newly diagnosed with prostate cancer 10/23/08

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Darrkmann1
New Member


Date Joined Dec 2008
Total Posts : 7
   Posted 12/24/2008 2:38 PM (GMT -7)   
Hi

I am newly diagnosed with prostate cancer 10/23/08 and going through the motions of decsion making for treatment. After stumbling across Proton Therapy online, I've pretty much decided to pursue it as my treatment option.

Last Thursday I had my first consultaion at MPRI in Bloomington, Indiana. Everything was going fine until the Doctor told me that He wanted to treat me with female hormones for 2 months prior to starting the treatment, 2 months during and 2 months after the treatment.

I'm just not feeling that, particularly with the new laundry list of possible side effects.

I'm 57 years old on 12/29, my gleason is 7, my PSA is 9.5 and I had a 12 core biopsy with cancer found in 2 of the 12 cores. No other symptoms... my test were ordered based on a heightened PSA during a routine physical. Basically in good to excellent health otherwise.

I was told that any side effects would be temporary until after the 6 month treatments ceased? I'm waiting for his reply as to whether or not he'd be willing to perfrom the Proton Therapy if I refuse the hormones? ANy input would be appreciated.

Thanks!

Gordy
Veteran Member


Date Joined Jun 2005
Total Posts : 528
   Posted 12/24/2008 3:37 PM (GMT -7)   
Take the ADT. He's not going to give you female hormones, he's going to give you meds which will suppress your production of androgens. Others, with more patience than I, will give you all the whys and wherefores.

-Les
1/2005 Dx PSA 26.5 Gleason 7 (4+3) @Age 61
1/2005 Start Casodex and Zoladex
PSA drops to <0.01
7/2005-8/2005 5 weeks of IMRT and then HDR brachy
1/2007 Rad Oncologist orders CT scan of pelvis
because of complaints of pain in both thighs
MRI confirms pain not caused by cancer BUT
1/2007 CT scan of pelvis picks up a nodule at bottom of left lung
5/2007 CT scan of lungs shows 1/2007 nodule has grown and
there are numerous nodules on both lungs.
6/2007 Thoracic surgeon removes wedge of left lung for biopsy
6/2007 Path report says 95% chance of metastatic PCa, but she's
never seen cells like this before.
8/2007 2nd opinion at M.D. Anderson in Houston.
They confirm: mutated PCa, very rare, but seen there 2 or
3 times. Recommendation: have CT scans every 6 weeks
and watch for change. At that point start chemo and will
survive for 22 - 24 months thereafter.
PSA still undetectable, but get Lupron shot to bring T down from 27
2/2008 Trip to Houston – PSA now 0.5 and nodules larger. Lupron shot.
6/2008 Trip to Houston - Finally got results from doc. A number of lung nodules have grown, but, more important to him, is the fact that the malignant lesion on my pelvis seems to have flared up and he wants me to start chemo. He said I could wait a few months, but I told him I want to start now. He to get me signed up for a clinical trial in nearby NY.
9/2008 Interim bone and CT scans show progress vs. scans done before beginning trial. I'm cautiously optimistic. Next scans 10/30/08.
10/2008Bone and CT scans continue to show improvement. Med onc attributes mostly to Taxotere/Prednisone while I believe majority of progress attributable to investigational drug, Sprycel.
12/2008 Latest scans show no change. Bah Humbug!


Darrkmann1
New Member


Date Joined Dec 2008
Total Posts : 7
   Posted 12/24/2008 4:36 PM (GMT -7)   
Currently there are only 5 facilities in the country that offer the treatment. A new center is being built at DuPage Hospitall in Illinois, one in Oklahoma and also the University of Miami. I've spoken to each of the centers except MD Anderson and found them all to be most helpful in my research and decision making process. If you call Loma Linda they will send you a free book written by Proton Treatment patient Bob Marchini... "How To Beat Prostate Cancer Without Surgery." along with a DVD and other material.


