What a day, many severe bladder spasms despite the med for it. Met with my new Radiation Oncologist, part of Cancer Center of the Carolinas here in Greenville, SC. We spent 2 1/2 hours together total, but one on one was about 90 minutes. He got called out of my meeting 5x for emergencies. He has been a Rad. Onc doctor for 30 years, he said that 85% of his practice is prostate cancer only. He said he there use to be a Prostate Oncologist in this area, but due to lack of biz closed down his practice and moved to a larger area.
He said after reveiwing my entire case from biopsies, through surgical notes and pathology reports, etc, if he had been me, he would have had surgery, based on my age, and the agressiveness of the PC. That kind of made me feel good. He spent time drawing pictures for me of how things looked before and since surgery inside. He's very up to date and stays that way.
He wants me to have 2 months of Lupron, then two months of radiation (70 grys) for 35 treatments over 7 weeks, and two more months of Lupron after. He did say however, that he is not convinced that I need the HT portion, but more that it was standard procedure for his practice. He said it may or may not help or make any differnece.
He will see me in a month. He is going to consult with my surgeon next week and compare notes. He agreed that we can not move ahead until these blockage issues are resolved. He said if need, he could radiate with a catheter in place. Instead of me drinking a bunch of water to fill the bladder while they zap, they could fill the cath full of water, zap, then release the water.
He said in my case, having a positive margin was a good thing. Because if there wasn't one, and my body was producing psa, then it would probably mean that it was distant instead of being in the prostate bed.
Based on his 30 years, his magic cutoff number is a post surgery psa of .50, at that level he mostly sees 100% sucess, from .50 to 1.0, he said its down to 50%, and anything over 1.0, not much point doing it.
I told him about our group, hes thinks thats a great idea, and he said I was probably one of the most informed patients he'd ever talked to. Kind of made me feel good.
He did say, there is no doubt in his mind, that I do have reaccurance. He mentioned other tests available, but he said that none of them could absolutely confirm or detect reaccurance with a psa of .16. Below, I will post another thread about some of his other comments related to PC.
Glad to be home,
david in sc
Age 57, 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
Pathlogy Report:Gleason 3+4=7, pT2c, 42 grm, tumor 20%, Contained in capsule, one post. margin, clear lymph nodes
2009 PSA 2/9 .05, 5/9 .10, 6/9 .11, 8/9 .16
Lastest 7/13 met with Rad. Oncl, considering options, 7/20 Catheter #6 after complete blockage, scarring closed up bladder neck, corrective laser surgery scheduled for 8/18,
meeting with Rad. Oncl on 8/14 about lastest PSA