Any thoughts on clinical trial with IMRT?

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60Michael
Veteran Member


Date Joined Jan 2009
Total Posts : 2229
   Posted 12/30/2009 9:25 AM (GMT -6)   
I will start IMRT next week, but met the radiation oncologist yesterday and was impressed with both him and the facility. Not as sterile as a hospital or surgery room. But he said that I was eligible for a clinical study due to reocurrence and the computer would pick betwenn HT with 2 shots at 3 and 6 months or have HT and radiation to the prostate bed and to the pelvic lymph nodes as well as HT.
 
I am a T2C with extraprostatic extension with both conventional acinar adenocarcinoma and prostatic adenarcinoma.Left lateral and left posterior margin invovlement. Less than 105 involvelment. Right and left seminal vesicles negative for malignancy. Any feedback is appreciated. My first thought is I dont want HT but my second thought is I want to live as long as possible.
Thanks
Michael
Dx with PCA 12/08 2 out of 12 cores positive 4.5 psa
59 yo when diagnosed
Robotic surgery 5/09 Atlanta, Ga
Catheter out after 10 days
Gleason upgraded to 3+5, volume less than 10%
Margin slightly involved
2 pads per day, 1 depends but getting better,
8/5 1 depend at night only, now none
 started ED tx 7/17, slow go
Post op dx of neuropathy
3 months psa.01, 6 month psa.4, 6 1/2 month psa.5
Consulting with Primary Urologist for further tx.
Great family and friends
Michael


Opa N
Regular Member


Date Joined Sep 2009
Total Posts : 150
   Posted 12/30/2009 9:34 AM (GMT -6)   
Most guys here with psa rise go for SRT without HT. If you get the HT followed by RT, you have to wait for 2 months for the hormones to kick in before you can begin the RT. The other study option is for HT alone, with no RT, right? I don't know if I would want to go that route.
I have been fortunate to get a psa result of zero for three tests, but have begun HT and will begin RT in January, all due to a pT3b result. I think you will hear a lot from the SRT guys here.
All the best.
Roger

 Age 67 at diagnosis. Treated for coronary artery disease (CAD) since 1998, and under control with medications.

2/6/09              Routine physical, with DRE and PSA Test. PSA 4.02. Referred to Uro

4/20/09            TRUS  w/needle biopsy

4/23/09            Diagnosis PCa with Gleason 4+3 in 2/2 cores, Gleason 3+3 in 5/10 cores.

                        CT scan and Bone Scan both negative. Stage T2C.

8/27/09            DaVinci RP at WakeMed Cary NC with Dr. Tortora. Discharged 8/28.

9/8/09              Catheder removed. Path post-surgery confirms PCa, with Gleason 3+3 with scattering of 4. Positive margins in L & R posterior, R and L seminal vesicles, with perineural invasion.  Stage pT3b.

9/30/09            PSA Post-Op <0.01. Met w/Uro/Surgeon to review surgery and path report. Referred to Prostate Oncologist and Radiation Oncologist. Appointments set for 10/8.

10/8/09            Met w/ both oncologists. Adjuvant Combination Therapy to begin ASAP.

10/21/09          First Lupron injection. 30 mg dose (4 month)

11/2/09            PSA 2-month <0.01. Cystoscope w/calibration and dilation to remove scar tissue from urethra. Big relief.

12/18/09          psa 4-Month <0.01 undetectable. MRI/CT scan set for 1/5/10 for IMRT planning. RT to begin week of 1/11/09. Anticipate 64-66 grays over 32-33 treatments. 

 

Initial incontinence pretty bad, starting w/6 Depends pants/day. Gradually getting better, with dramatic reduction in leakage around 9/20. Currently on 1 pad during the day and one at night (for security). Actually totally dry at night.

 

 

 


Geebra
Regular Member


Date Joined May 2009
Total Posts : 476
   Posted 12/30/2009 10:07 AM (GMT -6)   
There are a few studies that show significant survival benefit for RT + HT. HT is administered for two months prior to RT, during the RT and for two to six months after. Unfortunately, these studies are for primary treatment.

My Rad Onc said that there was a new study (that I was unable to find so far) that shows even better result with longer HT period (3 years) after the RT. That study, while not exclusively for SRT patients, at least included some of them.

The study you are talking about sounds like exclusive to SRT folks. This is great, I wish the results of this were available today.

I had a recurrence (I am a T3b with G7) and chose RT plus HT. I am two months after completion of RT. The agreement with the doc is I'll do six months of HT and then we discuss if any more is needed. I am not enjoying the HT, but it is not bad. Hot flushes and complete loss of libido are the main complaints.

60Michael
Veteran Member


Date Joined Jan 2009
Total Posts : 2229
   Posted 12/30/2009 9:13 PM (GMT -6)   
Thanks for the feedback Roger and Geebra. If I understood him right I would have one tx of HT at 3 months, so my IMRT would be completed. The next round of HT would be a the sixth month mark. But once again the computer picks your tx and not you on clinical studies. Will keep reading up until I feel comfortable either to committ or not.
Thanks
Michael
Dx with PCA 12/08 2 out of 12 cores positive 4.5 psa
59 yo when diagnosed
Robotic surgery 5/09 Atlanta, Ga
Catheter out after 10 days
Gleason upgraded to 3+5, volume less than 10%
Margin slightly involved
2 pads per day, 1 depends but getting better,
8/5 1 depend at night only, now none
 started ED tx 7/17, slow go
Post op dx of neuropathy
3 months psa.01, 6 month psa.4, 6 1/2 month psa.5
Consulting with Primary Urologist for further tx.
Great family and friends
Michael

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