treatment choice made

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Regular Member

Date Joined Sep 2010
Total Posts : 309
   Posted 10/13/2010 1:58 PM (GMT -6)   
Carter decided to treat his cancer with a combination of Brachytherapy and IMRT. To quickly refresh, his PSA is 6.7, Gleason 3+4=7, malignancy found on second biopsy, one core positive out of 6, at 10%. His urologist and the radiation oncologist both said either surgery or RT was an appropriate option for him.

This has been so hard. Neither direction was all good, and neither was all bad. Having to sort through so much often-conflicting data and reporting was extremely frustrating. I hate to be told what to do, and in this situation I'd have given anything to be told what to do!!

In the end, he felt like his current need to handle a challenging work schedule was very important to him and our family (we have failing-to-launch twenty-something kids who still need some help), and in a way it trumped the possible side effects of RT 15 to 20 years down the road. He simply had to weigh the side effects and down time of each choice in very real time scenarios. Bad past experiences with surgery weighed in as well.

So, we are awaiting return calls from the radiation oncology office to begin the processes. They will be done in different places, so more appointments to come.

I just have to tell you how helpful your response posts were to me. I read them carefully over and over. They gave me new ideas and possibilities to google. All of the discussions on this forum are so honest and so well-intended. Keep being there for each other, and as we begin our own treatment journey I may pop in and let you know how it is going. Hopefully, others considering radiation will learn from our experience as well as your wisdom.

I can't wait to pick up a good work of FICTION now! :)


Regular Member

Date Joined Oct 2009
Total Posts : 420
   Posted 10/13/2010 2:32 PM (GMT -6)   

Glad the difficult decision phase is now behind you and he can now concentrate on implementing the plan. I had a feeling he was leaning this way based on what you shared about the importance of side effects not getting in his way at this stage in his life. I think he made a great choice....but I am, admittedly, biased as my signature below shows.

Please let us know how it all works out. Regards,

Age 67 PSA 4.5 Biopsy 9/4/09 Bostwick Labs 5 of 8 sections (5 of 11 cores) positive-Gleason 3+3=6 Stage T1
BT on 12/11/09 (84 seeds of Palladium 103) Home same day/no catheter. Some burning, frequency, urgency for 6 weeks. No incontinence, mild ED. Normal activity within 3 days. 25 IGRT sessions ending 3/22/10 - some fatigue until 30 days after last treatment. PSA on 5/26 - 0.1 PSA on 9/1 - 0.1

Regular Member

Date Joined Jul 2010
Total Posts : 161
   Posted 10/13/2010 2:36 PM (GMT -6)   
Juliet........Glad to hear that you found your [husbands] right choice. A good book will probably will cut down on some of the stress [even the research for PCa can be very stressful.].....Good Luck,I hope all goes well!!!

Forum Moderator

Date Joined Sep 2008
Total Posts : 4183
   Posted 10/13/2010 3:01 PM (GMT -6)   
Hi Juliet:
Congratualtions on making a choice and I trust it will turn out to be a good one.  Please wish your husband well and please continue to post with his progress.
All the best,
Tudpock (Jim)
Age 62 (64 now), G 3 + 4 = 7, T1C, PSA 4.2, 2/16 cancerous, 27cc. Brachytherapy 12/9/08. 73 Iodine-125 seeds. Procedure went great, catheter out before I went home, only minor discomfort. Everything continues to function normally as of 9/10/10. 6 month PSA 1.4, 1 year PSA at 1.0. My docs are "delighted"! My journey:

Regular Member

Date Joined Feb 2010
Total Posts : 308
   Posted 10/13/2010 4:00 PM (GMT -6)   
extending best wishes on the upcoming journey...keep us posted!
Age@dx: 55
5/05 PSA: 1.8 ;12/07 PSA: 3.7 ;7/08 PSA:4.7
8/08 Biopsy1: 3 of 6 irreg
11/08 PSA: 6.5; 12/08 Biopsy 2: of 12, 3 cancer, other 9 irreg; Gl:3+3=6.
1/22/09 RRP; 1/25/09 Released; 1/28/09 Pathology: Cancer on 10% of gland, lymph & SV were benign, Gl re-typed 3+4=7, stage T2c
2/13/09 PSA:0.1
3/9/09 back to work
6/09 PSA:0.1; 10/09 PSA:0.1; 2/10 PSA:0.3 ; 4/10 PSA:0.4 Referred to RO
5/4/10 First RT.;6/25/10 Final RT. ended up 36 treatments, 64.8 Gy.
8/10 PSA:0.2

Regular Member

Date Joined Oct 2010
Total Posts : 175
   Posted 10/13/2010 4:03 PM (GMT -6)   
Juliet,this is my very first post after lurking here for 2 days and doing alot of reading.

Is your hubby doing this combo therapy in Georgia? I ask because I have a brochure about ProstRcision, and they are very specific about using lowered doses of Brachy and IMRT.

I can't tell if these people are legit? Company is limited to greater Atlant a area, and I'm thinking that if there unique approach is a good as they claim, then they'd be all over the country.


