post IMRT treatment

califvader
califvader Member Posts: 108
in Prostate Cancer #1
always good to post good news. originally had r/p in Sept. 2003 and had recurrence. i am 4 months post imrt treatment and got my second psa test result back yesterday. another significant drop in psa. now down from 2.6 to 1.7. just before treatment it was 5.1. next test will be in December. so far it looks like they hit the sweet spot. no problems what so ever with the radiation treatment.

Comments

  • mrspjd
    mrspjd Member Posts: 694 Member
    #2
    Good news
    Congrats! You've come a long way since your first post last year. Best wishes for continued success.
  • califvader
    califvader Member Posts: 108
    #3
    mrspjd said:

    Good news
    Congrats! You've come a long way since your first post last year. Best wishes for continued success.

    thanks for the good wishes mrspjd
    yes i have come a long way. i am glad that they have so many different options to treat prostate cancer. thanks to my brothers here for giving me invaluable information.
  • VascodaGama
    VascodaGama Member Posts: 3,701 Member
    #4
    califvader said:

    thanks for the good wishes mrspjd
    yes i have come a long way. i am glad that they have so many different options to treat prostate cancer. thanks to my brothers here for giving me invaluable information.

    Good results
    Califvader

    The drop is all indicative that the rays "hit" the target. Success is on its way but it may take sometime before you see your NADIR.
    Enjoy the numbers.

    Hope you inform us of more of those drops.

    VG
  • George A
    George A Member Posts: 9
    #5
    califvader said:

    thanks for the good wishes mrspjd
    yes i have come a long way. i am glad that they have so many different options to treat prostate cancer. thanks to my brothers here for giving me invaluable information.

    Congratulations, your experience might be my guidance
    Dear CalifVader,
    Wish you all the best fighting this beast, I am certain that you will beat it!
    You have been in this for many years! I have just started, I am on Hormon now, one shot every 3 months, my doctor said that he will make an appointment for me with the Radiologist for him to consider weather I need this or No!!!!!!!!

    I have a question here for you, who decides this ? on what criteria this is decided
    Hope to hear from u

    George
  • califvader
    califvader Member Posts: 108
    #6
    George A said:

    Congratulations, your experience might be my guidance
    Dear CalifVader,
    Wish you all the best fighting this beast, I am certain that you will beat it!
    You have been in this for many years! I have just started, I am on Hormon now, one shot every 3 months, my doctor said that he will make an appointment for me with the Radiologist for him to consider weather I need this or No!!!!!!!!

    I have a question here for you, who decides this ? on what criteria this is decided
    Hope to hear from u

    George

    keep the faith
    hello George,
    as you are aware each of us has our own distinct circumstances. you did not mention if you had surgery, (r/p). in my case i did. i had one in '03 and over the years my psa slowly climbed to the point were i had two options. hormonal therapy or radiation. i choose radiation because i was not very thrilled with the side effects of hormonal shots. in my case the remaining cancer cells were still confined to the prostate bed. so i am assuming that is way my psa is dropping approx. 50% each psa check now. i investigated every option and asked many questions here. vasodaGama and Kongo were very helpful in providing me with information. so, one has to get "educated" and then make his own decision. And yes, vaso, i will keep the panel informed with future psa checks. good luck to all.

    steve
  • califvader
    califvader Member Posts: 108
    #7
    George A said:

    Congratulations, your experience might be my guidance
    Dear CalifVader,
    Wish you all the best fighting this beast, I am certain that you will beat it!
    You have been in this for many years! I have just started, I am on Hormon now, one shot every 3 months, my doctor said that he will make an appointment for me with the Radiologist for him to consider weather I need this or No!!!!!!!!

