting another read on the radiation but I second that remark. I am 8 sessions shy of completing the IMRT and I am taking the Lupron with the four month intervals. I have lymph node involvement and the first 25 sessions were "full pelvic". The oncologist is optimistic about my chance for remission. His take is 70% the urologist was a little more pessimistic at 18%. Either way it is better than no chance at all.
I took Casodex for two weeks prior to the Lupron shot and then for two weeks after. The purpose of the Casodex was to prevent tumor flare up. I guess it worked as I had no pain associated with the shot other than what is expected for an intramuscular shot. Acute pain on insertion and soreness for two or three days.
Q1. Ditto the ones you have listed. Also loss of hair on legs and weight gain.
Q2. Probably not "forever" My course is for two years. Then off for awhile to see what the radiation has accomplished. If the results are not good then will need to go on hormones again until become refractory. I have heard from some folks who have been off and on for ten years or more.
Q3 Cost of lupron. The makers are pretty proud of their product. I worked out a payment with my urologist that is significantly less than the $3000 list price. My urologist supplies the drug as well as giving the injection. I am uninsured so I have been paying the total on my treatment thus far. The urologist and oncologist have been great in working out the cost. The hospitals were not so kind. Up front full freight. Fought like a tiger to get 10% off for cash. They charge an uninsured patient 2.5 to 4 times an insured patient. They won't admit it but there is plenty of research that says they do. Sorry, I am getting on my soap box.
Q4. I do not know anything about the chemo. My oncologist asked if I would be interested in getting into a trial that uses taxotere as early intervention and as concurrent therapy. I declined for personal reasons.
As for what to expect I am at a loss. I am only a few months ahead of you and probably have some of the same concerns. I have read as much as I can on the disease and routinely read the posts here. (thanks to all of you who so freely share your experiences) I have made up my mind to continue my life without dwelling on the PCa. I have given it my best shot according to the experts I have consulted so I will not be tempted to say "I shoulda" down the road.
Jack, good luck with your treatment and choices.
PSA 21.5 (first and only test resulted from follow up visit to emergency room for kidney stone. first time for kidney stone too)
Gleason 4 + 3
DRE palpable tumor on left side
100% of 12 cores positive for PCa range 35% to 85%
Bone scan clear
Chest x ray clear
CT scan shows potential lymph node involvement in pelvic region
Started Casodex on May 2 and stopped on June 1, 2008
Lupron injection on May 15 and every four months for next two years
Started IMRT/IGRT on July 10, 2008. 45 treatments scheduled
First 25 to be full pelvic for a total dose of 45 Gray to lymph nodes.
Last 20 to prostate only. Total dose to prostate 81 Gray.