The University of Texas M. D. Anderson Cancer Center
1515 Holcombe Blvd, Houston, TX 77030
1-800-392-1611 (USA) / 1-713-792-6161
www.mdanderson.org/care_centers/ radiationonco/ptc

Loma Linda University Medical Center James M. Slater, M.D.
Proton Treatment and Research Center
1-800-PROTONS
www.protons.com

Francis H. Burr Proton Therapy Center
30 Fruit Street
Boston, MA 02114
Phone: 617-726-0923
Fax: 617-726-6498 http://www.massgeneral.org/radiationoncology/BurrProtonCenter.aspx

University of Florida Proton Therapy Institute
Attn: Patient Intake Services
2015 North Jefferson Street
Jacksonville, FL 32206(904)588-1800, or toll free (877)686-6009 http://www.floridaproton.org/

Midwest Proton Radiotherapy Institute2425 Milo B. Sampson LaneBloomington, IN 47408
Phone: (812) 349–5074 Toll-free: 866–ITS–MPRI (866–487–6774)
http://www.mpri.org/index.html

pcdave
Regular Member


Date Joined Oct 2006
Total Posts : 444
   Posted 12/25/2008 8:41 PM (GMT -7)   
Hi Darkkmann1

I was not asked or advised to have hormone therapy in conjunction with my proton treatment in early 2007. You did not indicate in your message whether or not the proton treatment center indicated to you why they wanted you to take some hormone therapy before and after treatment. You should ascertain the reasons. I don't know why they refer to it as "female" hormones. Hormone therapy is sometimes given to patients before surgery or radiation treatment to slow or halt the progression of cancer (it does not eradicate the cancer) and also, I believe, to reduce the size of the prostate if it is enlarged. You did not mention if your prostate is enlarged. I am not an expert on hormone therapy, but I am sure that you can find some postings on this website from patients who have had this treatment. Yes, there are side effects which you can research on the internet. However, hormone therapy for shorter periods of time should not be too difficult to tolerate. My side effects during and after treatment with proton therapy have been minimal. If your proton center gives you a reasonable explanation as to why they want you to have some hormone therapy before and after treatment, I don't think that you should shy away from proton treatment if you think it is the right treatment for you. Please let us know why the proton center wants you to have some hormone therapy. Best of luck to you.

Dave
-70 years young!
-29 core biopsy 9/27/06 at age 68
-PSA 7.1, Stage T1c, Gleason 7 (3+4) [less than 20% in one area], Gleason 6 [less than 5% in two other areas], Negative DRE, bone scan and Endorectal MRI. 
-Completed 39 Proton radiation treatments 2/22/07-4/18/07.   
-PSA History: 7.1 pre-treatment; post treatment: 2.1 (3 mo.), 2.4 (6 mo.), 1.7 (9 mo), 1.6 (12 mo.), 1.0 (19 mo.)  Radiation oncologist said: the 3-mo. drop of 70% exceeded expectations; the slight 6-mo. bump up was not a cause for concern now; expected drop in 12-18 mo. is 75%.
-The following is a link to My Journey With Prostate Cancer -- Proton RadiationTherapy (which is now locked from further postings).  http://www.healingwell.com/community/default.aspx?f=35&m=1002871 
 
 

Post Edited (pcdave) : 12/25/2008 8:47:24 PM (GMT-7)


Darrkmann1
New Member


Date Joined Dec 2008
Total Posts : 7
   Posted 12/28/2008 1:14 PM (GMT -7)   

Good afternoon Dave... Season's Greetings,

 

I was and still remain sold on Proton Therapy as my treatment option. However, just not feeling strongly about the Hormonal Therapy in conjunction with it. I was told that because the cancer feeds off of testosterone, in advance stages of prostate cancer reports have shown a significant increase in successful treatment when hormonal therapy has been administered to halt the production of testosterone. Apparently there is now some belief that even in early stage PC the hormones help to increase your success rate for treatment?

 

To my knowledge my prostate isn't enlarged? I asked if I could receive the Proton Treatment without the Hormones and the Dr. said that he wasn't sure if he would do one without the other? He is out until the 6th of Jan and will review my charts and let me know his decision. In the mean time, I am continuing to research as much as I possibly can about the hormonal treament to help me with my decision.

There is a possibility that he may not have referred to it as "Female Hormone Therapy". It may have been my interpretation due to all of the symptoms of menopause being the possible side effects? Hot Flashes, weight gain, increase in short term memory, soreness (and in some cases growth) of the breast, Osteoporosis and increased chance of heart disease.