Ed C. (Old67)
Veteran Member

Date Joined Jan 2009
Total Posts : 2458
   Posted 10/13/2010 4:11 PM (GMT -6)   
Making a decision is always difficult with so many options on the table. Now you can put that behind you and never second guess yourself. Good luck moving forward.
Age: 67 at Dx on 12/30/08
PSA 9/05 1.15; 8/06 1.45; 12/07 2.41; 8/08 3.9; 11/08 3.5 free PSA 11%
2 cores out of 12 were positive Gleason (4+4) and (4+5)
Negative CT scan and bone scan done on 1/16
Robotic surgery performed 2/9/09 Dr Fagin, Austin TX
Prostate weighed 57 grams size:5.2 x 5.0 x 4.9 cm
Posterior lateral lesions measuring 1.5 x 1.4 x 1.0 cm showing focal capsular penetration over a distance of 3mm in circumference.
Prostatic adenocarciroma accounts for approx. 10-20% of the hemisphere.
Gleason 4+4
both nerve bundles removed,
pT3a Nx Mx, Negative margins
seminal vesicles clean, lymph nodes: not dissected
continent after 5 months
2 months PSA test 4/7/09 result <0.1
5 months PSA test 7/9/09 result <0.1
8 months PSA test 10/9/09 result <0.1
11 months PSA test 1/21/10 result 0.004
14 months PSA test 4/19/10 result 0.005

Veteran Member

Date Joined Oct 2006
Total Posts : 1210
   Posted 10/13/2010 4:11 PM (GMT -6)   
Hi Juliet & Carter. Now that one of the most difficult decision in your journey has been made by you guys, you deserve a well earned rest with a good book. I've had the open RP, but have since read many good things about brachytheraphy and IMRT. Although I'm quite contend with my result thus far, had I taken more time and better educated myself about prostate cancer before my RP, I might have chosen that route myself.
Anyway, congratulations and best of luck in your journey.
All the best to both you.

Born 1936
PSA 7.9, Gleason Score 3+4=7, 2 of 8 positive
open RP Nov 06, T3a, Gleasons 3+4=7, Seminal vesicles and lymph nodes clear
Catheter out 15 Dec 06, Dry since 11 Feb 07
All PSA tests in 2007 (4) <.04
PSA tests in 2008: Mar.=.04; Jun.=.05; Sept.=.08; at SRT Start=0.1, Salvage RT completed (33 days-66Gy) 19 Dec 08
PSA: in Jan 09 =.05, all tests to date (Jul 10) <.04

Post Edited (Magaboo) : 10/13/2010 3:14:34 PM (GMT-6)

Veteran Member

Date Joined Sep 2010
Total Posts : 1160
   Posted 10/13/2010 4:33 PM (GMT -6)   
Great post, Juliet. I'm happy for you that Carter has made his treatment decision. It's such an agonizing process, and I think things get better for most people once that decision is behind them. That's especially true if you make your decision firmly and don't indulge in second guesses.
For those with the luxury of treatment options, it's a real mixed blessing. You're right; it seems that no treatment course is all good or all bad. Any treatment option, if you analyze things carefully and honestly enough, has significant advantages and disadvantages. The notion that one treatment course or another will give you an easy, risk-free cure is an illusion, in my view.
The good news is that these various treatment options usually yield a very good outcome, and I wish you and Carter all the best. Please let us know how he's doing after his treatment. 

Regular Member

Date Joined Jun 2010
Total Posts : 74
   Posted 10/13/2010 4:37 PM (GMT -6)   

Juliet:  so true, so true:  CANT Someone tell me what to do!?  What is the right decision?!  - (and, maybe when I wake up tomorrow, this has really been a dream?).  But, you and your husband's decision is made and I wish you great luck on the next portion or your journey.


Age at Dx: 56
DaVinci Prostatectomy: 10/28/09

Stage: T2C

Gleason - 3+4 = 7

Prosate: 52 grams

Incontinence - absolutely at first, better with time and kegels

ED - Indeed

Married, father of two (boys 19 and 18)

11 months later: member of the "zero" club, working on one "safety" pad for 24 hours. Took Cialis for 6 months (no apparent affect), Tri-mix works, though!

John T
Veteran Member

Date Joined Nov 2008
Total Posts : 4237
   Posted 10/13/2010 7:25 PM (GMT -6)   
RTOG is a pretty old clinic that has been doing combination Brachytherapy and IMRT for a while. They are doing nothing more than many other hospitals and clinics are doing except they have brand named it "Prostacision"; There have been some recent critism of RTOG and how they have presented their data.
If I were in your area and considering this procedure I would look at the Dattoli Cancer Center in Sarosata Fla as another option.
I had the exact same procedure that Carter is having. I only had 4 weeks of urinary discomfort that was very tolorable. He should be able to function normally by day 2. Stay off all alcohol and caffine and take plenty of flowmax and Ibupropin and he should do just fine.
65 years old, rising psa for 10 years from 4 to 40; 12 biopsies and MRIS all negative. Oct 2009 DXed with G6 <5%. Color Doppler biopsy found 2.5 cm G4+3. Combidex clear. Seeds and IMRT, no side affects and psa .1 at 1.5 years.

Regular Member

Date Joined Sep 2010
Total Posts : 309
   Posted 10/13/2010 9:39 PM (GMT -6)   

We aren't in Georgia, so are not using that clinic. I did read a lot on their website, however. I thought they seemed to imply that they were the only ones who carefully consider the number of seeds to place. I'm quite sure all reputable and experienced Brachy doctors will give the same careful attention to individualizing the treatment. If your insurance will allow it, you could consider that clinic but make sure first. Ours will only pay for in-state treatment. You might check the Yananow website to see if some of the men who have posted their experiences there used that particular clinic. Good luck!

Thanks for the encouragement, all!

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