Decision Time RP or ADT/HDR/EBRT

Old Salt

Looks good to me!

The decline in PSA indicates that the ADT is effective. 

VascodaGama

Just on target

The decrease suggests that your type of cancerous cells respond well to hormonal treatment. You can depend on ADT in the future if such becomes necessary. I wonder if you had a testosterone test before starting treatment.  If not, I would recommend you to get one now for future evaluation.  T should be lower than 30 ng/dL.

Let's hope that RT works well too.

Best

CMO2021

Thank you both! Yes VG great

Thank you both! Yes VG great question as usual, I did ask about adding a testosterone level to my next blood draw and it has been confirmed it will be added to the next blood draw.  I always appreciate the insight of the members here. Thank you!

CMO2021

Quick Update

Labs today at MSK,  PSA down again from 0.7 to 0.35,  the Nurse practitioner had  told me after the dramatic decrease last month that the decrease would be slower, but I am happy that it decreased 50% from last months low. Not so thrilled that my Ast 39, Bilirubin 1.6  and LDH 256 are elevated.  I know some of the AST and Bilirubin can be due to Zytiga.  My Alkaline phosphatase actually decreased to 75 and has consistently been within normal limits.    I hoping the LDH is partially due to busting my butt pulling the engine our of my Father-in-laws vintage Studebaker mail truck (ZIP Van). All in all I am still feeling good and the ADT side effect have been tolerable and I feel fortunate that overall  I feel pretty good.  I have my HDR Brachy therapy two weeks from today.  I'm anxious to get it done. Thanks for listening/reading. 

eonore

CMO2021 said:

Quick Update

Labs today at MSK,  PSA down again from 0.7 to 0.35,  the Nurse practitioner had  told me after the dramatic decrease last month that the decrease would be slower, but I am happy that it decreased 50% from last months low. Not so thrilled that my Ast 39, Bilirubin 1.6  and LDH 256 are elevated.  I know some of the AST and Bilirubin can be due to Zytiga.  My Alkaline phosphatase actually decreased to 75 and has consistently been within normal limits.    I hoping the LDH is partially due to busting my butt pulling the engine our of my Father-in-laws vintage Studebaker mail truck (ZIP Van). All in all I am still feeling good and the ADT side effect have been tolerable and I feel fortunate that overall  I feel pretty good.  I have my HDR Brachy therapy two weeks from today.  I'm anxious to get it done. Thanks for listening/reading. 

Great news!

That's great news.  It is admirable how you have taken this bull by the horns. Keep up the great attitude and outlook.

As to the Zip van, I am old enough to have ridden in Studebakers and seen them on the road regularly.. However, I had never seen the Zip Van.  I googled it and what a great looking vehicle! Alot of fun.

Eric

CMO2021

eonore said:

Great news!

That's great news.  It is admirable how you have taken this bull by the horns. Keep up the great attitude and outlook.

As to the Zip van, I am old enough to have ridden in Studebakers and seen them on the road regularly.. However, I had never seen the Zip Van.  I googled it and what a great looking vehicle! Alot of fun.

Eric

Thank You, for your

Thank You, for your encoragement.  The Zip Van is a cute little truck.  The engine comes out by droping the whole front suspension out of it with the engine and transmission in what they call a bogie.  Also last vehicle that came of the Studebaker production line.

VascodaGama

Complete panel tests

I also think that those high levels are due to Zytiga. I recommend you to balance the situation with diets good for anemia, kind of iron rich foods. Vitamin B12 from seafood is also good.

Zytiga is linked to adrenal and kidney problems too. You can ask your GP to include periodical tests for checking these organs function.

Will wait for your next report.

Best,

VG

CMO2021

Thank you VG for the

Thank you VG for the suggestion for diets definitely an area I can improve on.  I have been trying to eat more fish.  Looks like time for more fresh spinach salads which  I really enjoy this time of year.  I will keep you posted as I continue on this journey. I will request the additional test from my GP.  Best Regards, CMO

Max Former Hodgkins Stage 3

CMO2021 said:

Thank you VG for the

Thank you VG for the suggestion for diets definitely an area I can improve on.  I have been trying to eat more fish.  Looks like time for more fresh spinach salads which  I really enjoy this time of year.  I will keep you posted as I continue on this journey. I will request the additional test from my GP.  Best Regards, CMO

Diet

CMO, 

As I have been fatigued and anemic for well over a decade from a variety of causes (but mostly from two cancers), let me say that I take a Super B OTC supplement daily.  It is great for more energy (B12 is the main ingedient in most 'energy' drinks).  Plus, my Super B also contains B6 and a variety of other positive elements.  The B-vitamins are all water-soluble, so accumulation in the body above normal is virtually impossible  (fat-soluble vitamins are of course much more potentially dangerous).

