Visited my Oncologist

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Geebra
Regular Member


Date Joined May 2009
Total Posts : 476
   Posted 1/13/2010 4:23 PM (GMT -6)   
I had one of mine 6-monthly visits with my Oncologist at Duke. He is now agreeing with my Rad Onc that I should stay on the HT for three years. Ouch! Not something I expected from him. He has previously said six months. I don't know why, but I feel disappointed. My first six months on HT were not a lot of fun. I've gained 15 pounds. At that rate, I will have gained 75 pounds, by the time this is over. I just hope this is not going to be linear. I have doubled the amount of exercise, but I am always hungry and tend to overeat.

My Onc recommended that I start on between 1,000 to 2,000 IU of vitamin D with calcium, fish oil and multi-vitamin.

Also, we had a what-if discussion. What if this did not help? There are a few very promising drugs in the pipeline (including Provenge) that will be approved in the next few years, though they are mostly HT drugs. Vaccines being the most promising new direction, he thinks that Provenge approval will generate a lot of research and competition in the area.

Finally, he is moving to UCSF to run the genitourinary cancer department. Highly recommend this guy to anyone in San Fran area. I am thinking I will keep seeing him. SF is a fun town to visit.
Father died from poorly differentiated PCa @ 78 - normal PSA and DRE
5 biopsies over 4 years negative while PSA going from 3.8 to 28
Dx Nov 2007, age 46, PSA 29, Gleason 4+4=8
Decided to participate in clinical trial at Duke - 6 rounds of chemo (Taxotere + Avastin)
PSA prior to treatment 1/8/2008 is 33.90, bounced on 1/31/2008 to 38.20, and down at the end of the treatment (4/24/2008) to 20.60
RRP at Duke (Dr. Moul) on 6/16/2008, Gleason downgraded 4+3=7, T3a N0MX, focal extraprostatic extension, two small positive margins
PSA undetectable for 8 months, then 2/6/2009 0.10, 4/26/2009 0.17, 5/22/2009 0.20, 6/11/2009 0.27
ADT (ongoing, duration TBD): Lupron started 6/22/2009
Salvage IMRT to prostate bed and pelvis - 72gy over 40 treatments finished 10/21/2009
PSA 6/25/2009 0.1, T=516, 7/23/2009 <0.05, T<10, 10/21/2009 <0.05, T<10


Cajun Jeff
Veteran Member


Date Joined Mar 2009
Total Posts : 4119
   Posted 1/13/2010 4:28 PM (GMT -6)   
Geebra, Sorry to hear this news. It is a plan and I wish you luck. Yes SF is a great place to visit.

Jeff T
Cajun Country
Jeff T Age 57

9/08 PSA 5.4, referred to Urologist
9/08 Biopsy: GS 3/4=7
10/08 Nerve sparing open RRP- Path Report: GS 3+3=7 Stg. pT2c, margins clear
3 mts: PSA .05 undetectable

10th month PSA <0.01
1year psa <0.01
ED- 5 mg Cialis daily, pump daily, going to try MUSE next. Next step injections.
15 months out injections Caveject (success)


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 1/13/2010 5:01 PM (GMT -6)   
Sorry Geebra, sure that was disapointing news. I don't think could assume you will gain 15 extra pounds each six months, hope you were kidding. I eat too much and I am not on HT. Too many sweets.

Was stationed for a spell in SF (Treasure Island to be exact), loved my time there. Beautiful city.

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


Doting Daughter
Veteran Member


Date Joined Aug 2007
Total Posts : 1064
   Posted 1/13/2010 7:46 PM (GMT -6)   
My dad went into HT with the commitment of trying one shot at a time. He threatened to stop HT each and every time he was due for a shot and he just completed two years. He had the same fears you did and did gain weight in the beginning, but managed to get a handle on things (not a love handle either :) and was back to his usual fit self in no time. The side effects are definitely there, but I hope you learn to manage them without too many problems. My father is beginning his HT vacation and I hope he can stay on it for a very long time. I hope the same for you. Hang in there and hope for the best!
Father's Age DX 62 (now 64)
Original Gleason 3+4=7, Post-Op Gleason- 4+3=7,
DaVinci Surgery Aug 31, 2007
Focally Positive Right Margin, One positive node. T3a N1 M0.
Bone Scan/CT Negative (Sept. 10, 2007)
Oct. 17 PSA 0.07
Nov. 13 PSA 0.05
Casodex adm. Nov 07, Lupron beg. Dec 03, 2007 2 yrs
Radiation March 03-April 22, 2008- 8 weeks 5x a week
July 2, 08 PSA <.02
Oct. 10, 08 PSA <.02
Oct. 9, 09 PSA <.01 Last Lupron Shot
Praying for a cured dad.

