Has anyone with a high GS had successful SRT?

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Carlos
Regular Member


Date Joined Nov 2009
Total Posts : 486
   Posted 12/10/2010 11:32 AM (GMT -6)   
Ok guys, a little anxiety is starting to creep in.  Has anyone on the forum with a high GS had a good outcome from SRT?  Just curious, won't change a thing and will start SRT next Wed.
 
Carlos

Dx 2/2008, age 71, PSA 9.1, G8,T1c. daVinci surgery 5/2008, G8(5+3), pT2c. LFPF, good QOL. PSA <0.1 for 2 yrs. PSA rose to .2 at 30 months, start SRT 12/15/2010.

Post Edited (Carlos) : 12/10/2010 2:53:10 PM (GMT-7)


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 12/10/2010 12:26 PM (GMT -6)   
Carlos, good luck ahead with your SRT. At your age, and the fact that it took 30 months post surgery to get you to this point, I think you should do well with it.
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos marg
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06 11/10 Not taking it
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/23/10

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 6949
   Posted 12/10/2010 3:30 PM (GMT -6)   
Carlos,
 
So far, so good. I'll let you know in a few years smilewinkgrin
 
Hope it is uneventful for you. It took me a while to get the water bomb timing right. I did a day-by-day of mine (link below).
 
I am a G 4+5 post-op DaVinci.
DaVinci 10/2009
My IGRT journey (2010) -
www.healingwell.com/community/default.aspx?f=35&m=1756808

Carlos
Regular Member


Date Joined Nov 2009
Total Posts : 486
   Posted 12/10/2010 3:51 PM (GMT -6)   
David, thanks for the encouragement.
142, I'm glad you have had a good outcome so far.  A question about incontinence.  You mentioned leakage issues during SRT.  Was this simply due to a full bladder?  Did you retain your normal continence that you had prior to SRT?  Is every thing back to normal now?  I know that continence may deteriorate with time but is there a point that you can relax and believe that the worst is behind you?  Sorry about all the questions.  Just no one else around to pester right now. 
 
Thanks,  Carlos

BB_Fan
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Date Joined Jan 2010
Total Posts : 1011
   Posted 12/10/2010 3:55 PM (GMT -6)   
Carlos, I am several months ahead of you. I am a GS 8 and finished SRT in October. I am on HT for 1 year so I won't know if it was successful until next summer/fall. I am also pretty concerned. Doctors I spoke with didn't give me better than a 50/50 chance of success. One said 30-40%. Just keeping my fingers crossed and taking one day at a time. Best of luck. BB

Carlos
Regular Member


Date Joined Nov 2009
Total Posts : 486
   Posted 12/10/2010 4:05 PM (GMT -6)   
BB,  The MSK nomogram suggested a 24% prob. of remission without HT and a much better prob. with it.  However, neither my uro onc. nor the rad. onc recommended neo adjuvant HT in my case.  They said I could have it if I wanted it.  If I were a young man like most of you men I would go for HT.  I'm 74 now and have a good QOL and am not sure the HT is worth trying to scrape out a few more years.
 
Thanks,  Carlos

BB_Fan
Veteran Member


Date Joined Jan 2010
Total Posts : 1011
   Posted 12/10/2010 6:05 PM (GMT -6)   
I see your point Carlos. It may be a age thing. My Uro, radiation oncologist, and 3 medical oncologists (I made the rounds) all recommended HT. However, only two of the medical oncologists recommended staying on HT after SRT was over.
Dx PCa Dec 2008 at 56, PSA 3.4
Biopsy: T1c, Geason 7 (3+4) - 8 cores, 4 positive, 30% of all 4 cores.
Robotic Surgery March 2009 Hartford Hospital, Dr Wagner
Pathology Report: T2c, Geason 8, organ confined, negitive margins, lymph nodes negitive - tumor volume 9%, nerves spared, no negitive side effects of surgery.
PSA's < .01, .01, .07, .28, .50. HT 5/10. IMRT 9/10.
PSA's post HT .01, < .01

howard l
Regular Member


Date Joined Aug 2010
Total Posts : 152
   Posted 12/10/2010 6:13 PM (GMT -6)   
 
I to am a gleason 9. RP in October of 2009. Undectible for 7 months post RP. PSA then went to .5 and then to 1 and then to 1.5. Started 39 treatments 72g. Finished in August 2010. Mid point of RT PSA 1. One month post SRT PSA .47. Three months post SRT PSA .24. It's working for me.
DX age 58
PSA 5.4
Gleason 5+4 = 9
City of Hope Clinical Trial (punch protocol). 6 sessions textore every 3 weeks + lupron
PSA .1
RP Oct 2009. Seminal Invasion positive margins. Lymphnods clear.
1 month PSA post op undetectable.
4 month PSA undetectable.
7 month PSA .5
Bone scan and CT scan negative. Prosticint scan mild activity in prostate bed.
EBRT May 2010. 39 sessions 70gy. On number 37.