    I have a question here for you, who decides this ? on what criteria this is decided
    Hope to hear from u

    George

    hello George,
    as you are
    hello George,
    as you are aware each of us has our own distinct circumstances. you did not mention if you had surgery, (r/p). in my case i did. i had one in '03 and over the years my psa slowly climbed to the point were i had two options. hormonal therapy or radiation. i choose radiation because i was not very thrilled with the side effects of hormonal shots. in my case the remaining cancer cells were still confined to the prostate bed. so i am assuming that is way my psa is dropping approx. 50% each psa check now. i investigated every option and asked many questions here. vasodaGama and Kongo were very helpful in providing me with information. so, one has to get "educated" and then make his own decision. And yes, vaso, i will keep the panel informed with future psa checks. good luck to all.

    steve
  • califvader
    califvader Member Posts: 108
    #8
    George A said:

    Congratulations, your experience might be my guidance
    Dear CalifVader,
    Wish you all the best fighting this beast, I am certain that you will beat it!
    You have been in this for many years! I have just started, I am on Hormon now, one shot every 3 months, my doctor said that he will make an appointment for me with the Radiologist for him to consider weather I need this or No!!!!!!!!

    I have a question here for you, who decides this ? on what criteria this is decided
    Hope to hear from u

    George

    keep the faith
    hello George,
    as you are aware each of us has our own distinct circumstances. you did not mention if you had surgery, (r/p). in my case i did. i had one in '03 and over the years my psa slowly climbed to the point were i had two options. hormonal therapy or radiation. i choose radiation because i was not very thrilled with the side effects of hormonal shots. in my case the remaining cancer cells were still confined to the prostate bed. so i am assuming that is way my psa is dropping approx. 50% each psa check now. i investigated every option and asked many questions here. vasodaGama and Kongo were very helpful in providing me with information. so, one has to get "educated" and then make his own decision. And yes, vasco, i will keep the panel informed with future psa checks. good luck to all.

    steve
  • califvader
    califvader Member Posts: 108
    #9
    califvader said:

    keep the faith
    hello George,
    as you are aware each of us has our own distinct circumstances. you did not mention if you had surgery, (r/p). in my case i did. i had one in '03 and over the years my psa slowly climbed to the point were i had two options. hormonal therapy or radiation. i choose radiation because i was not very thrilled with the side effects of hormonal shots. in my case the remaining cancer cells were still confined to the prostate bed. so i am assuming that is way my psa is dropping approx. 50% each psa check now. i investigated every option and asked many questions here. vasodaGama and Kongo were very helpful in providing me with information. so, one has to get "educated" and then make his own decision. And yes, vasco, i will keep the panel informed with future psa checks. good luck to all.

    steve

    oops...
    sorry about the duplicate listings.
  • George A
    George A Member Posts: 9
    #10
    califvader said:

    keep the faith
    hello George,
    as you are aware each of us has our own distinct circumstances. you did not mention if you had surgery, (r/p). in my case i did. i had one in '03 and over the years my psa slowly climbed to the point were i had two options. hormonal therapy or radiation. i choose radiation because i was not very thrilled with the side effects of hormonal shots. in my case the remaining cancer cells were still confined to the prostate bed. so i am assuming that is way my psa is dropping approx. 50% each psa check now. i investigated every option and asked many questions here. vasodaGama and Kongo were very helpful in providing me with information. so, one has to get "educated" and then make his own decision. And yes, vasco, i will keep the panel informed with future psa checks. good luck to all.

    steve

    Radiation
    Hi Steve,

    Thanks for the reply!
    Actually I was only diagnosed recently with Gleason 9 and PSA 57, the prostate cancer is already in the lymph nodes but not anywhere else!!

    I had my first shot of Hormon on October 5th and the next one is scheduled to be on Jan 5th.
    I checked the PSA last week and it is now 33. does that make sense??
    The other concen I have is about Radiation, my Doctor told me that the Radiologist will see you in two weeks time to decide whether or not you will be given Radiation.

    On which factors the Radiologist will base his decision regarding Radiations ??? and if he decides to do that, are they usually effective ?

