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Seed Implantation + External Radiation: Do Patients Really Benefit?

hopeful and opt...
Posts: 1282
Joined: Apr 2009

http://www.prostatevideos.com/2012/10/29/seed-implantation-external-radiation-do-patients-really-benefit/?utm_source=feedburner&utm_medium=email&utm_campaign=Feed%3A+prostatevideos+%28Prostate+Videos.com%29

Beau2
Posts: 228
Joined: Sep 2010

Ira,

Thanks for the video link.

It was aimed at treatment with seed implantation combined with external beam radiation; however, it brings to my mind the question of why treat low risk PCa? If your PSA is under ten and your Gleason is 6 do AS and your results will be as good as if you are treated right away with any treatment method.

Wish I would have come to this conclusion four plus years ago .... but then again I don't think I could have lived with knowing I had cancer and was not treating it. Guys who are on AS (like you) are certainly stronger then I.

hopeful and opt...
Posts: 1282
Joined: Apr 2009

maybe the opposite, trying to avoid active treatment and possible side effects.

When I was first diagnosed in 03/09, I saw a radiogist who wanted to do seeds and IMRT, and said that he thought that there was a 50 chance that it was outside the capsule, and he felt that I had 8 weeks to make a decision. For those other poster who are not familiar with my case, I had a low volume Gleason 3+3=6 cancer. (Complete details of my case are available by clicking my name). I believe that this RO saw a business opportunity at that time. Fortunately I did research and had a different opinion at that time.

Now my PSA is doubling at a yearly rate of 2.6. I am concerned. I have a biopsy scheduled for June 2013. I wonder at this time if I should wait thit long for the biopsy. It looks like I will have to have treatment. By the way, since I had more time to research and make a decision, I feel as comfortable as you can be about getting treatment.

Anyway I rambled along, I believe that it's all scary. Most of the time I am fine, but I certainly have the "prostate cancer moments"

VascodaGama's picture
VascodaGama
Posts: 1518
Joined: Nov 2010

Ira

Probably the “waiting” is making you anxious. You need to get involved in something else, a hobby, travelling, etc.

I may be wrong, but you have to recalculate your PSADT. The correct doubling rate since 2009 for twelve months is lower than 2.6 at approximately 1.6 ng/ml. In any case your PSA curve has been fluctuating from 4.2 (Dec 2011) to 4.1 (Jun 2012) to 4.3 (Oct 2012), and such presents still a lower rate in doubling. It also does not mean that the aggressivity has altered or that you got additional tumours in the “colony”. The next biopsy can be done as scheduled (June 2013) together with the T3 MRI. You could discuss with your doctor on the possibility of doing a colour Doppler at the clinic of Dr Duke Bahn (by himself). It would provide you with a better perspective of the prostate and surrounding tissues.

Though not deemed necessary, you could test your PSA in January 2013 for peace of mind. You know that there are treatments to provide you with a continuous control, if such time comes in future. I was G6 (2+3) with a PSA=22.4 at diagnosis at the age of 50. Similarly to your cancer type mine was sort of indolent.

At your age you are doing very well for not seeking a radical and risking the side effects. You prove to be a man of courage for “sleeping” with the enemy. You got the guts to follow AS and I admire your endeavour.

Thanks for sharing your story and the info you constantly provide to us.

Regards.
VGama

hopeful and opt...
Posts: 1282
Joined: Apr 2009

VG

Thanks

I calculated the doubling time of my PSA numbers from 1/13/2011
to 10/5/2012, when my PSA started to rise, in the a nomogram by Sloan Kettering. The results showed a doubling time of 2.56 years. I wonder if I am using the right dates?

Right now I am scheduled for a T3 MRI and a biopsy in June.

Kongo's picture
Kongo
Posts: 1167
Joined: Mar 2010

Ira, just a note. Be sure you're using the pre-treatment and not the post RP nomogram. It makes a big difference

Best.

VascodaGama's picture
VascodaGama
Posts: 1518
Joined: Nov 2010

Ira

You are confusing things. This is an evident prove that you need to fly to Iberia and visit some taverns for new wine tasting with me in November 16th. Do not forget of bringing along the moustache of Movember. (http://uk.movember.com/about)

In your previous posting you say that “my PSA is doubling at a yearly rate of 2.6” (erroneous), but in the answer to me you say that “the doubling time is of 2.56 years”. That is absolutely correct.

I checked your totals from January 2009 with a PSA=2.2 to October 2012 with a PSA=4.3, (including each and every result along the years) and got a velocity of 0.63 ng/ml per year with a PSADT of 41 months (3.4 years). The worrisome period you comment from January 2011 (PSA=2.5) to October 2012 (PSA=4.3) gives a velocity 0.9 ng/ml per year and a PSADT of 2.6 years (31 months). This is higher enough to include you in the “extremely low risk of death from prostate cancer” group of patients.

Here is a good explanation for the criteria in judging the PSADT;
http://prostatecancerinfolink.net/2008/05/29/guidelines-on-psa-doubling-time/

In the initial period from diagnosis (January 2009) to January 2011, the cancer was TOTALLY indolent. The sudden increase in 5 months from January 2011 (PSA=2.5) to June (PSA=3.6) could also be attributed to other causes such as a change in your life style or diet or intake of supplements.
Just try to go back in time and figure out about any possible effect.

You could look for added factors to control your AS endeavour. You will need to discuss with your supervising doctor about any interference in taking , for example, vitamin Gamma-E, which has shown in trials to KILL prostate cancer stem cells. This would give you a better grip on any advance in an indolent type of cancer.

The Gamma-tocotrienol is very effective in targeting prostate cancer stem cell, and these have been associated with the “origins” of PCa. Aspirin may be an option too.
Please read these two links for an idea of what I meant as “a continuous control” on my previous post:
http://www.ncbi.nlm.nih.gov/pubmed/20617516
http://www.ncbi.nlm.nih.gov/pubmed/22927523

There are four types of Tocotrienols; alpha, beta, gamma and delta. The gamma variety seems to be the best for Pca. Here is news on the Gamma Tocotrienol;

http://www.prnewswire.com/news-releases/gamma-tocotrienol-kills-prostate-cancer-stem-cells-99205919.html
From Wikipedia; (http://en.wikipedia.org/wiki/Tocotrienol)

Care in taking supplements should not be avoided. Vitamin E inhibits blood clotting and should not be taken with anticoagulant drugs or in cases of bleeding disorders. Here is a site on capsules of Gamma-tocotrienol which mixes the all tocotrienols but keeps the gamma as the principal element (read the contents);

http://www.iherb.com/Nutricology-CoQ-Gamma-E-60-Softgels/9816
http://www.iherb.com/Life-Extension-Gamma-E-Tocopherol-Tocotrienols-60-Softgels/16386

I think you have discussed about the above before, and I am sure you know the meaning of my advice.

Wishing you a “fantastic” Movember.

VGama

hopeful and opt...
Posts: 1282
Joined: Apr 2009

As usual I am awed by the research that you share. The site that interprets that the amount of my PSA puts me in the "This is higher enough to include you in the “extremely low risk of death from prostate cancer” group of patients" gives me peace of mind.......thank you.

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