Radiation with Hormone Therapy-Firmagon

Kongo said:

Interesting
Hi, Hopeful.

I'm glad you're progressing through your treatments without too many speed bumps. Frankly, I don't understand the thought process behind monitoring your PSA while still in the radiation process. I do understand the logic of doing a blood panel (although I don't know if that's standard for IMRT) and monitoring your white blood cell count which I suppose could be affected by radiation treatment.

During the radiation process, the prostate is going to be inflamed from the radiation. That's the source of the temporary urinary urgency issues some men experience. But the inflammation also causes PSA to elevate in the short term just like a prostate massage or a misadjusted bicycle seat. The fact that your PSA has dropped so far so fast even considering that the prostate is inflammed is a very good sign in my opinion.

My radiologist told me that the faster the drop the less likely that there will be a PSA "bounce" downstream and the higher the probability that the treatment will be successful.

I hoping that you're very happy with these numbers.

K

Interesting
Hello Kongo

Thank you for the encouraging reply.
I also wondered about the PSA being monitored while I'm doing radiation & questioned my radiation oncologist. She didn't think much of the PSA test either. She is more concerned with what the nadir will be once done with treatments.

The urologist is the one giving the monthly shots & giving scripts for the PSA testing, They are in different Health Networks--the rad oncologist is in the hospital & the urologist has a private practice. I had all the blood work & psa done at one center so I didn't have to get stuck twice. The insurance will not pay for the PSA at the hospital.

When I go for my stomach shot(4th) on Monday I'm going to question this.
Thanks again for the reply & I love the comment that the probability of success is high.
Bless you & everyone on this board

Rad Hopeful

RADIATION HOPEFUL said:

Interesting
Hello Kongo

Thank you for the encouraging reply.
I also wondered about the PSA being monitored while I'm doing radiation & questioned my radiation oncologist. She didn't think much of the PSA test either. She is more concerned with what the nadir will be once done with treatments.

The urologist is the one giving the monthly shots & giving scripts for the PSA testing, They are in different Health Networks--the rad oncologist is in the hospital & the urologist has a private practice. I had all the blood work & psa done at one center so I didn't have to get stuck twice. The insurance will not pay for the PSA at the hospital.

When I go for my stomach shot(4th) on Monday I'm going to question this.

(Questioned (Physician Assistant)urologist on Monday about the hormone therapy during rad treatments & was told only after I'm done with the radiation treatments will we see the final PSA results & that he expects them to be much lower.)
Thanks again for the reply & I love the comment that the probability of success is high.
Bless you & everyone on this board

Rad Hopeful

March3,2011 Update
Anyone following this radiation venture> Today I finished my 25 broad beam radiation treatments, Tomorrow I was told will be a picture taking only -NO TREATMENT- The doctor etc, wants to review everything before starting the cone shaped protocol focusing on the prostrate only (19 treatments)
The first 25 treatments weren't bad, I was able to do my normal work including plowing & shoveling snow. Hope the next 19 starting Monday the 7th go as well & the end result we were looking for is achieved.
Thanks to all that responded to my past questions -I appreciate it.
Blessings to everyone

Cordially
Rad Hopeful

VascodaGama said:

A break to let you breath
RadHope
This is a good break to let you breath. Hopefully the next step is as good as this first.
What about symptoms? Is there anything apparent? And
How are you copping with the side effects from Firmagon?

