Hi Tony 1951,
You seem a bit frustrated. You replied to a posting I made yesterday and asked if I would share my experience with IMRT and hormone treatment with you. Most emphatically Yes! If you would prefer a more private exchange I can provide you with an email address. I do think it would be good to post here as there are probably others who may find the conversation helpful. (As I did )
Now to your immediate concerns. My signature explains most of the pertinent points on my situation so I will not repeat here. My doctors recommended radiation and hormone treatments due to my high PSA 21.3, 4+3 gleason score, palpable tumor on DRE, high percentage of cancer in biopsy cores and possible pelvic lymph node involvement. The recommend treatment for me was similar to you. Hormone and radiation. Time from diagnosis to hormones was one month and three months to start of radiation. Pretty typical from what I know now.
First the hormone. I used Casodex for thirty days at the beginning of the treatment. The Casodex prevents a tumor flare up when you are given the first hormone injection. In your case Zoladex. I take Lupron Depot 30mg. Tumor flare up can cause bone pain if you have any metastasis. The cancer cells initial reaction to the hormone shot is to grow faster. That is the flare up. Hot flashes did not show up for me until about two or three weeks in. I thought the same as you. "This stuff isn't working." When the hot flashes start, and they will, you will know it is working. The HF's are not that bad. Other side effects are facial hair is lighter. Don't need to shave as often. Facial skin as clear as a babies. And the big one. No libido. I am single and not invloved in a relationship so this has not been a problem. I still appreciate the female form but don't seem to get as reved up as before. I have not had any of the man boobs either. (knock on wood) The length of time is two years. There are several research papers that recommend two years for advanced PCa. I have seen at least one that says six months for localized PCa and another says 2 or 3 years for advanced PCa. In my case two years seems to fit.
Second Radiation. Radiation does not start until you have been on the hormones for 8 weeks. This is to allow the tumor and the gland to shrink some. I just completed an IMRT/IGRT course of 45 treatments. Because of the potential metastasis to the lymph nodes the first 25 were full pelvic as well as prostate. The "markers" are three tiny gold seeds implanted in the gland to act as a target for alignment of the radiation machine and placement of the beam. (Doctor said I get to keep those ) The seeds are placed in an outpatient procedure. The seeds are put in about a week prior to start of radiation. Nothing to get excited about. No pain and a little blood in urine within first 24 hours. The radiation was relatively easy on me. I had some diarrhea and fatigue the fifth week which was the last week of full pelvic. Within 48 hours of the end of the full pelvic I felt good enough to go back to the gym. So, only one week was uncomfortable. Remaining 20 went quick and no problems. Still waiting to see if the residual issues appear at three months but I suspect they will not based on what the radiation techs and oncologist have told me.
One word of advice. (Usually worth what you pay for it) Try to settle your mind and learn as much as you can about your situation. There is an awful lot of "information" on the net and the doctors just do not seem to communicate well. I was lucky, both urologist and oncologist were very good but I went in with some education. I suggest you do the same. Be an informed consumer. It is tough to focus after you hear "you have cancer" but do your best.
Sorry I got so long winded. Tony, I wish you the best and I am always willing to listen or share my experience.
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
PSA test on July 14, 08 after 8 weeks hormone .82
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.
Completed IMRT/IGRT 09/11/08.
Second Lupron shot 09/11/08
Next PSA test by oncologist 03/09