Just on the ADT then radiation and ADT after actually can be a good program

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zufus
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Date Joined Dec 2008
Total Posts : 3149
   Posted 1/12/2009 5:47 AM (GMT -7)   

divo
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Date Joined Jul 2008
Total Posts : 637
   Posted 1/12/2009 6:07 AM (GMT -7)   
Wow, Bob, that is quite a list....Pete was on lupron for four months before his External Radiation and seed implant and then twelve months after. The rationale from the doctor was that it would give the seeds and radiation more time to "work".. That always seemed wierd to me, ...Has anyone done that? I was shocked also at the price of lupron.....

The other thing for us, was four years later, when the above "cure" failed, we were told that salvage surgery gave a 40% chance of total cure with a 2% chance of a fistula (connection between rectum and bladder). We chose one of the very best doctors in the country that does this type of surgery..The other choice that we could have done was HT, but both the surgeon and the oncologist said that Pete (despite all that radiation before) would benefit from the salvage surgery... However, looking back now...(which we should not do) is why didnt any doctor say "If you didnt do surgery in the first place, why would you want to do it after radiation?" 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
AUS improving..only 2 pads a day and one at night
Complete hip replacement surgery Dr. Waters Gainesville, FL 1/9/09
Forging ahead to health!


zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 1/12/2009 6:13 AM (GMT -7)   
Just on the ADT then radiation and ADT after actually can be a good program for certain patients, bascially I went down that road, because of abstracts that showed improved survival time over straight up EBRT or IMRT and I think even over straight ADT alone(been a while since I looked at all the lovely stuff). Hey if I can't win I am also interested in survival time, so far 7 yrs. from the diagnosis, I am pleased. I don't regret what I have chosen , I do regret the hurdles and jumps, the b.s. from some docs.

Hey do look back and if can be helpful to a newbie, to avoid a pitfall or give the newbie a look at it from a new angle, its all good for others. Who says you can't learns something from others experiences or possible mistakes. I even believe you can learn something from anyone, I don't care how poor or uneducated, status, whatever...listen and weigh and analyze. Some of the Forest Gumps of the World are geniuses compared to the some of our 'experts'.

I am not gonna question your treatment, we have to choose something, even watchful waiting is an option and decent one for people with super low stats, still has risk of course.

Post Edited (zufus) : 1/12/2009 12:08:46 PM (GMT-7)


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25353
   Posted 1/12/2009 8:31 AM (GMT -7)   
Bob, in defense of your post above, I would agree that any newbie to the world of PC would want only facts to deal with, as 100% accurate and factual as possible at all times. They don't need anyone sugar coating the reality of treatment options and after effects of those treatments, and they sure don't need anyone (doctors including) in blowing the proverbial smoke up their a**. While there are some people that are just natural denialists by choice, most people, facing something as serious as cancer, PC in this case, will adapt to that reality a whole let better and faster when they know they have all their options and facts in front of them.
Just my take.

David in SC

PS. I my many years in the biz world, some of the greatest ideas I ever heard came from the bottom tier and not from the experts and the wise. So we should keep our eyes and ears open at all times, never know when you are going to learn something new and interesting concerning our cancers.
Age 56, 56 at DX
PSA 7/7 5.8, 7/8 12.3, 9/8 14.9, 10/8 16.4
3rd Biopsy 9-2008 Positive 7 of 7 cores positive, ranging from 40 - 90%, G 4+3 & 3+4
Open RP surgery  November 14, 2008 at St. Francis Hospital, Greenville, SC, Dr. Ronald Smith - Surgeon, Non-nerve sparing, 4 days in hospital, staples removed 11/24/8, Catheter out on 12/15/8 on day 32.  Day 33, urine stopped flowing, new catheter put in 12/16/08, Catheter out 12/29/08.  After 7 hours, complete stoppage again, emergency room put in Catheter #3 early evening of day 45, still 12/29/08. 1/5/9 - Cath #3 out, dr. did cycloscope, saw potential blockage, put in Catheter #4, 1/9/9 - pre-op, 1/13/9 - corrective operation scheduled at St. Francis
Post-surgery Pathlogy Report:
Gleason 3+4=7, pT2c pN0 pMx, Prostate 42 grams, tumor 20% cancer
Contained in capsular, neg. margins apex, bladder neck, right lobe, neg. in seminal vessels and lymph nodes.
First PSA Post Surgery  Scheduled now for 2/9/9
 
 


dkob131
Regular Member


Date Joined Apr 2008
Total Posts : 364
   Posted 1/12/2009 11:29 AM (GMT -7)   

Bob:

I agree with you wholeheartedly, I've gone through a few uro's and onco's myself.  You may wonder why with my signature it probably looks like I have had a great outcome but we're not sure that is the case.

As you can see my PSA is undetectable and has been since surgery but I have been having pelvis and rib pain for sometime and talked muy uro into giving me a bone scan after my surgery and guess what ?  Two spots came back positive for bone metastasis.  Now I know about false positives and all of that good stuff but I have pain in the areas that the scan shows uptake in.  The onco (one of the head guys at the University of Washington) wanted to watch and wait, I wasn't having any of it and got on a plane to M.D. Anderson to get a second opinion.  They actually had the same opinion so I'm waiting a month or so for a new set of scans to see if anything has changed.  Yourself and some of the more experienced people on this site(Gordy and such) know that it's not all about just PSA's because there are some prostate cancers that grow without emitting PSA(small cell and a few others yuck).  Although I have been lucky with my care in a lot of respects, if I hadn't pushed and shoved my doc's into more tests we wouldn't have any idea this could possibly be going on.

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 1/12/2009 12:06 PM (GMT -7)   
Thanks for replies, the thread I started is about uro-doc and possible omission or errors. Someone else can rethread or re-tread this. I need to tone down a few of my posts for consideration of newbies and maybe overload of information.
Reply to last poster above: dkob131

(There are some PCa like you mentioned that don't give off psa numbers, it is alot rarer and will leave it there for now.) Radiation can be done for bone pain and maybe even 'spot' PCa kill, my rad-doc was often mentioned as the choice people around here were going to for such work. I have not had to deal with that issue at this juncture, so I really have not looked into the parameters and what can/can't be done. You are facing PCa control issues, if you don't have a good onco-doc, try to find another one that is maybe a PCa-onco-doc and has more heads up latest protocols and treatments.
 
Try searching either within or straight google: Bill Aishman or www.prostate-help.org/aishman.html
 Bill Aishman, anyway what a pioneer for us PCa people, he knows alot of protocols, did them and saved all the information for others. The man must have worked 24/7 as his life was on the line, very sad he is not here anymore. His legacy and papers on hrpca are definitive worth us looking at. I would say he was a 'chief' warrior on PCa and good researcher.
 
 

Post Edited (zufus) : 1/12/2009 12:46:34 PM (GMT-7)

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