Husband Newly Diagnosed Gleason 9 - Clinical T3

hopeful and optimistic said:

Avodart
is a new drug. There was a study among patients who have not been diagnosed that showed a reduced amount of men who developed prostate cancer/.

There is current controversy as to whether this drug should be administered to those who already have prostate cancer.

Very recently, information has come to light showing that there are increased deaths due to heart attacks among those who take this drug.

I considered taking the drug,and did some research. It was a hard decision but I chose not to take the drug. This was before the info about increased deaths from heart. I believe that this drug is harmful.

PSA numbers are cut in half for those who take avodart.

I am not knowledgeable about Tamulosin.

Prostate cancer is a long “affair” commitment
DH
It is wonderful to see you deep engaged in the care of your husband. I understand how stressful you may be since confronted with the words "cancer; aggressive growth; immediate treatment, etc.". I am sorry if my arguments have distracted you in your quest.
You are doing it the right way educating yourself to the problem and researching. Preparing a long list of questions (my advice below) and asking details when in consultations is the best to get to that final decision and peace of mind.

As recommended above by other survivors, your husband’s clinical profile should be taken into consideration. He will need a doctor that will follow-up his case after treatment too.
You could get the opinions from two or three physicians. A medical oncologist specialized in prostate cancer may give you the less biased opinion. It is common to read that urologists and radiologists recommend the treatment of their own field, even though many are well educated in all aspects of Pca. The patient is in charge of the decision and he will be signing an agreement releasing the doctor and the hospital from any responsibility in the outcome of the treatment.

Avodart (dutasteride) and tamsulosin (Flomax) is a combo used to treat benign prostatic hyperplasia (BPH). This is recommended to treat cases of enlarged prostate, particularly when patients have difficulty or pain when urinating.
Avodart is a drug of the 5-ARI class that prevents the conversion of testosterone to dihydrotestosterone (DHT), and it is used as a preventive pill for prostate cancer, but it is controversial as Hopeful comments above.

You should inform the consulting doctor in advance about these drugs too. The oncologist may recommend you a continuation of the drug if symptoms are still prevalent otherwise your husband may stop taking it. Its effect on the treatment of cancer as a sole drug is minimal in the total context of the hormonal therapy.

All treatments and drugs have risks and side effects associated to them. Your husband may need a sort of targeted treatment/medication that needs constant monitoring by a follow-up physician. Many drugs interact with other drugs taken for other illnesses and that must be avoided. Your husband is in a situation indicative that he may need still other medications to handle his other debilities.

You can find a list of questions by googleing this sentence; “questions to ask your doctor about prostate cancer”. Do not be shy about asking questions even if they seem weird to you. You could add these items to your list:
1. How aggressive can we consider his case taking into account his age and other health complications and symptoms?
2. How far advanced is it?
3. Should I get a second opinion for all choices?
4. What are all options?
5. Should I consider do nothing and just monitor any advance?
6. What treatments are best for my husband?
7. Can such treatment lead to other problems or interact with other medications?
8. What can be done to cope with the side effects?
9. Will my husband have to stay in the hospital for treatment? How long?
10. Will treatment keep him from doing certain things and look after himself?
11. How often will he be checked after treatment?
12. Can he go back to normal daily activities after treatment?
13. What experiences have other patients had with similar treatment regimens?
14. Is there any new type of treatment or trials that might be beneficial?
15. What has been your experience with prostate cancer patients similar to his case?
16. Can you recommend any patient support groups in my area?
17. Are there materials I can read about this cancer?

You can call the doctor’s office to request later for specific answers on your first consultation if you have doubts on any opinion.
Here is a post that may help you in deciphering more questions;
http://csn.cancer.org/node/224280

Anxiety can be your worst enemy. Deal with the facts as they come.

The best to both of you.

Vgama

dhrocks said:

Medication after diagnosis ???
Sorry to hear about your mother. She must be one strong woman.

I couldn't find any writeups regarding continuing medication before treatment. I'm sure I will find out after going to the oncologist on Tuesday but kind of wanted to know ahead of time. My husband is taking Avodart and Tamsulosin. The doctor gave him Avodart about 3 months ago but when his PSA was recently checked it ended up being 11 (although the doctor said it really measures about 22 because of the Avodart). I don't know what that means but I guess it is just another mystery I need to find out about.

I kind of went off track here but wanted to know if my husband eventually stops taking these medications because he will be treated via other methods or do you continue taking these types of medications?

As you can see, I ask the most simple questions because I am still learning. Sorry.

Thank you.

Enough Said
dh: I think that Vasco, Hopeful and I have pretty much covered all of the things that you need to consider before making a final or at least tentative treatment decision for your husband and I don't want to muddy the waters for you any further.

Your husband's medical condition is very complex and becomes more complex as you reveal more about his various medical/mental problems, the medications he's taking and his testing results. Needless to say, you need to reveal ALL of this information to the oncologists/radiologists that you consult in order to make a reasonable decision about what to do (or not do).

As Hopeful points out, it might be best to do nothing at all, except provide care and comfort to your husband in his final years in order to enhance his QUALITY OF LIFE (QOL) for the remainder of his years. If that's not an acceptable alternative to you, you will have to decide whether the risks of treatment are justified by the probable results and their likely effect on your husband's AND your QOL.

No one here can make that decision for you. Unfortunately, that is your responsibility but I am sure that you will do your best to make the best decision possible.

Again, best wishes and good luck!

dhrocks said:

RapidArc
Yes, I have a lot of information to digest and it just keeps coming.

I did a little research regarding the radiation oncologist we will be seeing on Tuesday and found out that the office uses RapidArc technology which treats the tumor 2-8 times quicker than conventional radiation. I can see how my emotions will get in the way of making a decision on my husband's treatment. I assume with the radiation treatments taking only a few minutes the side effects will be less too...or am I living in a fantasy world.

Like everybody said, you don't really know what to expect because there are so many variables.

The RapidArc technology isn't talked about much on this board...is it new or just not as good as other methods?

I will continue with my research...which looks like will never end.

RapidArc = IGRT
A quick Google search revealed that RapidArc is the proprietary name of a type of IGRT (Image Guided Radiation Therapy), which is similar to IMRT and 3D Conformal Radiation Therapy.

If you haven't seen it already, you should read MrsPJD's detailed history of her and her husband's decision to use HT, HDR BT and IMRT in combination to treat PJD's Stage T3 Pca. It was posted on 9/2/11 in the "3 Weeks After Testing Positive" thread.