Newbee, High dose radiation

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brb0923
Regular Member


Date Joined Jan 2009
Total Posts : 32
   Posted 1/8/2009 8:15 AM (GMT -6)   
Hi group, i'm new to the club.
I'm 59 and very healthy (with one exception!)
Don't have all the stats about my cancer, (hoping to get my records faxed to me today)
Iv'e been reading the posts, here is what i know for sure.

psa went from 3.2 to 4.9 in 18 months, and back down to 4.4 on the second test.
biopsy showed cancer in one out of 10 samples.

Doctor says all treatment options are available.
I haven't found any information on HDR on this forum. Anyone have any experience with it?
http://www.brachytherapy.com/prost-brachy.html

I am currently monitoring my cancer with quarterly psa tests, and trying dietary control. (open for dietary adice too). http://www.healingfoodreference.com/

My wife has a mitral valve issue will requireing repair soon. As you can see we have a lot of decisions to make. Hers is obviously more critical at the moment.

thanks for your support and sharing your experiences.
The information here is awesome and sometimes scary. Looks like everyone has different side effects and recovery times no matter what path is taken.

but in the end looks like the cancer gets removed in almost all cases.

LV-TX
Veteran Member


Date Joined Jul 2008
Total Posts : 966
   Posted 1/8/2009 9:03 AM (GMT -6)   
Hi brb0923...dang another brother joins the club unwillingly. Sorry you are here, but pull up a chair and sit a spell. I had surgery so I can't comment on the seeds, but from what you said about the biopsy, it is certainly a method to consider. There are prones and cons to each form of treatment, so research for what is best for you and your family. I am not familiar at all with your wifes condition, but it didn't sound very good...sounds like a surgery procedure...am I correct?

Lots of folks here will offer their take on dietary...and most will be of value. That is another area I don't know much about either...but my wife sure does and makes sure I am taking what she feels is best. Personally, I don't put a lot of faith into those sort of things...to me...eat healthy, stay active, get plenty of rest and exercise...that is the key to living a long life in my opinion.

Fill in your signiture when you have the stats so others can follow your journey.
You are beating back cancer, so hold your head up with dignity
 
Les
 
Age 58 at Diagnosis
Oct 2006 - PSA 2.6 - DRE Normal
May 2008 - PSA 4.6 - DRE Normal / TRUS normal-Gland 38 cc
July 2008 - Biopsy 4 of 12 Positive 5 - 30% Involved Bilateral (Perineural Invasion present at base)
Gleason (3+3) 6  Stage T1C
August 23 - Bone Scan - Hips, Spine and ribs marked uptake - X-Ray showed clear -Hooray
Sept 9 2nd DRE - questionable - TRUS...shadow in base - Gland now 41 cc
Robotic Surgery Sept 18, 2008
Pathology October 1,2008
Gleason 7 (4+3) Staged pT2c NO MX
Gland 50 cc
Seminal Vesicles and Lymph Nodes clear
Positive Margins Right Posterior Lobe
4 tumors in prostate - largest being 6 cm 
PSA Oct 08 <.05


don826
Veteran Member


Date Joined May 2008
Total Posts : 1010
   Posted 1/8/2009 9:31 AM (GMT -6)   
Hi brbop23,

While doing my research I came across a clinic in Georgia that does HDR. It is a procedure that implants the radioactive seeds and follows with IMRT. The firm is known as RCOG and claims to have a very high rate of success. If you google it you can read up on the treatment. http://www.prostate-cancer.com/index.html

By the way, here is a link to a spread sheet that summarizes the options for treatment. You can investigate each separately.

http://www.prostate-cancer.com/index.html

Good luck to you.
Don
Diagnosed 04/10/08
Age 58
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
 
 


brb0923
Regular Member


Date Joined Jan 2009
Total Posts : 32
   Posted 1/8/2009 10:26 AM (GMT -6)   
Thanks guys,
The links are great.



I have HDR available in Michigan through Michigan institute of urology. (anyone familiar with them?)

Would love to find someone who used the HDR method

Yeah wife is considering surgical options for her valve repair (open heart or robotic). We visit Cleveland clinic later this month. thanks for asking.

But really life is good, we just deal with it as it comes. Lovin each other through it!

dkob131
Regular Member


Date Joined Apr 2008
Total Posts : 364
   Posted 1/8/2009 11:22 AM (GMT -6)   

brb:  There are actually two types of HDR, the bracy that everyone seems to look into but also a type where rods are inserted into the prostate and left there for 24 hours or so and over that period of time HDR is given directly to the prostate in two or three short bursts lasting about 10 minutes each.  One of the head guys for Intel actually wrote an article about his experience with this treatment, he thought it was great.  I looked into it and actually went as far as having a Lupron shot to begin to shrink the tumor for the treatment.  I was then contacted by a surgeon and changed my mind and decided to have Robotic surgery.  The treatment is followed up by IMRT , just like the seeds implant is.

If you Google the name Andy Grove and prostate cancer you'll run across the article that he wrote.  It's worth a read and consideration.

