BCR - Clinical Trial

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Veteran Member

Date Joined Jul 2008
Total Posts : 966
   Posted 1/27/2011 3:34 PM (GMT -6)   
Okay, finally back from the oncologist...geez what a long day this has been.
Starters...this isn't the trial that uses the Avodart from a discussion about a week ago.  Sorry about that.  I thought it was.
This is trial IRB File Number 042010-062 RTOG 0534
This is a Phase III trial of short term androgen deprivation with radiation therapy.  There are three randomized arms of this trial. 
1)  Radiation to the prostate bed only
2)  Radiation to the prostate bed only and with hormone therapy
3)  Radiation to the prostate bed and pelvic lymph nodes with hormone therapy.
At this point, I won't know which arm I will be assigned to.  Too many other tests have to be done first.
*  I will have another bone scan.  They need a current scan due to the one I had was 2 1/2 years old.  The scan 2 1/2 years ago showed some uptake on the ribs and was ruled as prior injury.  So they expect that these areas will either be gone by now or further investigation will be needed.
*  A CT scan is required to locate all the organs and such prior to placing the tatoos for the radiation.
*  DNA testing...not sure what genetic markers they are looking for or at.
*  Complete blood work up
*  A complete cognitive test performed...don't know what that is all about either
They will also obtain samples from the original biopsy and slides from the pathology to confirm gleason and staging.  They don't expect any changes in this area, but just part of the protocol.
Now to the specifics.
DRE was performed (again) and he felt a spur(?) in the area of the positive margin from surgery.  Which was a good sign believe it or not.
The radiation is using the Rapid Arc technology with seven photon beams that consist of 5 smaller beams in each of those seven.  Dosage is 66.6 grys over a period of 37 treatments (44 if pelvic lymph nodes are radiated)  Must have an empty bowel and a full bladder during treatments.  Actual radiation time is about 1 1/2 minutes.  Usually 15 minutes is required for set up before hand.
Hormone therapy consists of one shot of Lupron (6 month depot) and Casadex daily for four months.  I forgot to ask what the dosage of the Casadex is.
If they do the hormone therapy, then the hormones will start two months prior to radiation.
All side effects from hormone and radiation are expected to taper off in about six to 12 months upon completion.  He did mention some instances of ED after about 2-3 years as a result of the radiation.
All in all a very informative meeting with all the doctors involved, which all of them mostly mirrored what has been said here from the experienced laymen. 
The primary reason for the study is to see which of the methods produce the best long term control of PSA after surgery with recurrence.
Currently with a 50/50 success at 5 years, they are hoping to increase the odds significantly and minimize the known side effects if possible.
As soon as I know which leg I will be on, I will let you all know.
Any questions just let me know.

Regular Member

Date Joined Jan 2009
Total Posts : 100
   Posted 1/27/2011 4:00 PM (GMT -6)   

All I can say is wow I'm really interested to see how this works out.


My Husband DX at age of 54 in 2006


Original Gleason 3+4=7Post OP 4+3=7

PSA PO RP .004

Everything going good till May 2008

05/08 PSA 0.05

07/08 -0.09

10/08 -0.16

01/09 -0.24

RT March 2009 33 in total

07/09 PSA 0.4 Testosterone -15

09/09 -0.55 T -13

10/09 bone scan Clear

12/09 PSA 0.52 T-13

03/2010 “ 0.7 T-11.8

06/10 “ 0.61 T - 9

09/10 “ 0.8 T -11.4

01/2011 PSA 1.07 T -12.7



Post Edited (waterloo) : 1/27/2011 3:04:28 PM (GMT-7)

Veteran Member

Date Joined Sep 2009
Total Posts : 3172
   Posted 1/27/2011 4:09 PM (GMT -6)   
Hi Les,

It sounds like you are drinking from the firehose...perhaps for the 2nd time, but this time you are more knowledgeable and able to deal with it. Good luck.

Can you please help me to understand this comment (from your post): "DRE was performed (again) and he felt a spur(?) in the area of the positive margin from surgery. Which was a good sign believe it or not."