At doctor orders, I take an Iron supplement daily.   Besides spinich, collard greens (I know, not really a 'thing' in NYC) are among the plants richest in iron.  Plant-based iron avoids some of the 'side-effects' of pill-form Iron supplements, which can be a 'colorful' experience.......

I also drink around 60 ounces of strong coffee daily, but even with all of the above, still require at least 12 hours of sleep a day, sometimes more.   I find disease and medication fatigue a hard thing to shake.    As with any med, ask your doctor before using any supplement; many supplements are prohibited during treatments, and can counteract the efficacy of the doctor's meds.   Medical oncologists seem more aware of this than urologists, so if you have urologists and medical oncologists, ask BOTH before making changes.

 

CMO2021

Max Former Hodgkins Stage 3 said:

Diet

CMO, 

As I have been fatigued and anemic for well over a decade from a variety of causes (but mostly from two cancers), let me say that I take a Super B OTC supplement daily.  It is great for more energy (B12 is the main ingedient in most 'energy' drinks).  Plus, my Super B also contains B6 and a variety of other positive elements.  The B-vitamins are all water-soluble, so accumulation in the body above normal is virtually impossible  (fat-soluble vitamins are of course much more potentially dangerous).

At doctor orders, I take an Iron supplement daily.   Besides spinich, collard greens (I know, not really a 'thing' in NYC) are among the plants richest in iron.  Plant-based iron avoids some of the 'side-effects' of pill-form Iron supplements, which can be a 'colorful' experience.......

I also drink around 60 ounces of strong coffee daily, but even with all of the above, still require at least 12 hours of sleep a day, sometimes more.   I find disease and medication fatigue a hard thing to shake.    As with any med, ask your doctor before using any supplement; many supplements are prohibited during treatments, and can counteract the efficacy of the doctor's meds.   Medical oncologists seem more aware of this than urologists, so if you have urologists and medical oncologists, ask BOTH before making changes.

 

Thank You Max

I will check with my MO about the B12 great suggestion. I will add it to my armetarium.  I like collards but the way my best friends Mom used to make him.  I think the ham hocks probably would defeat the purpose for eathing them.  We do grow Kale but not sure how much iron is in Kale.  Thank you for the suggestions and bring back some good memories of my best friends Mom's cooking.

CMO2021

Cardiac Ablation for Afib

I was diagnosed with Afib about  2.5 years ago.  Originally treated with Sotalol due to being pretty symptomatic when I had Afib.  Last July I started having a lot of breakthroug Afib even with the Sotalol.  In January 2021.  I underwent 7.5 hour cardiac ablation with both RF and cryo-ablation.  Procedure went well and I have not had any sustained Afib since the end of February. I have an occasional PAC but thats all.  Taking only amlodipine and metoprolol now plus pca ADT drugs. I would do it again because it has made such a difference.  Like anything else find the best EP guy/gal you can to do the procedure.

MK1965

Max Former Hodgkins Stage 3 said:

Diet

CMO, 

As I have been fatigued and anemic for well over a decade from a variety of causes (but mostly from two cancers), let me say that I take a Super B OTC supplement daily.  It is great for more energy (B12 is the main ingedient in most 'energy' drinks).  Plus, my Super B also contains B6 and a variety of other positive elements.  The B-vitamins are all water-soluble, so accumulation in the body above normal is virtually impossible  (fat-soluble vitamins are of course much more potentially dangerous).

At doctor orders, I take an Iron supplement daily.   Besides spinich, collard greens (I know, not really a 'thing' in NYC) are among the plants richest in iron.  Plant-based iron avoids some of the 'side-effects' of pill-form Iron supplements, which can be a 'colorful' experience.......

I also drink around 60 ounces of strong coffee daily, but even with all of the above, still require at least 12 hours of sleep a day, sometimes more.   I find disease and medication fatigue a hard thing to shake.    As with any med, ask your doctor before using any supplement; many supplements are prohibited during treatments, and can counteract the efficacy of the doctor's meds.   Medical oncologists seem more aware of this than urologists, so if you have urologists and medical oncologists, ask BOTH before making changes.

 

60 oz of coffee

 Max,

I used to drink around same amount as you did. Always drink double expresso with a extra bit of water.

Used to drink 7 double shots while working 10 hours daily, remotely from home. Had always cup of coffee on my desk. 
Ask me how many times I change my key board? Almost monthly.

In April, my heart started racing, I felt like fish is flipping in my chest and started having pressure in my chest like heavy sand back is on.

