My wife/I are back from the consultation visit with the Radiation Oncologist. The dr. I was suppose to see was in surgery, and the one I saw was the one that handled my previous radiation treatment back in 2000. He is also the most experienced at this practice.
For starters, I am very angry at my urologist/surgeon, who as you know, I always speak well on this site. The pathology report that I had prior today isn't even the full one I was told when it was given to me after surgery. This dr. today had the full one, and instead of being squeaky clean, it clearly showed a positive margin on the left lobe, when I was told and had beleived for 8 months was clean. I will take both copies to my urologist later this week and demand an explanation. I think he knew there was a potential problem and was gambling that I would be the 50% that wouldn't have reaccurance.
Bottom line, the Rad. Onc. had looked at everything, and says he is 100% certain there is reaccurance, and he strongly believes it will be contained to the prostate bed. He wants to start 35 rounds of radiation with a total gray of 70-72. Even though my last PSA was .11, he said there was no good reason to sit and watch it go up. The sooner it is treated, the best the chance of a cure. He said (about 25 years of experience btw) that .5 is the magic number that you never want to go over for salvage radiation. So he said waiting 2-6 months for additional PSA tests isn't going to help my case, and it would be a gamble with my history of PSA velocity that it might jump over the .5 mark before then.
He wants to consult with me again next Monday, and set a time frame and schedule for the radiation. He does not feel the need to combine any hormone treatment with the radiation treatment.
To put it into perspective, he said I had approx. 1/100th the ammount of cancer that I had prior to surgery. He said from looking over my case, he would have reccomended surgery back in November like I had, and he would have had surgery himself.
I wasn't surprised at today's news, that's the trouble when we research and study PC so much, but I was disapointed.
Got a lot to think about here, once again. We did discuss side effects, and he, like myself, is really concerned with my past track record, I may have a difficult time with blockages and such.
Great way to spend my birthday!
David in SC
Age 56, 56 at DX, PSA 7/7 5.8, 7/8 12.3,9/8 14.5
3rd Biopsy Sept 08: Positive 7 of 7 cores, 40-90%, Gleason 7, 4+3
Open RP surgery 11/14/8, Right nerves spared, 4 days hospital, staples out 11/24/8, 5th cath out on 1/19/9
Post-surgery Pathlogy Report:Gleason 3+4=7, pT2c, 42 grm, tumor 20%, Contained in capsular, clear margins, clear lymph nodes
First PSA Post Surgery 2/9 .05, 5/9 .10, 6/9 .11, July 13 - meet with radiation oncologist