how long from hormone therapy to radiation?

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michael006
New Member


Date Joined Sep 2009
Total Posts : 5
   Posted 9/28/2009 9:45 AM (GMT -6)   
Hello,

I am a gleason 3/3. I have been told it is 8-10 weeks from the hormone injection until the actual radiation starts. Is this correct?

Am going to be marked on Oct. 1st and radiation starts Oct. 19th. My injection was August 14th.

Thank you for your help and best of luck to everyone.
Michael

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 9/28/2009 10:08 AM (GMT -6)   
Hi Michael,
Welcome to HealingWell. It's the site no one wants to joing, but we are glad we found it. I started IMRT radiation approximately 5 weeks after my first Lupron injection. But there is no rush. Usually RO's wait until the "flare" from the HT is no longer present, and that only takes a few weeks, even less. Sometimes scheduling is the biggest factor to getting you started, and I suspect that is the case. But HT will keep things at bay until you get started.

If you can, tell us more about your journey. Usually Gleason 6 guys are not running to HT and radiation unless they had poor results from surgery, of a very high PSA...

Peace,

Tony
 Age 47 (44 when Dx)
Pre-op PSA was 19.8 : Surgery at The City of Hope on February 16, 2007
Gleason 4+3=7, Stage pT3b, N0, Mx
Positive Margins (PM), Extra Prostatic Extension (EPE) : Bilateral Seminal vesicle invasion (SVI)
HT began in May, '07 with Lupron and Casodex 50mg (2 Year ADT)
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (May 11, 2009): <0.1
 
My Journal is at Tony's Blog  
 
STAY POSITIVE!


Cajun Jeff
Veteran Member


Date Joined Mar 2009
Total Posts : 4106
   Posted 9/28/2009 10:21 AM (GMT -6)   
Michael, welcome to HW. You will fine this group very helpful in your journey. We are all friends in PC and we all have had questions about the process. Good luck and keep us posted. As Tony said please post your stats. I was a bit suprised that you were in HT and radiation with a Gleason 6.

Stay positive and know we are with you.

Jeff Travasos
Cajun Country
Jeff T Age 57
9/08 PSA 5.4, referred to Urologist
9/08 Biopsy: GS 3/4=7
10/08 Nerve sparing open RRP- Path Report: GS 3+3=7 Stg. pT2c, margins clear
3 mts: PSA .05 undetectable
 10th month  PSA <0.01
ED- 5 mg Cialis daily, pump daily, going to try MUSE next


michael006
New Member


Date Joined Sep 2009
Total Posts : 5
   Posted 9/28/2009 12:37 PM (GMT -6)   
Hi Tony and Jeff,


Thank you for replying. My story is very frustrating and from what i have read is not the way it normally goes.

I live in Ireland and had a PSA every year, which were normal. I'm 63 years old. In December 08, they found a slightly elevated PSA and sent me for a biopsy. The biopsy was done in February 09. On April 20th, i got the results saying cancer and a gleason 3. We discussed the various treatments and decided on brachy.

Was scheduled for a bone scan, MRI and Transrectal ultrasound scan (TRUS). This took from April until July 30th, when i was told that the prostate had grown too big for brachy and that the cancer had spread to the seminal vesicles and was now a stage 3. I started on Casodex the next day, July 31st for 2 weeks. On August 13th i got an injection of Decapeptyl and continued on the tablets until August 28th.

He told me that the plan of treatment would be; the hormone therapy, 5-8 weeks of radiation, at which time they would assess if brachy was needed in addition. This was because the prostate grew and the cancer spread.

I was told that i would be starting the radiation October 1st, but today found out that i will just be marked that day and the radiation will start, possibly, October 19th. They said it had to be 8-10 weeks after the injection, of course if it is the 19th it will be 10 weeks.

The waiting and frustration have been unsettling and have caused me and my family terrible stress. Each time i complained about the long wait, I was told that i am lucky to be moving along this quickly. In December it will be a year since the PSA test.

So, that's where i am now. Your thoughts are very welcome to me.
Thank you,
Michael

michael006
New Member


Date Joined Sep 2009
Total Posts : 5
   Posted 9/28/2009 12:40 PM (GMT -6)   
Oh, in December my PSA was 4.8 the normal being 4. In May the PSA was 5.2.

