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.