There is a fairly good chance that your father's ongoing treatment will be a lot like mine. So, a bit about
my experiences: I had a robotic prostatectomy in June of last year and my post-op pathology put me in a high-risk category for failure of surgery as a mono-therapy. When my urologist went over my pathology report with me he recommended that I talk to two other doctors -- a medical oncologist and a radiation oncologist. I saw the medical oncologist first and they both agreed on their recommendation -- adjuvant radiation combined with several years of hormone therapy.
I started the hormones in july (a couple of weeks after I got my pathology report) but we waited until the middle of October to start the radiation. This was to allow me to heal from the surgery and to regain as much urinary continence as possible. (Radiation slows the continence recovery process and the radiation has fewer side-effects if the patient can have at least some urine in his bladder during treatment.)
The kind of radiation I received is called Intensity Modulated Radiation Treatment (IMRT) and I received 66 Gray of radiation over 37 daily sessions. My appointment at the cancer center was at 4:15 every afternoon. The lady ahead of me (at 4:00) was being treated for breast cancer. I got to know her and her husband fairly well and they were very nice. She finished up the day before I did and I hope she is doing well.
Since my appointment was late in the day and since the machine is booked tightly any delay during the day would make my session start late. Once a week or so I would spend an extra hour in the waiting room chatting with the other patients.
The actual treatment wasn't bad. I would go into the room, stand beside the machine and sag my pants like a brother in the hood. The nurse would help me lay down, would put my feet in the foam mold they had made of my shoes and ankles the first day and they would turn on the big laser that made a X on my stomach and line up my tiny tattoo dots with the beam. Then they would squirt some cool gel on my pubes and prod me with an ultrasound (like a woman getting to see her baby). They were looking to see how full my bladder was and where it put my prostate bed (which they were trying to hit whit the radiation.) They would then push a few buttons which would nudge the table I was laying on this way or that to line me up. They would then tell me to lay still and leave the room.
The actual treatment uses high-energy x-rays produced by a particle accelerator. It looks a bit like an old-fashioned round washing machine on a big boom so they can point it at you from different directions. The treatment takes about
ten minutes and the machine whirrs and beeps and moves around to zap you from ten different directions. Then you're done for the day.
The common side effects of radiation are 1) it makes your hemorrhoids worse; 2) it makes your bowel movements gooey; 3) it can cause a bit of skin irritation (like a mild sunburn); 4) mostly, it makes you tired. (Your dad will take lots of naps during and for a few months after his treatments.)
They may or may not do the hormones with your dad. Some doctors think it is over-treatment for everyone but the highest-risk patients. But your dad is fairly high risk. There are two risk categories for GS7 -- (4+3) like your dad is worse than (3+4).
I don't know if you can read medical research papers. Here are a couple of links to research about
adjuvant hormone therapy after prostatectomy. (Adjuvant means right-away in this usage -- another treatment you start withing six months. Thus my radiation and my hormones were both adjuvant since both started within six months of my surgery.) If you can't read them or they don't make any sense they can still be something to ask your dad's doctors about
Adjuvant Androgen Deprivation for High-Risk Prostate Cancer After Radical Prostatectomy: SWOG S9921 Study: www.ncbi.nlm.nih.gov/pmc/articles/PMC3107759/
The Role of Adjuvant Hormonal Treatment after Surgery for Localized High-Risk Prostate Cancer: Results of a Matched Multiinstitutional Analysis:www.ncbi.nlm.nih.gov/pmc/articles/PMC3286887/
Slow PSA rise 2007-2012: 1.4=>8
4 bxs 2010-2012:
1)neg (some inflammation),
3)positive 1 of 14 cores GS6(3+3) 3-4%, 2nd opinion GS7(3+4)
Mild Pre-op ED
DaVinci RRP 6/14/12. left nerve spared
Path: pT3a pN0 R1 GS9(4+5) Pos margins on rt
Start 24 mo ADT3 7/26/12
Adjuvant IMRT 66.6 Gy 10/17/12 - 12/13/12
Incontinent, Trimix, VEDForum Moderator - Not a Medical Professional
Post Edited (PeterDisAbelard) : 1/22/2013 10:05:01 AM (GMT-7)