Co-Moderator Prostate Cancer Forum


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 1/14/2010 1:48 AM (GMT -6)   
Hi Geebra,
My T levels are creeping back after 2 years 4 months on Lupron/Casodex. While I am back up to 128 on the T levels (still a bit to go), I am feeling the effects of the return and notice the return of many good things. I mention this as I endured the longer term and got through it well and it has done a great job of helping maintain undetectable PSA's and for that I am very thankful. With the rise in T levels there has not been a rise in PSA to this date.

Hang in there and stay positive and you get through it fine. Don't let the extended run on ADT get you down. Keeping that PSA down is more important than a quick recess on ADT.

Tony
Prostate Cancer Forum Co-Moderator


CPA
Veteran Member


Date Joined Feb 2008
Total Posts : 655
   Posted 1/14/2010 7:55 AM (GMT -6)   
Greetings, Geebra.  Glad the HT seems to be working but sorry it looks like you'll need to stay on it longer.  SF is a nice place to visit.  Hang in there!  David

Diagnosed Dec 2007 during annual routine physical at age 55
PSA doubled from previous year from 1.5 to 3.2
12 biopsies - 2 pos; 2 marginal
Gleason 3+3; upgraded to 4+3 post surgery
RRP 4 Feb 08; both nerves spared
Good pathology - no margins - all encapsulated
Catheter out Feb 13 - pad free Feb 16
PSA every 90 days - ZERO's everytime!
Great wife and family who take very good care of me


Geebra
Regular Member


Date Joined May 2009
Total Posts : 476
   Posted 1/14/2010 8:33 AM (GMT -6)   
Thank you all for your support. I am taking it one shot at a time.
Father died from poorly differentiated PCa @ 78 - normal PSA and DRE
5 biopsies over 4 years negative while PSA going from 3.8 to 28
Dx Nov 2007, age 46, PSA 29, Gleason 4+4=8
Decided to participate in clinical trial at Duke - 6 rounds of chemo (Taxotere + Avastin)
PSA prior to treatment 1/8/2008 is 33.90, bounced on 1/31/2008 to 38.20, and down at the end of the treatment (4/24/2008) to 20.60
RRP at Duke (Dr. Moul) on 6/16/2008, Gleason downgraded 4+3=7, T3a N0MX, focal extraprostatic extension, two small positive margins
PSA undetectable for 8 months, then 2/6/2009 0.10, 4/26/2009 0.17, 5/22/2009 0.20, 6/11/2009 0.27
ADT (ongoing, duration TBD): Lupron started 6/22/2009
Salvage IMRT to prostate bed and pelvis - 72gy over 40 treatments finished 10/21/2009
PSA 6/25/2009 0.1, T=516, 7/23/2009 <0.05, T<10, 10/21/2009 <0.05, T<10


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4463
   Posted 1/14/2010 10:06 AM (GMT -6)   
Geebra, good to read you again, Sorry your Journey has been bumpy but we're here to help smooth some of the bumps, as you know.
James C. Age 62
Co-Moderator- Prostate Cancer Forum
4/07 PSA 7.6, referred to Urologist, recheck 6.7
7/07 Biopsy: 3 of 16 PCa, 5% involved, left lobe, GS 3/3=6
9/07 Nerve sparing open RRP 110gms.- Path Report: GS 3+3=6 Stg. pT2c, 110gms, margins clear
24 mts: PSA's: .04 each test since surgery, ED Continues-Bimix .3ml PRN or Trimix .15ml PRN

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