I wish you a continuous positive progress.
VGama

A break
Hello VGama

To answer your questions>

Symptons --None that prevented me from doing my normal daily routine, the only issue I encountered is the urgency to urinate & I don't know if it's from the Firmagon or not. The Firmagon has the same notice about urgency & seems to give me more problems than anything I received during the radiation.
I have a large lump on my stomach where they injected me with the Firmagon on Monday. I believe it stores the drug & releases it during the course of a month before I need another shot. a mild side affect of the Firmagon is an occassional hot flash (easily tolerated) Of course the PSA is also being checked monthly so when I get a CBC(complete blood count) script from the hospital, I also take the urologist script along & have them both tested at a independant lab thus only having to get stuck one time.
So far I'm pleased with the radiation aspect of treatment & truly believe the 25 wide beam treatments got any cells that may have--- notice I said may have ventured outside the prostrate. AS you know cancer cells aren't as tolerant as the normal cells & die easily while the good cells recover from any treatment. This 3 day break will give the good cells a opportunity to repair themselves beyond the normal two day weekend break. Now the next 19 will focus on the prostrate itself. I pray all the cancer was in the prostrate & now any left over will be destroyed-period.
Bless all & thanks again for the positive wish, I appreciate it.
I'll keep posting as I venture into the next phase.
Rad Hopeful

RADIATION HOPEFUL said:

Monday March 7th Update
All> Today was the first of 19 what they term Cone Down treatments. I was told the radiation will not encompass as large an area as the first 25 treatments. I'm glad I have the opportunity to see the radiation oncologist once every week to discuss the procedure & ask questions. I was given a prescription for Flow Max in the event I would need it. I told the doctor, I wouldn't use it unless I encountered a problem with voiding of urination which I haven't so far. Despite not having a full forceful stream, I can still void. I don't like taking more medication than I have to.
Bless everyone & again I'll update as I venture into this area of treatment.

Cordially
Rad Hopeful

FLOWMAX or TAMSULOSIN HGL .4 mg Capsules
Question> has anyone had experience with taking the Flowmax capsules? Now that I have focused radition treatment to the prostrate, I'm having some difficulty urinating & voiding fully. Got a prescription for the Flowmax but after reading the potential side affects it is scary.
Looking forward to replies of personal experiences

Thank to all & bless everyone

Rad Hopeful

Kongo said:

Flomax
Hopeful,

Radiation frequently causes some inflammation of the prostate. Although the uretha is pretty tough, it too can sometimes become inflamed. These short term side effects are frequently treated with Flomax but before you go that route, you may wish to try Advil instead. Advil is designed to reduce inflamation and swelling and in many cases it may be all you need. It can't hurt.

When I finished my radiation treatment I was due to start a few weeks of traveling so my doctor gave me a Flomax prescription "just in case." Although I got the pills I never took them as I only really felt the urgency you describe on one day after my final treatment. The Advil worked like a champ.

In any event, these symptoms are not uncommon and typically pass within a few days or weeks after ending treatment.

Good luck.

K

Flomax
Thanks for the reply regarding Flowmax--I took one of the capsules at lunch today---prior to reading your memo. Should of looked for replies first--my mistake. If I have any issues, I''l post them. The radiation technician this morning--suggested I take one after eating my noon meal which is what I did.
UPDATE> March 4th---ended my first week of cone down radiation. I asked the tech if this cone down was IMRT or IGRT & was told what I'm receiving is better it's called RAPID ARC. I was surprised to hear the term as I thought I was getting IMRT all along. Anyhow have been taking FLOMAX for a couple days now & it did allow a better urine stream. I noticed some small stones coming out when I urinated--apparently bladder stones from not voiding totally earlier. Hope this isn't another serious condition. I do feel better lately & got new blood work results. Everthing is within the forcasted reange including my lymphocytes which dropped from 21% to 15% but within range of 14% to 44%. Drop is probably due to body fighting any infection that may be present. Another Blood test in two weeks which will include PSA & Glucose checks. >>>>>>>>>Comments WELCOME
Will keep posting as the saga continues.
Again BLESS all going through these perilous journeys

Rad Hopeful

RADIATION HOPEFUL said:

Update March 16,2011
Hello Kongo

Thanks for the reply, today is the 8th cone down treatment & due to some burning & discharge in my urine, I had a urine culture test done at the hospital.