 


Darrkmann1
New Member


Date Joined Dec 2008
Total Posts : 7
   Posted 12/28/2008 1:22 PM (GMT -7)   
Side Effects Information VIEW IMAGE
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 Possible side effects for Hormonal Therapy
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Bone flare - Hormone therapy for prostate cancer can involve the use of a chemical to block production of testosterone, which results in shrinking of the prostate. Chemicals called luteinizing hormone releasing hormone agonists (LHRH agonists), decrease the production of testosterone in the long term. The first reaction of the body to these chemicals is to overproduce testosterone, so for a short period of time patients may experience a flare, or an increase in cancer related symptoms, including bone pain in patients with cancer that has spread to the bone. This bone flare will recede after the body adjusts to the presence of these LHRH agonists and shuts down production of testosterone. Often physicians will give some other drug in addition to the LHRH agonist for the first few weeks, to avoid this initial flare-up of cancer related symptoms.

Discuss with your doctor:
  1. What are the chances that I will experience a bone flare?

  2. What is the treatment for a bone flare?

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Diarrhea - Diarrhea is defined as bnormally loose bowel movements, of either semisolid or fluid fecal matter. Diarrhea can be one side effect of radiation therapy or total androgen blockade achieved with combination hormone therapy for prostate cancer. In particular, anti-androgens like flutamide and bicalutamide, which block the function of male hormones, can cause diarrhea as a side effect.

Discuss with your doctor:
  1. Is this side effect temporary or permanent?

  2. What is the incidence of diarrhea for your patients that received hormonal therapy?

  3. What medication(s) that I am on, or will be on, might cause diarrhea?

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Swelling & tenderness of the breast (gynecomastia) - One kind of hormone therapy involves use of estrogen to block testosterone production. Men who receive estrogen for this reason can experience swelling and tenderness of their breast tissue. This side effect can be dramatically reduced when three low-dose radiation treatments to the breast tissue are given before estrogen therapy is initiated. Although estrogen is the most common therapy leading to this problem, other kinds of hormone therapy can also cause breast swelling and tenderness to a smaller degree. If the swelling is severe, it can be treated surgically.

Discuss with your doctor:
  1. Is this side effect temporary or permanent?

  2. What is the treatment for gynecomastia?

  3. Am I on estrogen or will I be on estrogen in the future?

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Hot flashes - A hot flash is a sudden feeling of warmth that spreads throughout the upper body and can last up to an hour. This occurs when hormones change the way the body controls its temperature. Hot flashes are most commonly associated with menopause in women. Prostate cancer treatment that involves blocking the production or the effects of the male hormone testosterone can cause hot flashes in men. Patients on this type of therapy commonly experience hot flashes.

Treatment of hot flashes in men undergoing hormone therapy for prostate cancer is accomplished in several ways. Identifying and avoiding certain triggers is an important part of therapy. Triggers can include stress, alcohol or caffeine, hot or spicy food, external heat, and smoking. In addition, medications are available that can help control them. This symptom can be distressing for some patients. Talk with your doctor or oncology nurse about the likelihood of hot flashes following this therapy. If you experience hot flashes during or afterward, ask about available treatments and techniques that have been helpful to others.

Discuss with your doctor:
  1. What has the incidence of hot flashes been for your patients receiving hormonal therapy?

  2. Am I likely to experience hot flashes?

  3. What is the treatment for hot flashes?

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Decrease in erection durability (impotence) - Impotence or "erectile dysfunction" (ED) is defined as difficulty attaining and maintaining an erection. Impotence is one of several side effects within the larger category of sexual dysfunction associated with cancer and its treatment.

When the cause is related to prostate cancer surgery, it is due to damage to the nerves. When the cause is related to radiation therapy, it tends to be due to damage to the arteries. ED also can be due to lack of testosterone associated with hormone therapy. Depending on the cause, it can be either temporary or permanent.

For men who are good surgical candidates, nerve-sparing surgery appears to decrease the likelihood of impotence following surgery. And brachytherapy (seed implants) has a slightly lower impotence rate than external-beam radiation therapy.

There are a number of approaches for treating impotence, including medication, surgery, assistive devices, and alternative methods to achieve intimacy. Talk with your doctor or oncology nurse before your treatment about the likelihood of impotence following therapy. If you experience impotence after cancer therapy, ask about available treatments and techniques that have been helpful to others.

Sexuality is an important aspect of human emotional expression, and inability to function in this area can negatively impact quality of life.

Discuss with your doctor:
  1. Is my therapy likely to cause impotence?

