talked to radiation oncologist

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gregory m helman
New Member


Date Joined Oct 2009
Total Posts : 16
   Posted 11/19/2009 8:59 PM (GMT -6)   
went to a radiation oncologist today at our local hospital and had a examination and talked.
he wants to do a ct scan and bone scan and also a prostate scan. this test takes about 3 trips to the hospital and our hospital does not do this test.
will have to go to pittsburgh,pa. the oncologist also wants to do a hormone therapy. has anyone had this prostate scan and hormone treatment?.
after all of this , he will wants to do radiation. he hopes the pc is in the area where the prostate was removed and then he can zap that area with radiation.
 i thought this would be done over with just radiation, but i guess they want to be sure.
  age 52
had rectal exam and found prostrate nodule detected.
psa was .097 before exam.
referred to urologist and also rectal exam , but couldn't feel anything.
we discussed about biopsy to be on safe side.
Final   Diagnosis of biopsy
specimen  is received in formalin in 8 parts labeled A-H.
 
 
 
A-G ------ no atypia or malignancy found.
H---- prostrate needle biopsy, left anterior horn:   Adenocarcarcinoma,
gleason score 3 + 4= 7,    4 mm in greatest linear dimension, involving approximately 20% of tissue from this site. less than 1ml cancer and less 1% of gland involved.
 
 
prostrate surgery done 7/29/2009 -- radical perineal surgery.
robotic was out of the question due to previous surgeries, hernia repair,gall bladder,had mesh put in.
 before surgery , psa was at 0.97.
09/2009 psa ---- 0.55
10/2009 ----- 0.39
11/2009 ------- 0.45
10 days with foley  cathereter
drain tube for 2  days
hospital stay--- 2 1/2 days
 had trouble with bowl movements constipated due to pain meds .
on stool softners
 after cath was out 2 pads a day
6 weeks later just 1 pad a day.
slight leakage , when lifting, sneeziing
 
post op pathology report
 
comment
Macroscopic
specimen type - radical perineal prostatectomy
specimen is intact
pre op psa level 0.97/ng/ml
other organs-seminal vesicle(s)
microscopic --tumor site-1 nodule
nodule#1- involves left lateral mid and left lateral
dimensions--0.6 x 0.2 x 0.6 cm
Histologic type------ Adenocarinoma
histologic grade---gleason
primary pattern is-grade 3 : single acini of variable size and seperation , cribriform and papillary patterns
Secondary pattern is: grade 4 : irregular masses of acini and fused epithelium , can show clear cells
gleason score (primary + secondary)  = 7 : Moderately poorly differentiated
 
Tumor Quantitation:
preportion of prostrate involved by tumor =<1 %
estimated tumor volume(% involved by tumor x prifixation vol) =< 1 ml
 
extraprostaic extention - absent
seminal vesicle invasion- absent
perineural invasion - absent
blood /lymphatic vessel invasion --absent
extent of invasion : pT2a: tumor involves < one half of one lobe
regional lyph nodes: NX; cannot be assessed
 
margins :
 
margins involved by tumor : anterior left lateral mid
margin involvement is extensive (> 1 HPF)
beingn prostatc acini are present at margins , not in area of tumor
 
 
 
 
 
 
 
 
 


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 11/19/2009 9:09 PM (GMT -6)   
gregory,

having salvage radiation done with or without HT is always a big subject. i met with 3 different radiation oncologists before I chose, and two wanted just to just radiation, and one wanted radiation with HT. you will find there are a lot of opinions on this subject, and lots of merits with either path.

you may wish to have more than one opinion on this treatment path. in the end, i went for what the 2 radiation onclogists suggested, which was backed by my uro/surgeon and my long term GP. So far, I am comfortable with my choice.

I will still have HT available in the future should the radiation fail too.

Good luck to you as your sort all this out.

