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Marlin
New Member


Date Joined Feb 2010
Total Posts : 1
   Posted 2/28/2010 9:31 AM (GMT -6)   
Hi New member.In brief,Dx age59 ,gleason6,1 positive core.Uro said "couldn't have caught it any earlier".Uro adamant against surgery,rec Hdr using catheters2x with 25 Ebrt sandwiched in between Hdr.Original Psa2.5 at Dx.Three months after tx Psa1. Four months after Psa 4.6. Said possible "Psa bounce". Two weeks on Cipro then two weeks off.Psa went down to 3.3. Next Psa in three months. Wondering if anyone has had this type of treatment? What do you think of the phenonmen of Psa bounce? Dx Dec'08 Tx completed April'09. Now realize more clearly the anxiety that comes with this disease. Interesting point,Primary Physician Dx at same age,opted for same Tx with same Uro and Radiation Onco. When Psa came in at 2.5 from previous 1.7 in Nov'08, primary advised to wait 6mos. for next Psa but I insisted on looking into it immediately.Jumped on it as quickly as I could. Any comments or advice welcomed.By the way, Uro said it was so small that any tx that I decided would probably work. If it was him he would chose this tx.

John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4226
   Posted 2/28/2010 11:11 AM (GMT -6)   
I look at the seedpods site quite often. The psa's after radiation are all over the place and seem to settle out in 2 or three years. There have been a lot of patients that have had consecutive rises for two years only to have them drop; so don't do anything drastic. I would worry if psa achieved +2 of nadir.
After treatment 7 months ago my psa was <.1; at 7 months it is .2. I started with a psa of 40.0
JohnT

64 years old.

PSA rising for 10 years to 40, free psa 10-15. Had 5 urologists, 12 biopsies and MRIS all neg. Doctors DXed BPH and continue to get biopsies yearly. 13th biopsy positive in 10-08, 2 cores of 25, G6 less than 5%. Scheduled for surgery as recommended by Urological Oncologist.

2nd Opinion from Dr Sholtz, a Prostate Oncologist, said DX wrong, pathology shows indolant cancer, but psa history indicates large cancer or metastasis. Futher tests and Color Doppler confirmed large transition zone tumor that 13 biopsies and MRIS missed. G7, 4+3, approx 16mmX18mm.

Combidex MRI in Holland eliminated lymphnode mets. Casodex and Proscar reduced psa to 0.6 and prostate from 60mm to 32mm. Changed diet, no meat and dairy. All staging tests indicate that tumor is local and non agressive. (PAP, PCA3, MRIS, Color Doppler, Combidex, tumor reaction to diet and Casodex, and tumor location in transition zone). Surgery a poor option because tumor is located next to the urethea and positive margin is very likely; permanent incontenance is also high probability with surgery.

Seed implants on 5-19-09, 3 hours door to door, no pain, minor side affects are frequency and urgency; very controlable with Flowmax and lasted 4 weeks. Daily activities resumed day after implants with no restrictions. Gold markers implanted with seeds to guide IMRT.

25 treatments of IMRT 6 weeks after seed implants. No side affects at all.

PSA at end of treatment 0.02 mostly the result of Casodex. When I stop Casodex next week expect PSA to rise. Next PSA in November. Treatments and side affects have greatly exceeded my expectations. Glad to have this 11 year journey finally conclude.

JohnT


zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 3/1/2010 5:48 AM (GMT -6)   
Question did the place where you did this have IMRT radiation machines and if so, why were they not used? IMRT is superior for the patient as to possible collateral damage from rays, mentioning this to others especially if you are getting radiations(especially) without the benefit of using seeds along with it (maybe this why they used EBRT..I don't know). Technically EBRT is now old school and 3D-EBRT is a little better but IMRT is looking to be much superior as to control and patients subjection to possible colateral damages from rays. IMRT controls depth and deposit of rays and intensity thereof much more precisely, is what is written about and said on this radiation delivery. There are newer and better targeting things added to these IMRT machines, both machines use (photon rays..but how they are delivered and used can be a difference to the patient), the cost of the IMRT machines is significant and many places do not have these newer machines, probably in foreign countries you might even find 'Box-radiation' machines which are the worst for collateral damage and out dated....knowledge is your friend in this stuff. All radiations are not the same, and many choices out there.

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