Posted 3/10/2007 4:19 PM (GMT -7)
Hey Fred, I know a guy who had a Gleason of 30. He did the hormone stuff and went to Loma Linda for proton and photon about five years ago. Today he is just fine.

Bill

P.S. krt, I get the positioning x-rays every day.
Gleason 3+3=6, T1c, one core in twelve, another pre-cancerous.
62 years old and good health.  Married 37 years.  To same woman!

Posted 3/11/2007 9:07 AM (GMT -7)
KRT--Sorry to be late in getting back to you. In my case three small gold "seeds" were placed in my prostate by the urologist in a procedure similar to the biopsy. Before every IMRT treatment two X-rays are taken and my position adjusted since the prostate may move several millimeters according to rectal volume.

My choice of IMRT over Proton was guided by convenience--10 miles to a university affiliated hospital with IMRT vs. many 100's. Three different MD's advised against surgery because of other medical problems.

Good luck to you.
Posted 3/11/2007 10:30 AM (GMT -7)
Thanks for the info.

Something that just occurred to me this morning (and I cannot figure out why it came so late), since with radiation, you still have your prostate, the people I know that have been "successfully" treated continue to have PSA's (logical), also have DRE's.

Now since your prostate is still there to be "fingered" what is to prevent another new cancer from developing there down the road just as the original one did; i.e., what makes things any better than they were before the first cancer in terms of developing it again?

Thank you,

krt
Posted 3/11/2007 1:36 PM (GMT -7)
krt--It is not impossible to have a new cancer arise from the residual cells after IMRT but that is unlikely since most PC cells are destroyed and mostly only fibrous tissue (think structural elements like house beams) remains. It is more likely to have a recurrence of the original cancer. In any event it would be difficult (but not impossible) to make the distinction

That is the beauty of surgery. Done exactly with total removal of all cancer (if possible) there is no gland, no PSA (beyond trace), and no worry. That is why surgery may be best with localized disease of low grade (Gleason less than 7).
Posted 3/11/2007 2:42 PM (GMT -7)
KRT--My prior e-mail was somewhat abrupt. I don't want to imply that surgery as a treatment for PC is best, but rather that it is final with the potential of a 100% cure. That is why surgery does best with localized disease of low grade (Gleason less than 7) But the choice of therapy in PC is very complicated and many factors must be considered.

Patient who have IMRT/Proton (myself included) must live with possible recurrence since some cancer cells might remain. But because of poor operative technique, or disease extending beyond the gland, surgeons may not "get it all", and disease recurs. That is why the experience of the physician (radiation oncologist or surgeon) is very important. Beware of MD's with financial conflicts.

Periodically I may report my PSA but the low point may not happen for many months.

Age 63
DRE +, PSA (initial) 4.2
Biopsy 4/12 Gleason 7, 4/12 Gleason 6
Stage T2b
IMRT 42 treatments, total dose 7560 mGy

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