    I hope you have answers for me

    Best regards
    George
  • califvader
    califvader Member Posts: 108
    #11
    George A said:

    Radiation
    Hi Steve,

    Thanks for the reply!
    Actually I was only diagnosed recently with Gleason 9 and PSA 57, the prostate cancer is already in the lymph nodes but not anywhere else!!

    I had my first shot of Hormon on October 5th and the next one is scheduled to be on Jan 5th.
    I checked the PSA last week and it is now 33. does that make sense??
    The other concen I have is about Radiation, my Doctor told me that the Radiologist will see you in two weeks time to decide whether or not you will be given Radiation.

    On which factors the Radiologist will base his decision regarding Radiations ??? and if he decides to do that, are they usually effective ?

    I hope you have answers for me

    Best regards
    George

    hey george
    i would suggest writing your questions down on a piece of paper. that's what i did. every time i had a question i would add it to my sheet. you can address them on your next visit to the doc/radiologist. since your cancer has already spread to your lymph nodes i do not know if radiation would help. i changed doctors from my urologist, who was impatient and rude at times, to an oncologist that specialized in prostate cancer. she was compassionate and willing to explain things. i think the doctor patient relationship is very important. there are two gentlemen on this panel that can really give you some excellent guidance. what say you Kongo and VascodaGama?
  • califvader
    califvader Member Posts: 108
    #12
    califvader said:

    hey george
    i would suggest writing your questions down on a piece of paper. that's what i did. every time i had a question i would add it to my sheet. you can address them on your next visit to the doc/radiologist. since your cancer has already spread to your lymph nodes i do not know if radiation would help. i changed doctors from my urologist, who was impatient and rude at times, to an oncologist that specialized in prostate cancer. she was compassionate and willing to explain things. i think the doctor patient relationship is very important. there are two gentlemen on this panel that can really give you some excellent guidance. what say you Kongo and VascodaGama?

    my gleason was 3+3=6 stage T2. my psa at the time of surgery was 6.1. i had some tests to determine if my cancer had spread. i had a MRI with and without contrast fluid. i had a cancer cell blood test. also, i had a bone scan. all of these were negative. so the radiologist was feeling confident that my cancer was still confined to the prostate bed. George, if you do decide to go with radiation i can definitely help you with any questions you might have. good luck to you.
  • VascodaGama
    VascodaGama Member Posts: 3,701 Member
    #13
    califvader said:

    my gleason was 3+3=6 stage T2. my psa at the time of surgery was 6.1. i had some tests to determine if my cancer had spread. i had a MRI with and without contrast fluid. i had a cancer cell blood test. also, i had a bone scan. all of these were negative. so the radiologist was feeling confident that my cancer was still confined to the prostate bed. George, if you do decide to go with radiation i can definitely help you with any questions you might have. good luck to you.

    George; add my post in your research
    George

    In your thread (http://csn.cancer.org/node/228768) you did not comment about the hormonal shot. The drop in PSA from 53 to 33 in a span of 3 weeks is a good response for a G9 case. Though the cancer grade is high (4 and 5), it shows that it is hormonal dependent. This is good news because your treatment has high possibilities of a successful outcome.

    Your doctor will set the terms of your treatment. many do not recommend RT to G9 patients but you are the comandant of your "boat" and you can request if decided. In Canada doctors tend to be similar to the UK (people without ears) but you can try discussing the matter or at least forwarding questions that make sense. One thing you must understand is that you do not need to decide all at your next meeting. You can listen to what he has to say and ask for time to respond.

    I am not a doctor but I would understand your decision on radiation, at your age (54), fit and confident on possible side effects. I highly respect Dr. Charles Myers opinions in the treatment of prostate cancer and his comments and publications present the many logical reasons in the benefits of irradiation of lymph nodes in similar cases as yours

    You should investigate in detail about the risks of RT before deciding. The common is the problem of rectal ulcerative colitis (past medical history), which presence is prohibitive for RT. Some guys tend to be more sensitive to radiation than others (rare cases). The isodose planning should also be discussed with the radiologist in regards to the areas of the muscles that control erections, etc. There is always things that one cannot live without or with it.

