Survival

Swingshiftworker said:

Just Go On With Your LIfe
Congratulations on your apparently successful radiation treatment!

I would think you'd have already done what you need to do to "plan" out the remainder of your life in terms of an estate or end-of-life plan. Of course, you will have to continue to take periodic PSA tests for the remainder of your life in order to keep tabs on the cancer but you can't let the "worry" about that rule your life.

Your disease free survival depends on an assessment of your post PSA scores. Recurence is indicated if you have 3 successive increases in PSA or a rise of over 2 after reaching your "nadir" (lowest score). Having achieved a PSA below 0.1 already is extraordinary and is far better than I have achieved a year and 1/2 following my treatment. So, I certainly wouldn't worry about it (yet).

I would simply do what you are already doing -- exercise and eat well -- and just go on the things you (and your wife or SO, if any) enjoy without dwelling on the cancer and just deal w/any problems (if any) that arise in the future as they occur.

Good luck!!

Survival at any cost
Tony

I have followed your case described at your other post titled Hormone Therapy, and now followed by this thread;
(http://csn.cancer.org/node/240273#comment-1233424).

You can get the disease free survival rate by imputing your stats before treatment in a nomogram at the site of Sloan Kettering Cancer Center in this link:
http://www.mskcc.org/cancer-care/adult/prostate/prediction-tools
The two elements you should aim are:
“Planned radiation therapy dose if patient has already seen a radiation oncologist”,
And the below if HT has been neoadjuvant,
“Whether patient has had neoadjuvant hormones”

You are absolutely correct in your worries with “… uncertainty is the worst part….”. We survivours all feel the same and get used to the fact. In my case I have been on that for the past 12 years. Researching and studying any thing on PCa has given me that confidence along my journey.
Nevertheless, in PCa no two cases are equal but similar and those nomograms or tables for survival rates are just representative. Many do not fall into the medium term rates and just find themselves with longer or shorten periods.

In your posts you indicate the nasty reaction by your body after Zoladex (LHRH agonist) administration. Many of us experience similar symptoms but in many they are mild and welcomed. I do not agree with your urologist assertion that 81 years olds should not be given agonists. Moreover, if the patient is in “good health” as you commented, then there would be no reason for avoiding hormonal treatments. HT is not recommended in patients with other health issues, particularly related to heart/coronary health and diabetes.
In such risk patients HT is limited to certain drugs and only administered with caution and under strict vigilance by a specialized oncologist.

Drugs interact and the oncologist must be an “artist” in planning the required targeted medications, at the present and in future treatments.
LHRH agonists are also only recommended to be administered post a period of two weeks on antiandrogens to avoid flare (a worsen condition due to a sudden increase of testosterone levels).
Have you taken or been given any antiagonist?

You comment on the opinions of the urologist and oncologist but I wonder what the opinion of your radiologist was to your body reaction. He is the one that may have recommended the combination treatment with RT plus HT, and the protocol of dosage (Gys and mg).

Many studies on this type of combinations have pointed out to an increase in the rates of success. I myself as a layman have done researches in studies done in several countries (several races) and found that HT is beneficial when administered before RT (neoadjuvant) because it sensitizes the cancer cells receptors to absorbed radiation (it improves the RT outcome). After RT, adjuvant HT does not show considerable benefits in improving RT outcomes. Moreover, the effects of HT will “mask” the PSA results and therefore impairing any judgement of success based on the PSA as a marker alone.
This fact may impair your next PSA test to confirm your actual stats in the present time. You will need to wait until the effects of Zoladex subside (increasing levels of testosterone).

Typically, agonists lose their effectiveness 30 days after the end of their half-life. However, many guys report taking longer periods of 3-4 months before they start feeling better. You can verify the hormonal manipulation effectiveness with a testosterone test.
Low levels (castrate) means that your pituitary central axis is not functioning normal yet.
Zoladex should have caused a "stoppage" in testosterone manufacture, inducing castrate levels of lower than 25 ng/dL. The normal levels would start from 280 ng/dL, and that should give you a relief from menopause like symptoms.

Swing is giving you good advice on what to do “next”. In my case on HT (LHRH agonist Eligard) during 18 months I have experienced numerous side effects but mild. Fatigue was the worse and now I got low libido. In any case, I managed to control the advance of the cancer and aim survival, and such has provided me with the possibility of starting a “vacation” Off-drug (now on going), and therefore the possibility of getting a relief from the HT side effects.

I hope you improve and recover from the treatment.
Good luck in your journey.

VGama