My Husband's Journey Towards SRT

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Sephie
Veteran Member


Date Joined Jun 2008
Total Posts : 1804
   Posted 10/10/2009 8:12 AM (GMT -6)   
I promised to keep you all posted on where we are in the next leg of our journey.

To recap: John's PSA hit 0.0 shortly after surgery in March 2008 and stayed there til August 2009. His PSA came back at 0.1; another PSA was done 1 month later and came back at 0.3. Urologist said small increase, don't panic, but this might be a good time to talk with a radiation oncologist. We had appointments with 2: the first doctor is about 10 minutes from our home and the second is about 30 minutes (at a hospital). We met doctor #1 - and loved her! She gave us a tour of the facility, explained the whole process, was very calming and reassuring. We decided we liked her so much that we cancelled the appointment with the second rad onc. She could sense my anxiety and spoke to me privately, saying that with John's very low PSA and the fact that it took more than 12 months to show itself are both very good signs. She explained that in situations like John's, SRT treatment results are high. She gave John a DRE and said everything felt great "down there" - tissue very soft and pliable, no ridges, bumps, or anything.

Both the radiation oncologist and our urologist spoke during our meeting and discussed what tests we should do next. The obligatory abdominal and pelvic CT scan with IV contrast was ordered as well as a bone scan. While neither doctor felt the bone scan would show anything with John's very low PSA reading, we all agreed that it's better to be safe.

Both tests were done this past Thursday. The technician showed John the results of the bone scan and said "I don't see anything but the doctor will review the results and will let you know".

The rad onc had the results of both tests that same day and will review them next week. I expect we'll hear from her shortly after that with her plan of action.

John is very confident in the treatment and is not nearly as scared as he was a couple of weeks ago. I think that talking with the radiation oncologist, seeing the equipment, and understand exactly how it all works (along with the safety features built into the process) made him much more relaxed. And, if he's happy, so am I!

Now we wait again to hear from the radiation oncologist. I'm anxious to know what her treatment plan will be, especially the dosage as I've read that 7000 rads (70 gys) seems to the optimal dosage.

Will keep you all posted. Between David (Purgatory) and me, we'll soon be experts on salvage radiation therapy!
Husband diagnosed in 2/2008 at age 57 with stage T1c. Robotic surgery performed 3/2008. Stage upgraded to T3a (extraprostectic extension in posterior left). Perineural tumor infiltration present. Apex margin, bladder neck and SV negative. Gleason 3+4 (no change from biopsy). PSA results: April 2008 0.1; May 2008 0.0; August 2008 0.0; November 0.0; February 2009 0.0; May 2009 0.0; August 2009 0.1; September 2009 0.3. Met with radiation oncologist and began process for salvage radiation. CT scan and bone scan done on October 8 (bone scan clean!).


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 10/10/2009 8:39 AM (GMT -6)   
Sephie, good update.

I would expect John to be given a min of 70 greys. My radiation oncologist feels that with IMRT they can give higher, but safer and more directed radiation to the prostate bed and/or pelvic area. We talked about this last week, and she felt that doses under 70 greys probably wouldn't be effective for most men. Mine is set for 72.

Someone had to walk down the tunnel first, Sephie, but keep in mind, like everything else medical related, my sensitivities to radiation might not happen to John, or he could even feel worse, it varies that much. But at least from my reports, hopefully we can keep some sheer surprises out of your husbands path down the same road.

It feels great today (Sat) knowing I don't have to go back for any more zaps till Monday afternoon. The women that are treating me joked about not getting to comfortable, because they would be waiting with open arms for me to start all over again on Monday. We are already all on first name basis after just a week.

I even get on the bed portion of the machine in a butt backwards fashioned. They thought at first I was just being annoying, but soon realized that I am left handed and do most things in reverse order. Now they let me climb on and off in a way that makes sense to my strange brain, lol. Know one parallel parks like I do, but that's another story.

So John has not been mapped and tattooed yet I gather.

David in a rainy SC
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% cancer, 1 pos margin
Post Surgery  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, 8/9 2nd corr surgery, 8/9 cath #7 - out  38 days, 9/14/9 - met 3rd rad. oncl.agree to start radiation, mapping on 9/21/9, 9/24 - mtg with uro/surg, 9/29- pre-op, 10/1 - 3rd corr. surgery - suprapubic cath/hard dialation, 10/5 - first treatment IMRT.


Sephie
Veteran Member


Date Joined Jun 2008
Total Posts : 1804
   Posted 10/10/2009 9:21 AM (GMT -6)   
David, no John hasn't been mapped and tattooed yet as the doctor will be reviewing his CT scan and bone scan results next week. I expect she'll be calling us somewhere during the second half of next week to set up that appointment.

I've no idea how John will reaction to the radiation. We bought some candied ginger in case he feels any queasiness. Fortunately, he has the option of working from home or, if he wants to go into the office, it's a 7 mile drive and is within our town.

Enjoy your "time off" from RT...
Husband diagnosed in 2/2008 at age 57 with stage T1c. Robotic surgery performed 3/2008. Stage upgraded to T3a (extraprostectic extension in posterior left). Perineural tumor infiltration present. Apex margin, bladder neck and SV negative. Gleason 3+4 (no change from biopsy). PSA results: April 2008 0.1; May 2008 0.0; August 2008 0.0; November 0.0; February 2009 0.0; May 2009 0.0; August 2009 0.1; September 2009 0.3. Met with radiation oncologist and began process for salvage radiation. CT scan and bone scan done on October 8 (bone scan clean!).


lewvino
Regular Member


Date Joined Jul 2009
Total Posts : 384
   Posted 10/10/2009 2:17 PM (GMT -6)   

Sephie,

Thanks so much for posting and sharing with us about your husband's and your journey. Good luck on the follow up treatments.

Larry

 


Father treated for Prostate Cancer in 1997 with Proton Beam - Still doing well.
My Stats
Age at diagnosis 54, PSA 5.1
Biopsy 04/08 12 cores, 5 positive
Gleason 3 Cores at 4+3=7, 2 Cores at 3+4=7
Perineural Invasion Noted on biopsy

Robotic surgery 08/12/09 at Vanderbilt, Nashville TN. 
 
Post Surgery - Dr. Spared 100% of Nerves on the left side.
Estimated that 50 - 70% of the nerves were spared on the right side.
 
Final Path report
20% of the prostate Invovled
Tumor graded at T2C
Overall Gleason 3+4 (7)
Lymph Glands Clear
Positive Margin 1.8 cm in length Noted in Right Apex

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