    In your ongoing initial period on HT (3-month shot) much cancer will be “killed” and the prostate will shrink in size (yours is considered in the normal range). In such setting, radiation could attack the prostate deeply and radiate through-out the lymph nodes at the iliac and at the front pelvic, in addition to the other areas surrounding the prostate.

    The radiation treatment needs some preparation before starting (CT or MRI to locate areas of attack, isodose planning, fiducial setting, etc.). The facilities where you would be taking the radiation should also be checked in advance. Modern IMRT/IGRT machine is a must for a better outcome (lesser possibility of side effects).

    I recommend you to read details about radiotherapy researching the net. These are books that will help you to understand your case and that address the radiation modality too;

    "Surviving Prostate Cancer Without Surgery" by; Michael J. Dattoli, M.D, Jennifer Cash, ARNP,MS,OCN and Don Kaltenbach, (PCa Survivor)

    "Beating Prostate Cancer: Hormonal Therapy & Diet" by; Dr. Charles "Snuffy" Meyers, Medical Oncologist, Nutrition Expert and PCa Survivor.

    Wishing you peace of mind.

    VGama
  • nwgeoff
    nwgeoff Member Posts: 7
    #14
    George A said:

    Radiation
    Hi Steve,

    Thanks for the reply!
    Actually I was only diagnosed recently with Gleason 9 and PSA 57, the prostate cancer is already in the lymph nodes but not anywhere else!!

    I had my first shot of Hormon on October 5th and the next one is scheduled to be on Jan 5th.
    I checked the PSA last week and it is now 33. does that make sense??
    The other concen I have is about Radiation, my Doctor told me that the Radiologist will see you in two weeks time to decide whether or not you will be given Radiation.

    On which factors the Radiologist will base his decision regarding Radiations ??? and if he decides to do that, are they usually effective ?

    I hope you have answers for me

    Best regards
    George

    PSA drop with Lupron
    I was diagnosed in July with Gleason 8, 6 of 8 cores positive, PSA 7.5. I started Lupron on August 5. I had a PSA test 43 days later and it came back at 3.8 which surprised me. My doctor and most literature indicates that the PSA should fall fairly quickly (few weeks) to almost zero. I did some more research and discovered that not all men respond immediately to Lupron. I started radiation on 9/28 and will finish 11/29.

    Any other experiences on how fast PSA drops once you start on Lupron? Is it a negative indication when the PSA drops slowly?
  • VascodaGama
    VascodaGama Member Posts: 3,701 Member
    #15
    nwgeoff said:

    PSA drop with Lupron
    I was diagnosed in July with Gleason 8, 6 of 8 cores positive, PSA 7.5. I started Lupron on August 5. I had a PSA test 43 days later and it came back at 3.8 which surprised me. My doctor and most literature indicates that the PSA should fall fairly quickly (few weeks) to almost zero. I did some more research and discovered that not all men respond immediately to Lupron. I started radiation on 9/28 and will finish 11/29.

    Any other experiences on how fast PSA drops once you start on Lupron? Is it a negative indication when the PSA drops slowly?

    NW; PSA after HT
    NWgeoff

    The drop you describe is normal. A slow drop could be due to a low effect of the shot in lowering the testosterone in the body. In fact, the level of testosterone increases during the first few weeks of therapy, known as “flare”.
    To ascertain the drug’s effectiveness one should do a testosterone test and look for castration levels (lower than 30. ng/ml). Slow variations in the PSA are not indicative of treatment failure. Many factors can cause ups and downs if manipulation of the prostate is done in the period previous to drawing blood.

    In my case without a prostate gland, I started HT in November 2010 with one month on Cyproterone (antiandrogen) to avoid the “flare” and then got Eligard 6-month shot (equal to Lupron). At start the testosterone was 376 and the PSA was 1.0. These are the following results;
    Dec’10 PSA=0.18; T=28
    Mar’11 PSA=0.07; T=28
    May’11 PSA=0.05
    Aug’11 PSA=0.03; T=33

    It took 9 months to get it to nadir.