Started getting heart rates between 180 and 205 For 10-15 minutes. After that I would feel wiped out for the rest of day.

In May, diagnosed with AFib, SVT, PAC. Had consultation with electro physiologist which strongly recommended Cryogenic-ablation.

In 2 months, had 18 Afib  episodes registered with my Apple Watch. Had coronary Catheterization- my coronary arteries are clean as a whistle.

Still, did not make decision about ablation to sourt out mess with my electrical impulses.

MK

CMO2021

HDR Brachy at MSK

On Monday, I had my HDR Brachytherapy at MSK.  Things went well ADT with Zytiga had shrunk my already  reasonably small prostate even more.  No gross EPE seen on the MRI as needles were inserted.  Note: No spacer used because concern it would interfere with where the lesions were in my prostate (per the RO's Fellow) and placment of the needles. RO feels that its possible treatment with the HDR Brachy and follow-up EBRT maybe Curative.  I am realistic with my diagnosis of G9 with intraductal histology this not likely but will be happy if it helps kick it down the road abit.  I am very happy that the ADT appears to be working  as was suggested with the decreasing PSA.  Other than some slight burning on urination which is improving.  I have a little discomfort in perineum so using a cushion that helps takes the pressure of things. I feel really good and  have had no blood in urine since immediately after the procedure.  I know the long term side effects can takes years to show themselves but right now I am happy and feeling good. 

VascodaGama

Thanks for the update

CMO,

Thanks for the report. I am pleased to know that you are feeling well. I wonder how much Grays have been delivered and how many more will EBRT involve. The negative MRI is also good news but will that mean that they will shorten the field of attack? Are lymph nodes covered in the protocol?

I hope the procedure continues well and the results are super. 

Best wishes 

VG 

CMO2021

Total 15 GY with HDR

Thank you VG,

I had a total of 15GY administered during the HDR through 17 needles.  I am meeting with my RO doing the EBRT and will discuss the final plan for the EBRT not that HDR is completed.  I have one suspect pelvic node that is suspect so they  will give that node a "little extra" radiation and the plan is to hit the other lymph notdes as well. They will clean up the pelvic floor.  I will discuss the plan in more detail now HDR is completed regarding total GY.  I prefer to go a little more aggressive.

Best regards,

CMO

Old Salt

Thanks

for the update.

Very good to read that your plan of attack seems to be working well.

Good luck with the next phase (EBRT/IMRT).

CMO2021

August Labs 2.5 Wks Post HDR Brachytherapy

My monthly lab draws were done at MSK today with me being 2.5 weeks out from HDR Brachytherapy.  Everything looked good ELevated LFT's from last month all resolved.

I am a little disappointed that PSA went from 0.35 ng/ml to .45 ng/ml.  I'm hoping its due to the HDR brachytherapy.  I was hoping for at least .15 ng/ml but only time will tell if its a blip or is real.

VascodaGama

PSA increase is expected due to RT

Yes, you are right. The increase of the PSA is expected after radiation. A stable PSA may occur two months past EBRT. In any case the PSA level to judge success is to be from tests done after the end of ADT's influence. You should also check the testosterone  levels to get some understanding of PSA variations.

Let's wait and repeat the test two months after RT is complete. 

Best,

VG

CMO2021

Thanks VG

Thanks VG,  I appreciate your voice of reason and calm.

Max Former Hodgkins Stage 3

CMO2021 said:

Thanks VG

Thanks VG,  I appreciate your voice of reason and calm.

Chime in

CMO,

I have not been in your thread for a time, but wanted to say a few things.  First, congrats that things seem to be going well and effective.  About a month ago, you mentioned high LDH.   LDH is a marker for CELL death, which is why it used to be employed as an indicator of heart attack severity.    As a lymphoma patient, I learned that it at times is more an indicator that drugs are killing off cancer cells than it is indicative of active disease.  Mine was around 500 at times, or perhaps a bit higher.  Levels this high can clog the kidneys, as they try to pass dead tissue, which is why chemo patients must drink massive amounts of water.   What I am saying is that high LDH can be interpreted as a good thing, but only your oncologist can address this.  Also, many oncology drugs skew liver enzymes and other results.   Following an accident decades ago, my Belirubin was 18.2, so I would not fret over what you reported, which I think was around 1.6.  At over 18, my sweat, when wiped off, was gold colored, and I looked like a fresh pumpkin, and my nails were bright yellow. The doctors thought I had passed into complete liver failure, but thinngs went back to normal, somehow.   On chemo my AST/ALG ran about 200% above normal, which did not concern my oncologist at all.  The state motto of S.C., from colonial times, is Whilst I breath, I hope.

Keep fighting the good fight, and keep winning,