Michael

6071
Regular Member


Date Joined Jul 2008
Total Posts : 112
   Posted 9/28/2009 2:29 PM (GMT -6)   
Hi Michael
Welcome to HW i to am from Ireland and the the waiting is very long
as you know if you have vhi it will be a lot faster if is the Medical Card?
I got the markings in June and i started radiation in august i think you will be getting the Radiation in St Lukes in Dublin
I think you should get a copy of your Biopsy reports psa and please post them in your stats
What part of Ireland are you from i am from Dublin
Good luck to you
Age 61 at DX
Biopsy 7/2008 Positive 1 of 12 cores positive 3+4 5% To 10%
Open Radical Prostatectomy 15/10/2008
Stage pt2c
Post op staging Gleason's Score 3+4=7
apical margin is focally positive
no extraprostatic extension
Seminal vesicles and lymph nodes clear
Catheter out on the 13/11/2008
4 week PSA < 0.1
26/1/2009  < 0.1
20/4/2009 < 0.1
11/6/2009 ultra sensitive psa 0.07
20/7/2009 < 0.1
26/8/09 Starting IMRT
 
 







John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4223
   Posted 9/28/2009 4:19 PM (GMT -6)   
Michael,
How do they know that the seminal vessles are involved? If it was seen by the ultrasound then why didn't the ultrasound on your biopsy show it? It is very unusual for a G6 to grow that fast, and if in fact it is growing that fast you should be tested for a rare varient. Something here just doesn't add up and I would question the heck out of your doctors.
I sympathize for the wait you have had to endure; it must be very frustrating. To all that knock our health care system remember that we can receive scans in days and have almost any procedure within a few weeks.
JohnT

64 years old.

PSA rising for 10 years to 40, free psa 10-15. Had 5 urologists, 12 biopsies and MRIS all neg. Doctors DXed BPH and continue to get biopsies yearly. 13th biopsy positive in 10-08, 2 cores of 25, G6 less than 5%. Scheduled for surgery as recommended by Urological Oncologist.

2nd Opinion from Dr Sholtz, a Prostate Oncologist, said DX wrong, pathology shows indolant cancer, but psa history indicates large cancer or metastasis. Futher tests and Color Doppler confirmed large transition zone tumor that 13 biopsies and MRIS missed. G7, 4+3, approx 16mmX18mm.

Combidex MRI in Holland eliminated lymphnode mets. Casodex and Proscar reduced psa to 0.6 and prostate from 60mm to 32mm. Changed diet, no meat and dairy. All staging tests indicate that tumor is local and non agressive. (PAP, PCA3, MRIS, Color Doppler, Combidex, tumor reaction to diet and Casodex, and tumor location in transition zone). Surgery a poor option because tumor is located next to the urethea and positive margin is very likely; permanent incontenance is also high probability with surgery.

Seed implants on 5-19-09, 3 hours door to door, no pain, minor side affects are frequency and urgency; very controlable with Flowmax and lasted 4 weeks. Daily activities resumed day after implants with no restrictions. Gold markers implanted with seeds to guide IMRT.

25 treatments of IMRT 6 weeks after seed implants. No side affects at all.

PSA at end of treatment 0.02 mostly the result of Casodex. When I stop Casodex next week expect PSA to rise. Next PSA in November. Treatments and side affects have greatly exceeded my expectations. Glad to have this 11 year journey finally conclude.

JohnT


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 9/28/2009 4:34 PM (GMT -6)   
John, I think you are right ,and sometimes here in the US, long waits usally aren't the norm. I had all my biopsies within a week of them being ordered, my surgeon was 7 weeks from the last biopsy, 1 more than my dr wanted, the hospital was a little backed up at the time.
Thursday, I will have my 3rd corrective surgery this year, and was only ordered last Friday, and tommorow I go for the pre-op. Just kind of take it for granite that things happen fast here.
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20%, Contained in capsule, 1 pos margin
2009 PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Latest: 7/09 met 2 rad. oncl, 7/09 cath #6 - blockage, 8/09 2nd corr surgery, 8/9 cath #7 - out  38 days, 9/14/9 - met 3rd rad. oncl., agreed to start radiation, mapping on 9/21/9, 9/24 - mtg & procedure? with uro/surg, IMRT starts 10/5/9


6071
Regular Member


Date Joined Jul 2008
Total Posts : 112
   Posted 9/28/2009 5:30 PM (GMT -6)   
yes lads you are very lucky
to days news
http://iol.breakingnews.ie/news/ireland/
Irish health system ranked 13th in Euro league
28/09/2009 - 11:10:51
The Irish health service has moved up two places in an annual league table of the various health systems across Europe.
Ireland is ranked 13th out of 33 countries in the 2009 Euro Health Consumer Index, up from 15th place last year.
The Irish health service was ranked 28th in the league table three years ago.
The rankings are based on a range of criteria, including waiting times, medical outcomes, patient rights and the range of services provided
PSA Results waiting time 10 to 14 days
Biopsy Results waiting 4 to 5 weeks
waiting time to start Radiation 8 to 10 months
waiting time open Radical Prostatectomy 4 months
so lads you have it good over in the usa


Age 61 at DX
Biopsy 7/2008 Positive 1 of 12 cores positive 3+4 5% To 10%
Open Radical Prostatectomy 15/10/2008
Stage pt2c
Post op staging Gleason's Score 3+4=7
apical margin is focally positive
no extraprostatic extension
Seminal vesicles and lymph nodes clear
Catheter out on the 13/11/2008
4 week PSA < 0.1
26/1/2009  < 0.1
20/4/2009 < 0.1
11/6/2009 ultra sensitive psa 0.07
20/7/2009 < 0.1
26/8/09 Starting IMRT
 