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 6949
   Posted 12/10/2010 6:39 PM (GMT -6)   
Carlos,
 
I am not without issues, but most were expected and predictable.
 
Incontinence - I was at 1 pad per day when I started RT - we had stalled a little getting started in hopes it would get better. It did not, and near the end I started slipping - am now at 2-3 pads per day, and it is likely caused by the RT, according to my uro & GP. The Radiation Oncologist says no, not a side effect (yeah, I don't agree with the RO either).
The leaks (well, better said floods) I had the first days were simply because of the schedule of drinking so much water at one time. Took a while to get used to that.
 
Fatigue - it is very slowly improving. Again, it is likely caused by the RT, according to my uro & GP. The Radiation Oncologist says no, not a side effect (yeah, been there already).
 
Bowels - I have had colon issues (both minor and serious) for years. The radiation has a certain impact that has manifested itself as very frequent bowel movements. Not diarrhea, just frequent. It has gotten better from the real problems I was having the last couple of weeks of treatment, but again, a certain impact is expected. My colo-rectal surgeon says it is common. I'll not repeat the RO comment again, see above.
 
I think that one of the real considerations of RT is that side-effects can come to light months or years down the line.
 
 

Carlos
Regular Member


Date Joined Nov 2009
Total Posts : 486
   Posted 12/10/2010 7:02 PM (GMT -6)   
BB & Howard,  thanks for the replies.
142, Thanks for details and heads up on what I may expect.  I still have a pkg. of pads left over from surgery that I saved just in case.  I really hope I won't need those things again.  I go to the gym regularly and was encouraged by my rad onc to keep going.  He said regular exercise would keep the blood flowing and promote healing of the damaged tissue.  HW posters that don't have any SE's from RT are pretty darn lucky.
 
Thanks again,  Carlos

BB_Fan
Veteran Member


Date Joined Jan 2010
Total Posts : 1011
   Posted 12/10/2010 7:18 PM (GMT -6)   
My side effects were very light, some fatigue, irritation on butt, towards the end. I did walk about 4 miles a day during SRT. Perhaps that helped.
Dx PCa Dec 2008 at 56, PSA 3.4
Biopsy: T1c, Geason 7 (3+4) - 8 cores, 4 positive, 30% of all 4 cores.
Robotic Surgery March 2009 Hartford Hospital, Dr Wagner
Pathology Report: T2c, Geason 8, organ confined, negitive margins, lymph nodes negitive - tumor volume 9%, nerves spared, no negitive side effects of surgery.
PSA's < .01, .01, .07, .28, .50. HT 5/10. IMRT 9/10.
PSA's post HT .01, < .01

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 12/10/2010 9:34 PM (GMT -6)   
My SRT story is well known and documented here, its a story of what can go wrong. I had 39 treatments totalling 72 gys via IMRT. I started experiencing buring pains before the end of the first week. I also had a suprapubic catheter in place during the entire time, do to my chronic stricture issues. Instead of drinking water ahead of time, the dr. decided to zap me dry. Big mistake. They could have easily have injected an adequate amount of water up the catheter before zapping. Long story short - I spent 11 months post radiation is severe pain, as the radiation did heavy damage to my bladder and bladder neck, I was forced to keep the catheter in for one week shy of a year. In the end, I was never going to be able to urinate in a normal manner, thus I ended up with this ileal conduit surgery, and now sport a Urostomy (stoma and all), and will pee from a hole in my side into a bag the rest of my life.

When I complained to the radiation dr, she kept denying that I was being burned. It was only during the last 2 weeks that she started listening, after prodding phone calls from my uro on my behalf. But she never changed the plan, or even stopped the treatments. But that's a whole nother story, that is still ongoing with my attorney.

I didnt get any bowel problems till about 6 months after they ended the srt, I still sometimes get bowel urgency, and when I have to go, I best be within seconds of a crapper. Doesnt matter what I eat or don't eat, there's no rhyme or reason for it when it happens.

Also, it has now been 13 months since the radiation ended, and I still get severe radiation fatigue every day, usually hits me like a wall anywhere from 2-4 pm in the day, and so far, physical therapy isn't helping matters in that department. It is listed as a Chronic situation, same thing happened when I had major radiation nearly 11 year ago for other cancers.

I agree that most men would never go through what I did, but its not always the walk in the park that some post. There always are extremes in treatments and side effects, like in most medical matters.

Some bodies are more sensitive to radiation poisoning than others. The medical oncologist 11 years ago warned me at the time, that people that are heat sensitive and/or sensitive to being in the sun, often have a harder time enduring radiation. I was in both those categories, and both times with radiation I have experienced extreme reactions to it.

I would never go through it a 3rd time. Twice in one lifetime is quite enough. Just wanted to remind some of our new folks, that they should never take radiation as a casual thing. Like all PC treatments, they should ask a lot of questions and get more than one opinion before jumping into the frying pan.

