3-d mapping & brachytherapy

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propaul
New Member


Date Joined Mar 2009
Total Posts : 8
   Posted 10/13/2009 3:30 PM (GMT -6)   
Hello again to all of you that responded to one of my previous threads.
It seems that most of the participants of this dialogue have gone through radical surgery.  I was wondering if any of you had 3-d mapping prior to surgery?  Had any of you considered "seeding", but found that it was not an effective route for you?  I had a general biopsy, 26 slides, showing a small focus of adenocarcinoma, gleason grade 3+3=6 in 2 of the 6 areas sampled? Because it is not widespread I am considering mostt other options than prostate removal and would appreciate any input from you.
 
Propaul

John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4269
   Posted 10/13/2009 4:00 PM (GMT -6)   
ProPaul,
What was your psa? how old are you? A g6 low psa is ideal for active survelience or just about any treatment. You can get a 3D mapping or a color doppler just to be sure, but 26 cores is pretty much a 3D mapping anyway.
If you were to go on AS get a doctor that is familiar with it; the important thing to monitor is your psa doubling time. If it is over three years and stays above three years there is very little chance of your PC ever hurting you.
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 : 25393
   Posted 10/13/2009 4:07 PM (GMT -6)   
Propaul, I original was sold on and wanted seeding, but couldn't have it. My PSA was too high, and my PSA velocity was really troublesome, indicating a pretty agressive cancer. In the end, I went with open surgery. Now I am in the midst of salvage radiation.

I think seeding is a great alternative to those who meet the criteria.
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 - began IMRT SRT - 39 sessions/72 gys.

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