R/T 1st,R/T with ADT,or go straight to ADT

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turner
Regular Member


Date Joined Jan 2010
Total Posts : 119
   Posted 1/11/2010 10:25 PM (GMT -6)   
 Met with oncologist at UofM today. Wants a Ct of neck and abdomen due to previous suspicious prostastint scan.(surprise!). Says if nothing shows up to start R/T of prostate bed and if that fails to start H/T.
 Givien my path report (which UofM verified),quick time to psa failure &doubleing time of  2months (psa this week 1.1) am i waisting valueable time delaying ADT? Its time to get the ball rolling. Anyone car to chime in?...turner
 
 diag 2/09 @ 3 wks before 50th
 
 psa 4.5
 
 t2b
 
 5 of 6 cores pos....5,20,50,25,5 %
 
 gleason 3+4
 
 RALRP 4-20-09
 Path: lymph node -
          seminal ves -
          margins -
          EPE -
          preineural inv-
          gleason 3+7
          stage pt2c
          tumor vol 40%
         
 
 psa 7/22/09  0.1
      10/23/09  0.3
       11/23/09 0.5
       01/05/10 1.1
 Met with raidioligst 12-28
 Meeting prostate oncologist @Uof M 1-11
 Not like'n where this heading.  Surgery was and still is a walk in the park compared to what lies ahead :(
 
 
 
 


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 1/11/2010 10:30 PM (GMT -6)   
Turner, been following your numbers too. With your current PSA number that high and that soon after surgery, at the least, I would be doing the salvage radiation just like I completed in November. Your current PSA is almost 10x higher than mine was at the start of the radiation. Some radiation oncologists would reccomend doing the radiation with hormone treatments, and others would say to do the radiation first, then to hormone if the radiation fails (that was my doctors reccomendation for me). Good luck and please keep posting.

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


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 1/11/2010 10:34 PM (GMT -6)   
Hi Turner,
Sounds like you should be headed to Radiation alone first. Of the additional therapies hormonal therapy carries the least curative and most side effects given your age. At this point you may just need a "mop up" post surgery. The choice of surgery is intended to be a curative approach with a fall back to radiation in local reoccurrence. The only reason I added HT was because all those negatives in your pathology were positives (Ugh!) in my pathology report. If I could have avoided HT I would have, but it is what it is.

Don't be over aggressive if you don't truly have to is my approach. And HT is indeed an aggressive systemic approach and you have no confirmed evidence of systemic disease.

Tony
Prostate Cancer Forum Co-Moderator


goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2692
   Posted 1/11/2010 10:56 PM (GMT -6)   
The HT has no chance of curing you of cancer.

The RT, while the odds may be long, has some chance. In my opinion you are down to playing a game of chance.

Go for the choice that has some odds of succeeding forst, then move on to the HT.

The U of M people are sharp, Did you see Dr. Hussein ? She is the best of the best. I think I would trust them as to the best approach.

Goodlife
Age 58, PSA 4.47 Biopsy - 2/12 cores , Gleason 4 + 5 = 9
Da Vinci, Cleveland Clinic  4/14/09   Nerves spared, but carved up a little.
0/23 lymph nodes involved  pT3a NO MX
Catheter and 2 stints in ureters for 2 weeks .
Neg Margins, bladder neck negative
Living the Good Life, cancer free  6 week PSA  <.03
3 month PSA <.01 (different lab)
5 month PSA <.03 (undetectable)
6 Month PSA <.01
1 pad a day, no progress on ED.  Trimix injection
No pads, 1/1/10


turner
Regular Member


Date Joined Jan 2010
Total Posts : 119
   Posted 1/12/2010 8:25 AM (GMT -6)   

 Thankyou all so much for your input.I believe we all need a different prespective every now and then. Its hard to be positive when the odds of R/T be effective(local recurence) are somewhere between slim and none.But......its where iam at now. Time to make some calls to set up CT and hopefully on to the next step(s)....turner

 


 
 diag 2/09 @ 3 wks before 50th
 
 psa 4.5
 
 t2b
 
 5 of 6 cores pos....5,20,50,25,5 %
 
 gleason 3+4
 
 N/S RALRP 4-20-09
 Path: lymph node -
          seminal ves -
          margins -
          EPE -
          preineural inv-
          gleason 3+4
          stage pt2c
          tumor vol 40
Continence- 99%- @3-4 months post op
ED-gradual work in progress w/meds
         
 
 psa 7/22/09  0.1
      10/23/09  0.3
       11/23/09 0.5
       01/05/10 1.1
 Met with raidioligst 12-28
 Meeting prostate oncologist @Uof M 1-11
 Not like'n where this heading.  Surgery was and still is a walk in the park compared to what lies ahead :(
 
 
 
 


Casey59
Veteran Member


Date Joined Sep 2009
Total Posts : 3172
   Posted 1/12/2010 1:39 PM (GMT -6)   
Turner, please be aware that there have been tremendous, documented strides forward in using radiation as a salvage therapy.  This site provides an overwhelming amount of emotional support to the PC community, but I've found other sites more useful for the purposes of getting solid educational input on PC topics.  Try this link on salvage RT, and in particular the posting #4 in the thread:
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