Husband had a follow-up MRI of prostate last week. We met with oncologist at Sloan Kettering yesterday. The news was disappointing on several counts.
1. HT (Lupron x 3 months) had no effect on shrinking prostate size, which is the same at 79 cc volume. In other words, still very large.
2. There's been a slight decrease in size in the questionable lymph node, suggestive that it's responded to the HT and therefore involved.
3. Husband has been extremely fatigued and somewhat dizzy on standing. This is a big change for him over his usual chipper self.
Our MD is concerned that with the large prostate size, its placement protruding into the bladder, possible lymph node involvement, the radiation field of necessity would be large and damage considerable adjacent tissue. He quickly consulted with two radiation oncologists at MSKCC, and called us back this morning. The next step will be to do a radiation "simulation" to determine the feasibility of IMRT. [In any case I'll see if husband is a candidate for proton beam radiation, but will wait until after consult and opinions with MSKCC rad specialists.]
MD is not convinced yet that the lymph node size reduction is indicative of Ca, since it was borderline enlarged in the first place. (Only a biopsy will tell for sure.)
MD also discontinued Lupron for now, noting that dear husband "is not the same." I was not even aware until last week that husband was feeling exhausted! He self-diagnosed himself as borderline anemic and was taking iron pills. But once I became aware, I went online and saw that fatigue is a common side effect of Lupron. Our oncologist agreed completely.
[GUYS, please keep your partners in the loop as to how you're feeling. ]
Next steps look to be: conduct radiation simulation; possible biopsy of questionable lymph node.
We are grateful to have such great expertise at Sloan Kettering available to us. Plus we'll seek the expertise wherever it is, if need be.
At age 82, the prospect of ANY surgery - with all side effects and risks - gives one real pause. Quality of remaining life is important, and really impacts decisions.
We've been married 35+ yrs. I'm some 20 years younger that hubby and still working full-time. Hubby has MMC: marital managed care, deluxe life-time policy!
Thanks to everyone for their good wishes, support and suggestions. I haven't yet gotten down to reading a number of suggested books, but this will happen soon.
Husband diagnosed 9/06 at age 81; after PSA test of 26.5 (baseline was 14-16 for many years);
Biopsy highest Gleason 4+4=8; prostate size 100
Started HT 12/06, 4 months, prostate size 75 (Apr 07); additional 3 months HT, prostate size 75 PSA .14 (July 07).
Dx: Stage T1c or T3c? one slightly enlarged abdominal lymph node
TURP 1999 negative for PCa