David in 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
Incontinence:  1 Month     ED:  Non issue at any point post surgery
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out  38 days, 9/9 - met 3rd rad. oncl., mapped  9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - began IMRT SRT - 39 sess/72 gys cath #8 33 days, 11/2- SP Cath #9 in place


gregory m helman
New Member


Date Joined Oct 2009
Total Posts : 16
   Posted 11/19/2009 9:27 PM (GMT -6)   
this is my second radiation oncology and after what i heard  about this scan ,it gives me second thoughts.
i will talk to my uro/surgeon and get his thoughts on this.
  age 52
had rectal exam and found prostrate nodule detected.
psa was .097 before exam.
referred to urologist and also rectal exam , but couldn't feel anything.
we discussed about biopsy to be on safe side.
Final   Diagnosis of biopsy
specimen  is received in formalin in 8 parts labeled A-H.
 
 
 
A-G ------ no atypia or malignancy found.
H---- prostrate needle biopsy, left anterior horn:   Adenocarcarcinoma,
gleason score 3 + 4= 7,    4 mm in greatest linear dimension, involving approximately 20% of tissue from this site. less than 1ml cancer and less 1% of gland involved.
 
 
prostrate surgery done 7/29/2009 -- radical perineal surgery.
robotic was out of the question due to previous surgeries, hernia repair,gall bladder,had mesh put in.
 before surgery , psa was at 0.97.
09/2009 psa ---- 0.55
10/2009 ----- 0.39
11/2009 ------- 0.45
10 days with foley  cathereter
drain tube for 2  days
hospital stay--- 2 1/2 days
 had trouble with bowl movements constipated due to pain meds .
on stool softners
 after cath was out 2 pads a day
6 weeks later just 1 pad a day.
slight leakage , when lifting, sneeziing
 
post op pathology report
 
comment
Macroscopic
specimen type - radical perineal prostatectomy
specimen is intact
pre op psa level 0.97/ng/ml
other organs-seminal vesicle(s)
microscopic --tumor site-1 nodule
nodule#1- involves left lateral mid and left lateral
dimensions--0.6 x 0.2 x 0.6 cm
Histologic type------ Adenocarinoma
histologic grade---gleason
primary pattern is-grade 3 : single acini of variable size and seperation , cribriform and papillary patterns
Secondary pattern is: grade 4 : irregular masses of acini and fused epithelium , can show clear cells
gleason score (primary + secondary)  = 7 : Moderately poorly differentiated
 
Tumor Quantitation:
preportion of prostrate involved by tumor =<1 %
estimated tumor volume(% involved by tumor x prifixation vol) =< 1 ml
 
extraprostaic extention - absent
seminal vesicle invasion- absent
perineural invasion - absent
blood /lymphatic vessel invasion --absent
extent of invasion : pT2a: tumor involves < one half of one lobe
regional lyph nodes: NX; cannot be assessed
 
margins :
 
margins involved by tumor : anterior left lateral mid
margin involvement is extensive (> 1 HPF)
beingn prostatc acini are present at margins , not in area of tumor
 
 
 
 
 
 
 
 
 


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 11/19/2009 10:18 PM (GMT -6)   
gather all the opinions you can, my friend, knowledge is strength here, and knowledge will help knock out any fears or doubts
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
Incontinence:  1 Month     ED:  Non issue at any point post surgery
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out  38 days, 9/9 - met 3rd rad. oncl., mapped  9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - began IMRT SRT - 39 sess/72 gys cath #8 33 days, 11/2- SP Cath #9 in place


Dave7
Regular Member


Date Joined Jul 2006
Total Posts : 202
   Posted 11/19/2009 10:41 PM (GMT -6)   
I think the doctor wants to make sure there isn't detctable distant metastasis before doing the pelvic radiation.
If there's distant metastasis the pelvic radiation isn't going to work.
 
It makes sense to me.  Why are you having second thoughts?
 
Dave
Age:54
PSA 5/22/06: 5.6
DaVinci surgery: 9/14/06
Gleason: 3+3
Organ confined, clean margins.
Both nerve bundles spared.

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