  2. What has your success (or failure) been preventing and treating impotence resulting from hormonal therapy?

  3. What treatments are available if I become impotent?

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Loss of sexual desire - Hormone therapy and surgical castration (removal of the testicles) result in elimination of circulating testosterone in the blood stream. This lack of testosterone will decrease a patient's interest in sexual activities. It is important to realize that a man who has undergone one of these treatments is usually still able to have and sustain an erection, and that lack of interest does not equal lack of ability to perform sexually. However, this change can add to the stress of a diagnosis of cancer and affect a patient's relationships. Other factors can influence sexual desire (libido), including medications, psychological issues, and how well or ill a patient feels, but loss of testosterone most commonly is the main culprit when libido is lacking.

This side effect should be part of any discussion the doctor and patient have when choosing prostate cancer therapy in general. Talk with your doctor or oncology nurse early in your care about the likelihood of loss of libido following therapy. There is no effective treatment yet for loss of sexual desire, but measures can be taken to counteract this effect.

Discuss with your doctor:
  1. Is the loss of sexual desire a temporary or permanent condition?

  2. How is this treated?

  3. Is there a medication I can take to treat this side effect?

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Nausea - Nausea is a common side effect of many types of prostate cancer therapy. Nausea is sometimes caused when the lining of the stomach is irritated by treatment for cancer. The patient may decrease intake of food because of severe nausea and subsequently experience weight loss and loss of stamina because of decreased food intake. Nausea can frequently be treated with medication such as trimethobenzamide (Tigan®) and ondansetron (Zofran®), as well as observation for and avoidance of triggers that stimulate nausea.

Discuss with your doctor:
  1. How often will I experience this side effect?

  2. What are the hormonal medications that may cause nausea?

  3. What has the incidence rate of nausea been for your patients?

  4. How can nausea be prevented and treated?

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Weight gain - A common side effect of hormonal therapies that inhibit testosterone production or prevent it from reaching prostate cells and stimulating cancer growth is weight gain. This side effect may be due to water retention, increased appetite, or possibly a difference in the way the body metabolizes fat. The only effective long-term treatment for weight gain is a combination of exercise and a low calorie diet.

Discuss with your doctor:
  1. What percentage of your patients experience weight gain after they start hormone treatment?

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Fatigue - One common side effect of some therapies can be fatigue. Patients experiencing fatigue have a diminished quality of life because they are too tired to take part in normal activities. This can result from therapies causing a decrease in the number of red blood cells carrying oxygen around the body, or it can be a more general result of illness and depression. This is often temporary, and some new medications can be given to help patients who experience extreme fatigue. Fatigue sometimes can be offset by regular exercise with strength training.

Discuss with your doctor:
  1. How will fatigue affect my activities of daily living?

  2. How much fatigue should I expect?

  3. What measures can be used to minimize fatigue or improve my energy level?

  4. Would a mild exercise program be beneficial for me during treatment?

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Risks of surgery - The risks of surgery are much like those of any major surgery, including risks from anesthesia. Among the most serious, there is a small risk of heart attack, stroke, blood clots in the legs that may travel to the lungs as pulmonary emboli, and infection at the incision site. Another risk is bleeding during or after the surgery. Blood transfusions, which carry their own small risk, may be needed. In extremely rare cases, people die due to complications of an operation. Surgical risks depend, in part, upon the individual's age, their general health, and the skill and experience of the surgical team.

Discuss with your doctor:
  1. What are the risks of orchiectomy?

Darrkmann1
New Member


Date Joined Dec 2008
Total Posts : 7
   Posted 12/28/2008 1:25 PM (GMT -7)   
Hormone Therapy for Prostate Cancer
The experts at Cancer Treatment Centers of America use hormone therapy (also called hormonal therapy) for both prostate cancer and breast cancer. This type of treatment is used to keep cancer cells from getting the hormones they need to grow. Hormones are chemicals produced by glands in your body, and are circulated in the bloodstream. Estrogen and progesterone are hormones that affect the way some cancers grow. If tests show that your cancer cells have estrogen, progesterone, and/or testosterone receptors (molecules found in some cancer cells to which estrogen and progesterone will attach), hormone therapy is used to block the way these hormones help the cancer grow. This treatment may include the use of drugs that change the way hormones work, or surgery to remove the testicles, which produce male hormones.Like chemotherapy, hormonal therapy is a systemic treatment; it can affect cancer cells throughout the body. When a man undergoes hormone therapy, the level of male hormones is decreased. This drop in hormone level can affect all prostate cancer cells, even if they have spread to other parts of the body.There are several forms of hormone therapy for prostate cancer. One is surgery to remove the testicles. This operation, called orchiectomy, eliminates the main source of male hormones.The use of luteinizing hormone-releasing hormone (LHRH) agonist is another type of hormone therapy. LHRH agonists prevent your testicles from producing testosterone.In another form of hormone therapy, your CTCA care team may advise you to take the female hormone estrogen, to stop your testicles from producing testosterone.After orchiectomy or treatment with an LHRH agonist or estrogen, your body will no longer get testosterone from your testicles. However, your adrenal glands still produce small amounts of male hormones. You may also be given an antiandrogen, a drug that blocks the effect of any remaining male hormones. This combination of treatment is known as a total androgen blockade.If you have prostate cancer that has spread to other parts of your body, it can usually be controlled with hormone therapy for a period of time, often several years. Eventually, however, most prostate cancers are able to grow with very little or no male hormones. When this happens, hormone therapy is no longer effective, and your doctor may suggest other forms of treatment.