David


 54 y.o.
 Diagnosed 4/10/08
 DRE Normal
 PSA-5.5
 Biopsy- 12 cores, 4 positive highest 4+4=8
 Bone scan, CT scan and Chest X-ray clear 4/16/08
 Urologist suggested surgery 4/16/08
 MRI on 4/24/08 clear no suggestion of lymph node   involvement.
 4/24/08 -Started on Lupron and Casodex preparing for HBRT and IMRT in late July.  This treatment will not preclude me from surgery if I change my mind.
Decide to have DaVinci surgery after another consult with surgeon.
6/19/08- DaVinci surgery at University of Washington.
6/25/08- Path report, clear margins, no noted extension
9/12/08- PSA <0.02 
12/05/08-PSA <0.02 Six months after surgery 


zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 1/8/2009 12:13 PM (GMT -6)   
David gave you the heads up on various types. There are people you can see and talk to who been there and done that. www.yananow.net (see mentors listing-treatments etc.)

RCOG and Dattolia Centers (Georgia & Florida) have info availabe and would send you info, atleast to look at even if you don't choose them. There are many places that can do it, expertise is #1 on anything.

Best to you, I did radiation unique protocol, but not with seeds envolved. I would say I had no complications and no issues long term, 6 yrs.+ since it was done. Good luck on this, don't let possible horror stories sway you from looking closely into this, the horror stories exist on all protocols, seen that over 6 yrs. on internet etc.

Neutrondbob-zufus

Post Edited (zufus) : 1/8/2009 10:19:48 AM (GMT-7)


brb0923
Regular Member


Date Joined Jan 2009
Total Posts : 32
   Posted 1/8/2009 2:03 PM (GMT -6)   
You guys are the best!

this is awesome information,
thank you very much,
Barney

Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4183
   Posted 1/8/2009 3:10 PM (GMT -6)   

Dear Brb:

Sorry you're here but this is a great place for information and compassion.  Since you are considering options and radiation in particular, I will bump up my original post, "Tudpock's Brachytherapy Journey".  Hopefully you will find that helpful not only for the process of making a choice but also to understand my experience so far with brachytherapy...which has been great.

This site has plenty of info from surgery patients as they seem to be most common here.  However, I encourage you to check out the other experiences as well including the brachytherapy journey of JustJulie and the posts of Selmer and others who are either waiting or have chosen non-surgical options.  That way you will gain some different perspective.

Good luck...take the time to study your options....choose an EXPERIENCED practitioner and then get well!

Tudpock


Age 62
Gleason 4 +3 = 7
T1C
PSA 4.2
2 of 16 cores cancerous
27cc
Brachytherapy December 9, 2008.  73 Iodine-125 seeds.  Procedure went great, catheter out before I went home, only minor discomfort.  Regular activities resumed, everything continues to function normally as of 12/30/08.


divo
Veteran Member


Date Joined Jul 2008
Total Posts : 637
   Posted 1/8/2009 8:03 PM (GMT -6)   
Dear Brb, Just remember one thing as you go on your path: If you have surgery first, and the cancer returns, you can THEN have salvage radiation....If you have seeds and radiation, and the cancer returns, the salvage surgery will then be very difficult.... That is the route we took....very difficult..to say the least... 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


Gordy
Veteran Member


Date Joined Jun 2005
Total Posts : 528
   Posted 1/8/2009 8:16 PM (GMT -6)   
dkob131 - I believe you meant to say that there are two kinds of brachy of which HDR is one.

brb0923 - 3 1/2 years ago I had 5 weeks of external beam and then HDR. I don't know if the procedure has changed much in this time, but I'd be glad to answer any questions you have, based on my experience.

-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!


brb0923
Regular Member


Date Joined Jan 2009
Total Posts : 32
   Posted 1/9/2009 1:53 PM (GMT -6)   
Thanks again for all of your responses.
Thanks Les, yes i would like to know how the process went for you.
Consulting with a radiation oncologist about HDR 1/19/09. He was referred by the urologist. The urologist is also a surgeon but he hasn't yet tried to push me in any particular direction.
Age 59, very healthy
Psa 2007 3.2
Psa fall 2008 4.9 two weeks later 4.4
11/2008 biopsy, T1c, gleason 3+3=6 low-volume prostrate carcinoma
1 of 12 samples malignant
Left lateral mid .05mm (5%)
CT scan negative
Consultation 12/2008 decided active waiting (diet) while researching options.
Followup PSA in March 2009


Gordy
Veteran Member


Date Joined Jun 2005
Total Posts : 528
   Posted 1/10/2009 12:37 PM (GMT -6)   
The process took a day and a half with an overnight stay in the hospital. Spent the whole time on my back because of the 20 or 25 hollow needles in my perineum (inserted under general anesthesia). Three sessions of HDR. No pain or discomfort at all except for the removal of the needles, which was very painful, but only lasted a few seconds. Are you a man or a mouse?

Don't know if I'm typical, but, even with 5 weeks of external beam and the HDR brachy, not one drop of incontinence and no impotence. Forty to fifty pounds overweight, no exercise, no Kegels.

-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!


livinadream
Veteran Member


Date Joined Apr 2008
Total Posts : 1382
   Posted 1/10/2009 12:41 PM (GMT -6)   
welcome to the club my friend. I think you will find real quick how much knowledge, love, and support you will find here. Be sure to ask plenty of questions and jump into the conversations at anytime. I wish you the best in this journey you are about to embark on. If I can be of any help along the way please let me know.

peace and love
Dale
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
latest PSA 5-27-08 0.11
PSA July 24th, 2008 is 0.04
PSA Dec 16th, 2008 is .06
Testosterone keeps rising, the current number is 156, up from 57 in May
cancer in 4 of 6 cores
92%
80%
37%
28%
 

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