Yes, and I feel like I am the middle man in the street fight. I continue to follow up at six month intervals with the rad doc. Next visit is September. The uro said come back in a year. Not sure I liked that approach. The urologist mentioned that we would most likely not do anything until the PSA got to around a 2. Still not sure I like that approach either.
The Casodex was only to prevent the flare. My prostate was not that large to begin with but I was told that it would also shrink the tumor and make it easier to treat. I did a bit of research on the HT and looked at opinions on single, double and triple blockade. At the end of the day there did not seem to be an advantage to overall survival for single vs double or triple. So, I went with the uro's recommendation of Lupron as a single agent.
I have had some brief conversations with the rad oncologist about chemo or other therapy going forward. He gave me a run down of the usual stuff that I see on the net. His office participates in trials and he asked if I was interested. I told him not just yet.
I am currently looking for a good medical oncologist to help me manage going forward. Have not found one yet so if you know a good one in the area around Boise, Idaho let me know. I am taking it on my own to get a PSA once a month since I had the little bump in June. My GP is not much help and seems rather dismayed by any discussion around PCa. Good news is the PSA seems to be level at around the .32 mark. In addition I have read that Proscar or Avodart offer some benefit as a maintenance drug after stopping the hormone but neither of my docs have mentioned this other than a brief conversation with the rad oncologist.
If this all seems sort of drifty to you it is to me as well. I guess I thought there would be more direction from my current doctors and in general things are going OK. So, maybe no need to do anything now but I like to know my options.
Thanks for the well wishes.
Diagnosed 04/10/08 Age 58 at the time
Gleason 4 + 3
DRE palpable tumor on left side
100% of 12 cores positive for PCa range 35% to 85%
Bone scan clear and chest x ray clear
CT scan shows potential lymph node involvement in pelvic region
Started Casodex on May 2 and stopped on June 1, 2008
Two years on Lupron completed 01/2010.
Started IMRT/IGRT on July 10, 2008. 45 treatments scheduled
First 25 were full pelvic for a total dose of 45 Gray to lymph nodes.
Last 20 to prostate only. Total dose to prostate 81 Gray.
Completed IMRT/IGRT 09/11/08.
PSA 02/08 21.5 at diagnosis
PSA 07/08 .82 after 8 wks of hormones
PSA 10/08 .642 one month after completion of IMRT, 6 months hormone
PSA 03/09 .38 six months post radiation and nine months into hormones
PSA 06/09 .36 or .30 depending on who did the test
PSA 09/09 .33 one year after IMRT and 16 months into hormone
PSA 03/10 .32 18 months after IMRT Still on hormones
PSA 05/10 .42 Rising a little as the lupron wears off. Last lupron shot 01/10.
PSA 06/10 .322 Maybe the .42 reported in May was in error?