I was on top notch hardware, so don't always get caught up in the glamor of that end of the treatments. That's no guarantee of an easy ride either.

David in SC
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos marg
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06 11/10 Not taking it
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/23/10

BuiDoi
Regular Member


Date Joined Aug 2010
Total Posts : 234
   Posted 12/11/2010 2:39 AM (GMT -6)   
Purgatory said...
Just wanted to remind some of our new folks, that they should never take radiation as a casual thing. Like all PC treatments, they should ask a lot of questions and get more than one opinion before jumping into the frying pan.


I'm glad that you made the comment. Some seem to think that radiation is saving them from something unpleasant. In fact it should be a LAST resort, as it is reverse of radical surgery.
With Radical Surgery, you have the BIG problems just after the operation.
With radiation, the problems start after the treatment and can take three years to manifest with the SAME problems and many more ( including NEW cancers), and if you THEN need surgery, then there is little that can be done in the 'salvage' area. You can't sew up a cooked chook , but you can - a raw one !

It was a radiation technician who said to me "I would rather DIE, than have radiation.... I have seen the patients come back worse than they came in"
Radiation is for when NOTHING else can be done, not as an easy first step.

Purgatory - You should change your handle 'HellNback'. or 'Someone Should be sued"
.
.
Nov 2009 = First-PSA 5.3 @ 60yo - Asymptomatic - DRE-Non-Palpable
Jan-'10 = TRUS Bx DX - AdenoCar T1c - GS(3+3)=6 , 5 & 45% max., L-MidZone
May-'10 = RRP-Nrv-Spare
Post Op. GS(3+4)=7, 1.1cm3, Pos Margins, EPE (focal) Lateral Left
Margin-Involvement (extensive) Posterior , Grade3 x 8mm
+8week PSA<0.01, ED-85%, Incont-30%
+16W PSA<0.01, ED -85%, Cont -5%
+17W First 'DRY' day. ED -90%

Post Edited (BuiDoi) : 12/11/2010 1:43:30 AM (GMT-7)


Willie B
Regular Member


Date Joined Jul 2010
Total Posts : 155
   Posted 12/11/2010 3:34 AM (GMT -6)   
Carlos, Good luck with your SRT, it can and does work for many patients.

My experience with SRT was that it left me very fatigued, started my habit of daily naps and caused some irritation that was relatively short lived.

I haven't had much luck since my diagnosis but it's probably more due to the 'overt malignancy' than the treatments. Positive node...

Surgery, SRT and hormones have not been effective.....my psa doubling time is scary to say in the least.

BUT, I am still here, happy to say!

Keep on keeping on Carlos, we're rooting for you.

Baptista
Regular Member


Date Joined Aug 2010
Total Posts : 84
   Posted 12/11/2010 4:13 AM (GMT -6)   
Hi Carlos

You are looking for info on good results from SRT, meaning remission forever. By experience, I got to the remission level but the statistics on time-to-relapse took over 4 years later. I had IMRT in Nov2006 with a PSA 3.80 pre-RT. That came down in a continuous curve to 0.05 thirteen months after therapy.
Biochemical failure was on the 29th months (PSA=0.26) and there after the PSADT was of 9.5 month.
The opinion of my surgeon of RP (Aug 2000) in regards to the results of SRT was “… RT was successful in bringing down the PSA signaling that the cancer is mostly still localized in the pelvic. Fewer cancer cells were not reached by the rays…”. For some guys success value has different faces.
I wish you break the statists and make it must longer.

Good luck and quick recovery.
Baptista
Age: 50 at Dx on May/2000; PSA=22.4;
6x cores biopsy positive; Gleason score (2+3=5)
RP in Aug/2000, PSA=24.2
Negative S-vesicles & lymph node (9); capsular penetration
Voluminous Adenocarcinoma, well-differentiated, Gs (3+2=5); pT3apN0
Post-op lowest PSA=0.18 on Oct/2000; Classified as Micro Metastasis
Jan/2001 PSA=0.26 Biochemical recurrence
AS (Watchful W.) until PSA=3.80 on Oct/2006; MRI & Bone scan negative
Nov/2006 SRT (3D IMRT; 68Gy / 37 fractions)
Feb/2008 lowest nPSA=0.05
May/2009 PSA=0.26 Biochemical recurrence
Oct/2010 PSA=0.95 (doubling at 9.6 months)
Nov/2010 ADT Cyproterone 100mg/day + Eligard 45mg 6-month depot
Asymptomatic, never incontinent, ED since RP

Carlos
Regular Member


Date Joined Nov 2009
Total Posts : 486
   Posted 12/11/2010 5:41 AM (GMT -6)   
Thanks for all the replies.  I should finish SRT in early Feb. and will let you know what happens.
 
Thanks again,  Carlos
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