I don't understand the "good sign" part.

thanks in advance

Veteran Member

Date Joined Jul 2008
Total Posts : 966
   Posted 1/27/2011 4:19 PM (GMT -6)   
Hi Casey,

The positive margin I had was located next to the rectal wall. Feeling something could mean a lot of things, but if it was the tumor, then finding it ahead of radiation means they can target the radiation better at the tumor. Most of the time you don't know where exactly the tumor(s) are and you get radiated on the most likely area...the prostate bed.

The CT scan won't show anything, but it is an area of interest unless it's just a surgical clip or scar tissue. But if they are really interested they could biopsy it, but that isn't going to happen.

If it is a surgical clip, then the scan will reveal that.
You are beating back cancer, so hold your head up with dignity


Robotic Surgery Sept 2008
PSA increasing since January 2009
Current PSA .44 (29 months)
PSA Doubling time approx. 6 months

Regular Member

Date Joined Feb 2010
Total Posts : 308
   Posted 1/27/2011 4:59 PM (GMT -6)   
Les, thanks for the detailed account: please keep us updated....wishing you all the best through this portion of the journey
5/05 PSA:1.8
12/07 PSA:3.7
7/08 PSA:4.7
8/08 Biopsy#1:3 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 Path: PCa on 10%, lymph & SV benign, Gl:3+4=7,stage T2c
2/13/09 PSA:0.1
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
11/10 PSA: 0.1

Veteran Member

Date Joined Dec 2008
Total Posts : 3149
   Posted 1/27/2011 6:54 PM (GMT -6)   
The cognitive gig is about the HT therapies they can reduce memory, i.e. memory loss.
As a laugh casodex could give you mamary gain in comparison (lol). Oh is it spelled as casodex a good rule is like remembering  ca$h-o-dex because it is costly compared to the generics.(lol)
I guess your casodex is 50 mg (as standard protocols) but they could do 100 mg, unlikely they will do ultra high dose  150 mg (that can generate boob activity and faster-fyi) Side effects nono

The DNA testing is maybe to determine what your PCa DNA ploidy analysis actual is(diploid, aneuploid, etc.) and put patients further into classifications?
They monitor blood markers which could change while doing radiations and/or HT therapies, is my guess, too. idea

This is all my speculation, but what do expect for free from Jr. Samples brother. tongue
I hope you get the full monte for treatment, and forget the control group. Best to you.

Post Edited (zufus) : 1/27/2011 6:06:53 PM (GMT-7)

Veteran Member

Date Joined Jul 2008
Total Posts : 966
   Posted 1/28/2011 7:51 AM (GMT -6)   
Thanks waterloo and bsjoplin...will let you know which leg I am assigned.

Zufus....thanks for the correction on spelling. I believe the DNA is for research only and not for treatment plans or further classification. But you are correct in the ploidy analysis as well as other markers. I think one of the markers they are looking for has to do with radiation side effects. Something along the lines if they have certain markers that might cause the radiation to be a problem, then they can advise patients not to do radiation and such (* had to throw the "and such" in there...lol)

I got a one in three chances to do one of three treatment methods...best odds I have had so far.
You are beating back cancer, so hold your head up with dignity


Robotic Surgery Sept 2008
PSA increasing since January 2009
Current PSA .44 (29 months)
PSA Doubling time approx. 6 months

Veteran Member

Date Joined Dec 2008
Total Posts : 3149
   Posted 1/28/2011 9:31 AM (GMT -6)   
Best to you Les I hope you get the fuller Monte on the deal for best possible results. I see the *and such phrase* is catching on, might be addictive and almost as useful as using *etc. or *yada...yada...yada. Used perfectly too, thanks for elaborating some on that, if you find out more, we probably would'nt mind being the soak up sponges on more information!

Do jump into my new poll as to Twilight Zone, Limbo Land or Outer Limits.

Having been a casodex graduate I am familar with it, but past tense now. (lol)

Post Edited (zufus) : 1/28/2011 12:00:40 PM (GMT-7)

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