Congratulations on your recent score and results. I can only imagine the relief it must bring. I have a multipart question I have a PSA at 13, Gleason of 4+4=8 on both left and right side. Trying to decide if I have a radical prostatectomy plus radiation or just go with wide beam radiation, brachyterapy and then radiactive seeds. How has the radiation treatments been? What are the side effects you have experienced? Any bowel trouble? Urination problems? how bad are the hormones?
The more information you can provide would be extremely useful to me as I try and decide which course of treatment is best for me>
Keep up the great test results and once again congratulations on the wonderful news.
First, thank you for your congratulations, and believe me, when I was diagnosed with G9 and a PSA of 11.9 it was a numbing experience and I am very luck to be where I am today, though with a high grade PCa one is really never out of the woods.
Regarding treatment, my experience with brachytherapy + IMRT was fairly consistent with what others on this forum have reported. First, three months before the operation I was given an injection of Lupron to shrink the prostate gland. The seed implant surgery took place early in late November 2009 in the morning and lasted about
an hour. The catheter was removed about
thirty minutes after I awoke in the recovery room, and I was able to urinate on my own in about
an hour, accompanied by quite a burning sensation. The burning sensation continued for another 24 hours or so, then urination because more or less normal. For about
a month after the operation I had what is called urinary urgency, that is to say, a very great urge to urinate. Other than that I was able to assume a more or less normal routine in about
two or three days, and began taking my morning walks four days after the seed implant surgery. And a month later I traveled to Mexico where I spent a couple of weeks. I still had some urinary urgency at that time so I had to constantly watch where I was so that I could make it to a bath room if necessary. I never had any problem with bowel movements but I did have a lot of anal irritation, which was relieved with hot baths to which I added salt.
In early February 2010 I began the first of 25 IMRT sessions. I experienced some fatigue with this treatment, peaking at the end of the week on Friday at the last of my five weekly sessions. The IMRT sessions also brought back some urinary urgency and the same anal irritation I had experienced after the seeds, but none of this impacted my ability to carry on my daily routine activities.
You will also note that because of the high grade PCa the treating oncologists recommended that I stay on hormone therapy for two or three years. The theory on this is that with a very high grade PCa it is possible that there are some micro mets which will die off in time if their energy source is denied. Your condition is rather similar to mine so you might want to talk to your physicians about
the possibility of hormone therapy. It is not, however, without its down side, including complete loss of libido and the possibility of other symptoms such as hot flashes, loss of energy, weight gain, bone density loss, anemia, etc. I had some of these symptoms in the first 6-9 months of HT but none of them now, with the exception of total loss of libido. However, in three or six months I will go off HT and with any look the libido will return. But being without sexual desires is not as bad as it seems, and does not eliminate other meaningful ways of intimacy with one's spouse.
Looking back on all of this I have to say that the overall impact on my life from the seeds, IMRT and HT has been less than I feared and taken on the whole it has not had a lot of impact on my quality of life. And at this point I am totally recovered from the radiation and have no lingering effects from it.
If you decide to have brachytherapy I recommend that you pay a lot of attention to who you choose as skill and experience does make a difference. I am from South Carolina but decided to have the seed implant surgery done at a center in Florida because I was more comfortable with the skill level of the oncologist down there who did the surgery than anyone in my area.
Hope this is useful to you, and my best to you as you try to make your decision for treatment. I am personally very satisfied with my choice of treatment, and with the result. But this is a highly personal decision and above all you should do your own research and feel comfortable with the decision you make. My urologist recommended a RP for me, but after doing my own research and consultations I came to the conclusion that the course of action I chose was the better one for me.
Age 66, PC diagnosed 7/2009 at age 65
Stage: T2c, Gleason: 9 (4 + 5), 6 of 6 cores positive
Bone, CAT and MIR scans negative
Treatment: brachytherapy (103 palladium), 100 gy, 11/2009 + ADT3 (Lupron + Casodex+Avodart) + IMRT on Novalis, 45 gy, 3/2010.
PSA: 7/2009, At time of diagnosis -- 11.9
10/2009 -- 5.0
12/2009 -- 0.56
5/2010 -- 0.15
8/9/2010 -- 0.06
11/2010 -- 0.013
Post Edited (Sancarlos) : 2/27/2011 9:49:26 AM (GMT-7)