 






Post Edited (6071) : 9/28/2009 5:42:21 PM (GMT-6)


michael006
New Member


Date Joined Sep 2009
Total Posts : 5
   Posted 9/29/2009 4:29 AM (GMT -6)   
I am in the West of Ireland and going to University hospital in Galway for radiation. On the medical card. I have to stay in a house there provided by the hospital for the radiation patients who live more than 1/2 hour from hospital. Can go home on weekends if up to it, they tell me.

On Thursday, i will ask all the questions you pointed out and see if i can get copies of tests to post here.

In regards to the seminal involvement...the consultant said after reviewing all the tests, they feel that it has moved into that area and said the treatment would be as i mentioned above. That's it...told me no more.

My sister is in the US and is very mad and upset at the wait over here, and the lack of information. She wants to write to the Heath Services who run the system, but i told her it would do no good, as there are people much worse and sicker than me and they just have to wait.

Thank you for all your information. I will grill them on Thursday, which can't come soon enough for me. To those that had the radiation, how did you feel? Side effects? How long did the radiation go on? (sorry for all the questions, but i see you are all very informed)

Thanks very much.
Michael.

Geebra
Regular Member


Date Joined May 2009
Total Posts : 476
   Posted 9/29/2009 6:00 AM (GMT -6)   
Michael,

While it is frustrating to wait, it actually medically beneficial for you. There are studies that show that pre-treatment with HT for at least two months before radiation and continuing ADT for up to six months or longer during and after radiation significantly improves the outcome.

Best of luck on your treatments.

Greg

Father died from poorly differentiated PCa @ 78 - normal PSA and DRE

5 biopsies over 4 years negative while PSA going from 3.8 to 28

Dx Nov 2007, age 46, PSA 29, Gleason 4+4=8

Decided to participate in clinical trial at Duke - 6 rounds of chemo (Taxotere+Avastin)

PSA prior to treatment on 1/8/2008 is 33.90, bounced on 1/31/2008 to 38.20, and down at the end of the treatment (4/24/2008) to 20.60

RRP at Duke (Dr. Moul) on 6/16/2008, Gleason downgraded 4+3=7, T3a N0MX, focal extraprostatic extension, two small positive margins

PSA undetectable for 8 months, then 2/6/2009-0.10, 4/26/2009-0.17, 5/22/2009-0.20, 6/11/2009-0.27

Salvage IMRT + 6 Months ADT: Casodex started 6/12/2009, Lupron 6/22/2009, PSA 6/25/2009-0.1, T=516, 7/23/2009-<0.05, T<10, IMRT to start mid-Aug


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 9/29/2009 6:33 AM (GMT -6)   
6071,

Those kinds of waits would be totally unacceptable by most all in the US. Good luck to you.
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20%, Contained in capsule, 1 pos margin
2009 PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Latest: 7/09 met 2 rad. oncl, 7/09 cath #6 - blockage, 8/09 2nd corr surgery, 8/9 cath #7 - out  38 days, 9/14/9 - met 3rd rad. oncl., agreed to start radiation, mapping on 9/21/9, 9/24 - mtg & procedure? with uro/surg, IMRT starts 10/5/9


michael006
New Member


Date Joined Sep 2009
Total Posts : 5
   Posted 9/29/2009 6:35 AM (GMT -6)   
Greg,

Thank you, that is good to hear for sure. With all the delays, i didn't think any could be beneficial.

The neck pain and headache from the Decapeptyl make me feel as if in a fog all the time. Extreme tiredness has now set in as well. Naps in the afternoon are the norm now.

Thanks again,
Michael

6071
Regular Member


Date Joined Jul 2008
Total Posts : 112
   Posted 9/29/2009 10:49 AM (GMT -6)   
hi Michael
How Far do you live from the hospital?
if you need Transport give the Irish Cancer Society a call and they might get Transport for you
Irish Cancer Society Freefone 1800 380 380
Monday - Thursday 9am - 7pm. Friday 9am - 5pm
good luck to you
Age 61 at DX
Biopsy 7/2008 Positive 1 of 12 cores positive 3+4 5% To 10%
Open Radical Prostatectomy 15/10/2008
Stage pt2c
Post op staging Gleason's Score 3+4=7
apical margin is focally positive
no extraprostatic extension
Seminal vesicles and lymph nodes clear
Catheter out on the 13/11/2008
4 week PSA < 0.1
26/1/2009  < 0.1
20/4/2009 < 0.1
11/6/2009 ultra sensitive psa 0.07
20/7/2009 < 0.1
26/8/09 Starting IMRT
 
 






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