Post HDRB update

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grouchytx
Regular Member


Date Joined Oct 2009
Total Posts : 32
   Posted 12/11/2009 12:45 PM (GMT -6)   
I finished my second and last HDRB treatment Monday.  I had 28 daily  radiation treatments prior to the HDRB.
 
It went amazingly easy for me.  I did not have any major problems.
 
The HDRB has been more of a problem.  I had some problems the night of the first treatment but got thru it and was in pretty good shape this last Monday.
 
This last Monday evening went very well and I thought I was home free.  But.....night before last I started having maajor intestinal problems.  I decided to tough it out and it continued to get worse thru the day.  I finally called the clinic yesterday afternoon and they made some suggestions on what I could do for relief.  It seemed to be going a little better until about 11:00PM .  At that time I started having bladder spasms and very poor urine flow.  It seemed like everytime I needed to urinate, my bowels needed to void at the same time.  It was a very long night.
 
Today is going better and maybe I am over the hump.
 
Bill
Age: 63
 
Gleason: 8 (5+3) Biopsys ranged from 90% to 100%
Refused surgery and hormone therapy. Doctor really made an argument for benefits of hormone therapy, I could not accept the consequences.
 
28 IMRT treatments.  Originally scheduled to get seed implants but doc decided that due to my prognosis High Dose Rate Brachythrapy was a better path to attempt.
 
PSA: 13
 
Let the chips fall where they may.


zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 12/12/2009 6:10 AM (GMT -6)   
Bill hope you get through this without any long term effects and probably you won't have such, but you can ask your rad-doc comparitively with other patients, how your situation is stacking up.
Hindsight (lol) if someone told you the tests, protocols and things you have to do to fight this dragon would you have rolled your eyes(DRE, biopsies thru what?)...or thought the John McRoe vision of "you can't be serious?? It is bizzare for an outsider to contemplate these various techniques and protocols to arrive at similar results with way different types of modalities.

Big 'if' you don't conquer this beast this way, you will be buying time and some new things are in use even now like Leukine and it is not hormone therapy and little or no side effects and has results, the down side is either you have to have great insurance or be wealthy to buy it. Guy I know is using this via Dr. Scholtz (injections at home with it...cost $8000 for 3 months in his deal), his insurance is paying for it, too. Liquid gold because it has a patent, I am hopeful for others that the patent dies off or somebody else gets around it, free market competition is the righteous way.

grouchytx
Regular Member


Date Joined Oct 2009
Total Posts : 32
   Posted 12/12/2009 9:43 AM (GMT -6)   
zufus:

Thanks for the reply.

Due to my past experience with colon cancer, the tests, biopsies, etc. were not a major problem for me. That is one of those "do whatever is needed deals" in my opinion.

I know some on the board felt that I had made a major mistake by refusing surgery and hormone therapy.

The surgeon I met with said that surgery after radiation treatment was not a possibility, but that due to my diagnosis radiation was required. Without being disrespectful towards surgeons, I knew going in he would say "cut it out."

The radiologist said that he disagreed with that statement. He said that there were surgeons who specialized in that, but it was a much more difficult procedure. He also said that hormone treatment later on down the line was still an option.

I may have made bad decisions in my approach, but I did make the decision and am prepared to let it play out.

Bill
Age: 63
 
Gleason: 8 (5+3) Biopsys ranged from 90% to 100%
Refused surgery and hormone therapy. Doctor really made an argument for benefits of hormone therapy, I could not accept the consequences.
 
28 IMRT treatments.  Originally scheduled to get seed implants but doc decided that due to my prognosis High Dose Rate Brachythrapy was a better path to attempt.
 
PSA: 13
 
Let the chips fall where they may.


Jim B
Regular Member


Date Joined Mar 2009
Total Posts : 45
   Posted 12/12/2009 10:04 AM (GMT -6)   
Bill,

I was somewhat in the same boat as you. When discovered the biopsy indicated it was already outside the prostate so cutting it out would not cure anything. I was lucky because it was my surgeon who said go for the radiation. When it started to come back, the specialists at Oregon Health Sciences University suggested we explore surgery, but after radiation it is not a thought of maybe there will be side effects, it's how many side effects. After the bone scans they found the cancer in the pelvic and tail bone area so it appears all cancer in the prostate was killed, we just missed those cells that had already escaped. Thankfully I'm still asymptomatic and it still seems to be unreal that I am sick.
Dx age 48 PSA 11.58
Biopsy Nov 04
4 of 6 specimens positive
gleason 4+5=9
Perineural invasion at two locations
40 radiation treatments Jan-Mar 05
PSA May 05 0.07
Aug 05 0.15
Feb 06 0.92
Oct 06 0.55
Sep 07 0.42
Mar 08 1.13
Aug 08 2.26
Nov 08 3.98
Jan 09 5.81
Mar 09 9.02
Bone scan in Nov 08- one spot in pelvic region 1.9cm with SUV of 11
Bone scan in Mar 09-two spots. Original now 2.5cm with SUV of 22 and 2nd spot less than 1cm with SUV of 7.8


John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4223
   Posted 12/12/2009 11:54 AM (GMT -6)   
Bill,
Just curious; why did you choose HDR Brachy instead of regular Brachy?
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


grouchytx
Regular Member


Date Joined Oct 2009
Total Posts : 32
   Posted 12/12/2009 1:25 PM (GMT -6)   
JohnT:

My radiologist said that my PC had progressed too far for regular treatment.

Bill
Age: 63
 
Gleason: 8 (5+3) Biopsys ranged from 90% to 100%
Refused surgery and hormone therapy. Doctor really made an argument for benefits of hormone therapy, I could not accept the consequences.
 
28 IMRT treatments.  Originally scheduled to get seed implants but doc decided that due to my prognosis High Dose Rate Brachythrapy was a better path to attempt.
 
PSA: 13
 
Let the chips fall where they may.

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