Hormone therapy right after radical prostatectomy, on average how long before starting?

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LuvMyDAD
Regular Member


Date Joined Dec 2009
Total Posts : 316
   Posted 1/6/2010 6:21 PM (GMT -6)   
My father just completed a radical prostatectomy about three weeks ago. He got an appointment with a doctor for follow up treatment for Feb. 12. Because he is a gleason 9 t3b, all studies point to combination therapy of HT plus radiation. What I wanted to know is on average, how long do people wait after radical prostatectomy before starting hormone treatment? I know radiation its at least 2-3 months but I am afraid that appointment is too late and he needs to he should have or needs to start it earlier. Any info you guys have on this would be greatly appreciated.
Thank you so much.
A girl who deeply loves her father,
LuvMyDAD

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25394
   Posted 1/6/2010 6:33 PM (GMT -6)   
Can't answer your question, but you are a great daughter!!! I got my own daddy's girl, thankful for that.

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
Post SRT PSA: 1/10 .12
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 - 11/27 IMRT SRT 39 sess/72 gys ,cath #8 33 days, Cath #9 35 days, 12/7 - Cath #10 in place


Opa N
Regular Member


Date Joined Sep 2009
Total Posts : 150
   Posted 1/6/2010 8:12 PM (GMT -6)   
I had my surgery on 8/20/09. First post-op psa on 9/20/09 (<0.01). Had first Lupron injection on 10/20/09. PSA tests on 10/26/09 and 12/20/09, both <0.01. Starting RT on 1/18/10. Lupron will do 2 things for you - 1st it can kill off some PCa cells from starvation, and 2nd it will lower the testosterone to undetectable levels, thus depriving any remaining PCa of its food source. RT is usually started 8 weeks after beginning HT. BUT, I can only tell you that there was a 2 month time period between surgery and start of HT in my case. My urologist is controlling that part of my treatment. Why don't you call yours and ask how soon you can begin? BTW, with my pulling three zeroes my RO felt comfortable postponing the RT for another month out so I could enjoy the holidays.
Side effects of Lupron for me have been quite bearable. I get hot flashes, especially at night, and I have put on 20 pounds. Can't do anything about the heat, but I joined a gym today, something I should have done a long time ago.
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.

 

 

 


LuvMyDAD
Regular Member


Date Joined Dec 2009
Total Posts : 316
   Posted 1/6/2010 8:30 PM (GMT -6)   
Hey Opa, thanks for your reply. My father had the surgery in NY but my sister got him follow up care at the Cleveland Clinic since has some connections there. We were just worried about the month and a half wait, but I guess it shouldn't be a problem. (I hope).
 
I should be studying for my bar exam but I really can't get my mind off of this. But thanks for your response I feel a little bit better now.
 
David I am glad you have a daddy's girl, nothing is like having a daughter by your side.

brainsurgeon
Regular Member


Date Joined Jul 2009
Total Posts : 137
   Posted 1/7/2010 11:17 AM (GMT -6)   
Every man should have a daughter, if for nothing more than the education one gets. Mine is a treasure.
70 years old (1939) USA citizen
Prostatic carcinoma dxed June 2009 by PSA (7.0) and then Bx
PSAs yearly since 2001 ranged 1.52 to 7.0
Neg. CT and Bone Scan
4 of 8 biopsies positive (all right side) Gleason Score 3+4=7
Robotic assisted total prostatectomy and node excision July 2009 in Luzern, Switzerland by Dr. A. Mattei in the Kantonsspital
pT2c G3 pN0 (0/14)
Catheter out in 5 days (home in 3 days)
No incontinence
Positional neurpraxia resolved in 5 months.
Potency: beginning tumescence??? at 3 weeks post-op. Still happens at 3 months PO. Nearly usable one month later. At 5 mo. with 100 mg Vitamin V, pretty good.
3month PSA less than 0.01


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 1/7/2010 2:35 PM (GMT -6)   
Hi LuvMyDaD,
We have a reason to share information. My post surgery numbers are as follows:
Gleason 4+3=7
Stage pT3b, positive margins, Extra-prostatic Extension, Bilateral seminal vesicle invasion.

My journey is here:
www.caringbridge.org/visit/tonycrispino

I could have waited for radiation and hormone therapy, but the likelyhood of progression was in the 90% at year ten. I decided on immediate hormonal therapy combined with adjuvant IMRT radiation with pelvic lymph nodes radiated. My results at year three is that I have been blessed with a string of undetectable PSA's. I recently stopped hormonal therapy and I am awaiting last Monday's test results. Already I feel better with the increase in testosterone and I also have excellent bladder control and, blush, I am feeling much more friskey.

My Email is open here and I would be happy to share my experience with your father. I am the President of a large prostate cancer support group chapter of UsTOO and I speak with men and loved ones all the time. Your father has quite a few reasons to feel good. One, he has you looking out for him. Two, his diagnosis is not a death sentence. Three, he will still have many wonderful years ahead with his family and friends.

My motto is stay Positive. I share it with everyone!

Tony
Prostate Cancer Forum Co-Moderator

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