    Regards,
    VGama
  • nwgeoff
    nwgeoff Member Posts: 7
    #16
    VascodaGama said:

    NW; PSA after HT
    NWgeoff

    The drop you describe is normal. A slow drop could be due to a low effect of the shot in lowering the testosterone in the body. In fact, the level of testosterone increases during the first few weeks of therapy, known as “flare”.
    To ascertain the drug’s effectiveness one should do a testosterone test and look for castration levels (lower than 30. ng/ml). Slow variations in the PSA are not indicative of treatment failure. Many factors can cause ups and downs if manipulation of the prostate is done in the period previous to drawing blood.

    In my case without a prostate gland, I started HT in November 2010 with one month on Cyproterone (antiandrogen) to avoid the “flare” and then got Eligard 6-month shot (equal to Lupron). At start the testosterone was 376 and the PSA was 1.0. These are the following results;
    Dec’10 PSA=0.18; T=28
    Mar’11 PSA=0.07; T=28
    May’11 PSA=0.05
    Aug’11 PSA=0.03; T=33

    It took 9 months to get it to nadir.

    Regards,
    VGama

    PSA level
    VascodaGama

    Thanks for the info. I won't worry about that anymore.

    Only 16 more RT sessions and I'm done. Then I can start angsting about the PSA tests that mean something
  • mwozney
    mwozney Member Posts: 5
    #17
    nwgeoff said:

    PSA drop with Lupron
    I was diagnosed in July with Gleason 8, 6 of 8 cores positive, PSA 7.5. I started Lupron on August 5. I had a PSA test 43 days later and it came back at 3.8 which surprised me. My doctor and most literature indicates that the PSA should fall fairly quickly (few weeks) to almost zero. I did some more research and discovered that not all men respond immediately to Lupron. I started radiation on 9/28 and will finish 11/29.

    Any other experiences on how fast PSA drops once you start on Lupron? Is it a negative indication when the PSA drops slowly?

    how is radiation?
    My husband will need 35 rounds of radiation and I'm just wondering if you could share with me what side effects you have had. Thank you!
  • Beel
    Beel Member Posts: 1
    #18
    califvader said:

    keep the faith
    hello George,
    as you are aware each of us has our own distinct circumstances. you did not mention if you had surgery, (r/p). in my case i did. i had one in '03 and over the years my psa slowly climbed to the point were i had two options. hormonal therapy or radiation. i choose radiation because i was not very thrilled with the side effects of hormonal shots. in my case the remaining cancer cells were still confined to the prostate bed. so i am assuming that is way my psa is dropping approx. 50% each psa check now. i investigated every option and asked many questions here. vasodaGama and Kongo were very helpful in providing me with information. so, one has to get "educated" and then make his own decision. And yes, vaso, i will keep the panel informed with future psa checks. good luck to all.

    steve

    Side effects from radiation?
    Califvader,

    My prostate was removed 2 yrs ago...psa is up. Now facing radiation therapy on prostate bed. I am worried about incontinence after treatment. Can't find much info. Can you help me.

    Beel
  • nwgeoff
    nwgeoff Member Posts: 7
    #19
    mwozney said:

    how is radiation?
    My husband will need 35 rounds of radiation and I'm just wondering if you could share with me what side effects you have had. Thank you!

    Radiation side effects
    I have just completed 44 rounds of radiation treatment (IMRT). It was not especially difficult if you are not working full time. Being on Lupron probably compounded the fatigue. The hardest part for me was the impact that radiation had on my digestive system. What worked for me was going on a bland diet. No vegetables, white rice, fish, very little meat (no beef). Fruit smoothies with protein powder. white bread. pro-biotics before each meal. Easy on the digestive system. Contrary to conventional diet recommendations of greens, fiber and vegetables. Once I figured out my diet the major side effect was fatigue.

Discussion Boards