Darrkmann1
New Member


Date Joined Dec 2008
Total Posts : 7
   Posted 12/28/2008 1:28 PM (GMT -7)   
Hormone blockade therapy for prostate cancer affects the mind
by J. Strax

Memory and thinking abilities show distinct measurable effects from testosterone and estradiol deprivation caused by common treatments.

PSA Rising. March 1, 2005 -- Drugs that block testosterone and other sex hormones are widely used in treatments for men with prostate cancer. Androgens (male hormones) enable receptors on prostate cancer cells to stimulate tumor growth. Hormonal blockade therapy to shut down testosterone production can shrink prostate cancer tumors and halt pain, and may extend life.

But for men who take these drugs side effects can be profound. Loss of sexual desire, impotence, penile shrinkage, loss of muscle, hot flashes, anemia and fragile bones (osteoporosis) are documented side effects of androgen blockade, though not always discussed between doctor and patient.

Now researchers are documenting subtle ways in which hormonal blockade affects male brain function. In doing so they are looking not just at loss of testosterone but also at loss of estradiol.

Loss of testosterone can lower estradiol, usually considered a female hormone but found also in men. Testosterone and estradiol are important in neurological development and play a particularly important role in the cognitive areas of learning and memory. Previous studies in women have shown that declining estradiol levels affect cognition but until now little data existed in men.

Now in two related studies Eeva Salminen, M.D. and colleagues at Turku University Hospital, Finland have documented how testosterone deprivation and estradiol deprivation affect the mental functioning of men treated with hormone therapy for prostate cancer. Most though not all of the effects are negative.

Older prostate cancer patients (mean age 65 years) who were tested with the drugs showed "significant associations between cognitive performances and testosterone decline," Salminen reported in November, 2004. Now in a second study slated to appear in April 2005, the same team says that low estradiol levels affect patients' visual and numerical processing.

Testosterone deprivation affected men's attention and working memory and speed of messages from eye to brain and back to hand or other body part ("visuomotor slowing"). Patients undergoing therapy showed "impaired hit rate in a vigilance test, impaired delayed recall and recognition speed of letters, but improvement in object recall." These results suggest "selective associations between testosterone decline and cognition."

Changes in cognitive performance with loss of normal serum testosterone levels have "substantial implications for informed patient support in prostate cancer," the researchers state.

In a follow up study, Dr. Salminen documented cognitive dysfunction in these men which appeared to be related to a decline in serum estradiol brought on by hormonal treatment.

In both of the studies, patients were tested at baseline and at 6 and 12 months on androgen deprivation (AD). Cognitive performances were evaluated with standardized measures of information processing, including working memory and attention, visual and verbal skills, and memory performances in 31 tests.

Mental abilities found to be significantly associated with decline in estradiol included "visual memory of figures " (i.e. shapes) and "recognition speed of numbers." These abilities were impaired at 6 months after starting drugs. Verbal fluency, however, appeared improved at 12 months. Other cognitive domains appeared unaffected by estradiol decline. The character of change (impairment or improvement) depended on the magnitude of estradiol decline.

Surprisingly, the researchers conclude that despite these "selective and marginal" changes associated with estradiol declines, "cognitive function appears to be well preserved during 12 months AD in men without previous neurological or psychological diseases."

Androgen-deprivation therapy (AD) in the form of injectable "depot" drugs such as Lupron (leuprolide) and Zoladex (goserelin) is one of the most widely used treatments for prostate cancer. Since the 1980s, these injectible "chemical castration" drugs have been used as first-line therapy for advanced prostate cancer. In addition, some physicians prescribe hormone blockade before and/or after surgery or radiotherapy for men with high-risk earlier stage prostate cancer.

