Appointment with a Radiation Oncologist. Now What?

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JB71
Regular Member


Date Joined Nov 2009
Total Posts : 206
   Posted 2/19/2010 12:58 PM (GMT -6)   
After reading my pathalogy report (please, see my signature) following open surgery on January 20th.,
by Dr. J. Chin, he has made an appointment for me with a Radition Oncologist for Feb. 26.
 
I have absolutely no idea as what to expect or ask from him. Does a radiation doctor automatically recommend
a radiation treatment ?  If so, are there options ? What kind ?  WHEN ?
 
When I was first diagnosed, all I could think of was, get the operation and get rid of the cancer. But that might not be, in my case.
 
Will some of you, PLEASE, have a look at my path. report and educate me as to what I should consider next.
 
Thanks All.
.
Age, only 71.
 
July 2009, PSA 9.1, free ratio 0.16
September GLEASON 4+4=8, T2A
Prostate 44cc.
 
Calcium: 2.46  (range: 2.20 - 2.65 mmol/L)
25 Hydroxy Vitamin D: 102 (range: sufficiency:
76 - 250 nmol/L)
 
Bone Scan: Negative
CT Scan scheduled for Dec. 1st. Negative.
 
Started Casodex 50mg. on Nov. 6, first pill of 30.
Got Lupron 22.5mg ( 90 day ) on  November 19.
 
No real side effects as of Dec. 15 except dry skin and hair but getting quite 'porky' in the belt area even though now I go to the gym, three times a week. Also I dont have a need to shave anymore so now I can save my 'shaving' allowance and direct it to my stash of Depends !
 
Christmas Day got my first hot flashes. Thanks Santa!
 
Open surgery scheduled for Jan. 22 by Dr. J. Chen
at London (Ontario) Health Sciences Centre.
 
Open surgery done on Jan. 20th. by Dr. J. Chin at London's University Hospital.
 
Cath removel scheduled for Feb. 8th. Yes, I know,
that will be 19 days. Dr. is out of country until then.
====================================
Pathology Report:
 
Gleason Score: cannot be determined due to therapy effects.
 
Extraprostatic Extension:
present, left radial, multifocal
present, left basal, multifocal
 
Resection Margins:
Apical: involved by invasive carcinoma, multifocal
Bladder Neck: involved by invasive carcinoma, unifocal on left side.Other: non-tumoural prostatic present at resection margin.
 
Perineural Invasion: present.
Seminal Vesicle Invasion: absent
Lymphovascular Invasion: absent
Lymph Node Status: no malignancy in regional lymph nodes
 
Additional path. findings:
high grade prostatic intraepithelial neoplasia
 
Pathology Stage: yp T3a NO MX
==================================
Now waiting for an appointment with a radialigist
==================================
 
Need to get this over with ASAP so this season
I can continue with motorcycling, sailing  and enjoying life, TOGETHER with my wife, Debbie
who has been the most supportive wife possible.
.


LV-TX
Veteran Member


Date Joined Jul 2008
Total Posts : 966
   Posted 2/19/2010 1:25 PM (GMT -6)   
JB...of course only you and your doctors can map a treatment plan that is best for you. But from my perspective only and looking at your path report, I think that talking to a radiation oncologist is the right thing to do at this point. There have been several published reports that indicate that adjunctive treatment with your stats is better served by treating early rather than waiting until later on.

I would make sure to discuss all the options and potential side effects from radiation. Otherwise I will let those that have been down the radiation route share their thoughts and suggestions
You are beating back cancer, so hold your head up with dignity
 
Les
 
Age 58 at Diagnosis
Oct 2006 - PSA 2.6 - DRE Normal
May 2008 - PSA 4.6 - DRE Normal / TRUS normal
July 2008 - Biopsy 4 of 12 Positive 5 - 30% Involved Bilateral w/PNI - Gleason (3+3)6 Stage T1C
Robotic Surgery Sept 18, 2008
Pathology October 1, 2008 - Gleason 7 (3+4) Staged pT2c NO MX - Gland 50 cc
Seminal Vesicles and Lymph Nodes clear
Positive Margins Right Posterior Lobe
PSA 5 week Oct 2008 <.05
                   3 month Jan 2009 .06
                   6 month Apr 2009 .06
                   9 month Jul  2009 .08
                 12 month Oct 2009 .09 


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 2/19/2010 2:23 PM (GMT -6)   
jb,

you are a stage 3, so perhaps your doc is being on the cautious side, little surprised they are not waiting for your first post surgery psa test to see where you are at. with your pathology, doesn't guarantee that you will have recurrance, but you could at some point. wont hurt to talk to radiation folks, see what they would suggest and their line of thinking.

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 43 days, 1/19 - Corr Surgery #4,  Caths #11 and #12 in at the same time, 2/8-Cath #11 out - 21 days

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