Pleased to report no sign of infection. I was told the problem I'm having may be due to irration of the bladder from the rad treatment. (Glad no infection)
After today I have 11 more cone down treatments & again I'm feeling "OK"-- drive myself to daily treatments, see the rad oncologist every week & pray this approach works for me. "Next week I will have another blood test & will post results"

Bless everyone with whatever your dealing with, wishing the best of outcomes for everyone

Rad Hopeful

March 24,2011 --UPDATE
Hello All

For those following this venture, I had a complete blood count & PSA results this morning.

PSA is now at 1.6 which is another 37% drop from the 2.64 in February. Although it's going down, I was hoping for a lower number.

Results so far> November 2010 --- 53.99
December 2010 --- 17.87
January 2011 --- 4.18
February 2011 --- 2.64
March 2011 --- 1.66

Next Hormone shot is Monday March 28,2011

The following were shown as low on the blood analysis

Hemoglobin> 13.0 g/dl
Hematocrit> 38.2%
RBC> 3.94 mill/cmm
Absolute Lymph> .9 thous/cmm
Lymphocytes> 16.0%
One item was shown as high& that was something called NEUTROPHILS> 74
All the other readings were within ranges given

Looking forward to input from my friends following this radiation journey
Again Bless everyone with their fight whatever the condition.

Rad Hopeful

RADIATION HOPEFUL said:

Thanks to Vgama & Kongo for replies--appreciate it.
Next week I have 4 more radiation treatments --then done & looking forward to final analysis.
VG--Thanks for the (neutrophil) explanation, I thought it was something bad with a high reading---the range was 40 to 70 & I had 74.
I have been fortunate with the tremendous decline of PSA over the past few months--From 54 to 1.6 is fantastic, I just hope the radiation did it's job in killing the cancer cells. I keep myself busy & last Friday when I got home from the hospital, I shoveled a ton of mulch on a wagon. My strength is good & the only problem I had with the Firmagon is the large welt it leaves on the stomach for several days. I believe I read it takes months to rid the body of the dead cancer cells & that although dead are counted in the PSA readings. If anyone knows this to be true I would appreciate a reply.
Working on the farm keeps me busy all the time & I look forward to Spring & Summer when the temps are better--no more plowing etc.

Again THANKS for the replies & Bless everyone

Rad Hopeful

Update
ALL

It's now 12 days after my last rad treatment & the only issue I have is urgency to urinate especially after doing some physical work. I don't know how long this will last, it also burns when I urinate. anyone have input regarding this affect?

Rad Hopeful

VascodaGama said:

Medications for inflammation (antibiotics) do the job
RadHope
After radiation treatment is common to experience urgency in urination and burning sensation due to inflammation at the bladder neck (sphincter). The burning is caused by the constant passing of urine at the urethra inner walls.
If left as it is, infection could cause urethral stricture (tightening of the urethra piping) which would require a cystoscopy manoeuver to widen (dilate) the urethra with a widening device or by cutting the stricture (under local anesthesia). Pain could signal such advanced status.

Usually medications for inflammation (antibiotics) do the job. You should inform your medical team about this symptom.

What about any other symptom? Have you experienced soft uncontrollable stools?

These side effects are usually short lived. Hope you get better the soonest.

Wishing you a smooth recovery from treatment.
VGama

Inflamation
Hello VGama

Once again THANK YOU FOR the response.

Today is day 14 after treatment & the burning is subsiding, I don't have any trouble with stools other than a little burning now & then--eating a lot of apple pie keeps things regular & formed well. The urgency to urinate is bothering me especially after I drink fluids. I'm drinking a lot of craneberry juice.
I will be seeing the urologist at the end of the month, perhaps by then I'll be better, I will also get another blood test. I have to see my primary for the complete blood test, the hospital doesn't monitor it after radiation is complete and my urologist has a business office himself away from the hospital staff. I wiil mention the urgency to all three doctors providing it continues. (I did read on the internet it could take a few weeks to months for the burning & urgency to subside ---I was afraid something else was wrong)
Thanks for the reply--I truly appreciate it.

Rad Hopeful