The Finnish researchers conclude that adverse effects of hormonal manipulation to treat prostate cancer "need to be established in view of its increasing use as an adjuvant treatment." Objective confirmation of diminished mental sharpness may come as a blow, but men themselves describe hormonal blockade as a "lead suit" and this new information may help doctors and patients discuss the problem more freely and select better therapies.

Links
Article: "Estradiol and Cognition during Androgen Deprivation in Men with Prostate Carcinoma," , R.I. Portin, A. Koskinen, H. Helenius, and M. Nurmi, CANCER; Published Online: February 28, 2005 (DOI: 10.1002/cncr.20962); Print Issue Date: April 1, 2005.



A previous study in the USA: Effects of Combined Androgen Blockade on Cognitive Function, 2003



Edited by J. Strax, March 1, 2005

zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 12/28/2008 5:56 PM (GMT -7)   
Two cents from my drug therapies: prior to radiation, neo-adjuvant hormone therapy is sometimes most effective if it is for 4-6 months prior to radiations, and could be used after radiations for short period or longer term for patients with extremely high nasty stats found for PCa. During radiation doc may have you stop most drugs (casodex)and herbs etc., maybe stay on Lupron or Zoladex as it is in you still (most likely).

Before starting LHRH drugs it is perhaps alot wiser to take casodex or its equals, for 7-14 days approx., to prevent "flare" cause by LHRH (rises testosterone firstly-could fuel PCa cells in that process) and my stupid uro did not advise me of that(and of course Docs supposedly know it-well he didn't) and it could have made my journey worse...as I was high risk-high stats on diagnosis. So, don't ask you uro-doc (folks) tell him that is the way you want it, this information is confirmed in "A Primer on Prostate Cancer" book. By the way that uro-doc did some other things that made it easy for me to fire him as some point, he was surpised or acted as such. Luckily my insurance allowed me that luxury and made me more empowered. I needed to find an Onco-doc anyway, for long term care for patient with higher stats, found a great one after another journey.



I seriously doubt your doc was going to give you DES (made made estrogen compounded drug)for two months prior and after, but even if he were it is not the big deal you are thinking it is, that drug has almost no side effects compared to the LHRH or ADT1-3 drug combos. I know cause I have done them all, ADT3 for 2 years, DES for little less than 2 yrs (by itself) and loved that drug compared to the others. LHRH and combo drugs will make you feel about female, no drive, loss of libido, weak, sweating, fatigue, muscle pains and weight gain...but you don't have to stay on them that long, so consider it part of what needs to get done to make your possible cure happen. When I took DES had no side effects to speak of, I handled the possible issues up front, possible breast enlargement (countered by light duty job of breast radiation or a drug can be taken to counter that...also casodex can even cause this to happen also), blood clotting (you can take aspirin or coumadin is prefferd for safety and use 1-mg DES or less).

I know of patient whom really got agressive about his treatment: chemo (up front), radiations and then followed by hormone drugs ADT1-3 combos, last I heard his numbers looked really good, and his stats did not warrant chemo useage, but he looked into it with a doc whom had some knowledge of this protocol. Time will tell if this worthy for others to look at. Hey there are various ways to fight this beast.

Bob P. (zufus)

divo
Veteran Member


Date Joined Jul 2008
Total Posts : 637
   Posted 12/28/2008 6:54 PM (GMT -7)   
Zufus...You are wearing me out.....Di
Husband Pete
dx Jan 2001 gleason 4 + 3 PSA 16.5
Seed implant and conformal radiation and Lupron from Jan 2001 to Jan2002
2005 Dec PSA began to rise from .5 to 8 within 6 months
Salvage surgery at MSK 9/06 Dr. Eastham
Fistula operation 2/07 MSK Dr. Wong
Many cystoscopies and ER visits with strictures
Catheter for one year....Catheter taken out Sept 07..
Total Incontinence since then....
PSA .52 3/08
AUS Operation at MSK Sept 8 2008 Dr. Sandhu
Activated Oct 28th Dr. Sandhu..MSK
Some difficulty with AUS arising Nov 10 2008
Meeting with Dr. Sandhu to discuss AUS problems and new PSA test Dec 11, 2008
PSA .6 12/08
Waiting to see if AUS gets better results
Complete hip replacement surgery coming up Jan 9, 2009

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