Firmagon and IMRT

nels1922
nels1922 Member Posts: 2
in Prostate Cancer #1
I discovered I had prostate cancer about a month ago with 9 out of 12 biopsy samples of 7 to 9 Gleason scores. Bone scan and CT scan showed no cancer. My urologist gave me firmagon last week and I had a little pain and redness for a few days. He plans to give me a shot of lupron after 4 weeks. I am to meet my radiation oncologist next Monday, August 27, to discuss a radiation plan. My question to those of you who have done this before is what data and questions should I ask him? I like to plan ahead especially for these treatments.

I will be 90 in November and in very good health due good cardio and strength exercises most days and trying to keep to a Mediterranean diet.

Thanks for any help you can give me.

Comments

  • Kongo
    Kongo Member Posts: 1,166 Member
    #2
    Wow
    Nels,

    I hope you are getting some second opinions on your diagnosis and treatment plan. Did the doctors explain the trade offs between side effects from the treatment options and possible longevity?

    I don't want to suggest that you're too old for treatment I just think you should get some second opinions to make sure any treatment at this point is warranted.

    Best of luck to you and I hope you're here at 100!
  • Swingshiftworker
    Swingshiftworker Member Posts: 1,017 Member
    #3
    OMG!
    Well, I think you know what your diagnosis is very serious and, even if the bone/CT scans came up negative, that there's a possibility that the cancer has already migrated beyond the prostate.

    I think your first question to your docs should be about that -- what's the likelihood the cancer has already spread, how else (other by than bone/CT scans) it can be determined or monitored and what's their treatment plan (probably chemo) if it has spread.

    Since it "looks" like the cancer is confined to the prostate so far, your docs apparently plan to use a combined radiation/hormone treatment protocol which is common for more advanced cancers (albeit less advanced than yours).

    So you should also ask what method of radiation they plan for use and its probability of "success" in killing off the cancer. The one most commonly used with hormone treatemnt is IMRT (intensity modulated radiation therapy) but there are others, including IGRT, 3D CRT and SBRT. Just Google then acronyms to find info about them.

    Even at your age, I don't think radiation treatment by IMRT (or similar methods) should be a major problem (if administered properly) but many men (much younger than you) have had problems w/hormone treatments. So, you should also consider asking your docs about the possibilities of such problems and the alternatives (other than just stopping HT) if any.

    Good luck!
  • hopeful and optimistic
    hopeful and optimistic Member Posts: 2,346 Member
    #4
    Swingshiftworker said:

    OMG!
    Well, I think you know what your diagnosis is very serious and, even if the bone/CT scans came up negative, that there's a possibility that the cancer has already migrated beyond the prostate.

    I think your first question to your docs should be about that -- what's the likelihood the cancer has already spread, how else (other by than bone/CT scans) it can be determined or monitored and what's their treatment plan (probably chemo) if it has spread.

    Since it "looks" like the cancer is confined to the prostate so far, your docs apparently plan to use a combined radiation/hormone treatment protocol which is common for more advanced cancers (albeit less advanced than yours).

    So you should also ask what method of radiation they plan for use and its probability of "success" in killing off the cancer. The one most commonly used with hormone treatemnt is IMRT (intensity modulated radiation therapy) but there are others, including IGRT, 3D CRT and SBRT. Just Google then acronyms to find info about them.

    Even at your age, I don't think radiation treatment by IMRT (or similar methods) should be a major problem (if administered properly) but many men (much younger than you) have had problems w/hormone treatments. So, you should also consider asking your docs about the possibilities of such problems and the alternatives (other than just stopping HT) if any.

    Good luck!

    risk /reward
    Did the digital rectal exam show any abnormalities?

    Do you now exhibit any signs of prostate cancer

    Each modality of treatment can have significant side effects, you are scheduled for two

    Having radiation or hormone therapy is not a walk in the park

    I wonder how long it will take for your cancer to advance, causing you discomfort

    Eventhough 90 is the new 70 in some cases, I wonder what your life expectency will be.

    I agree with kongo, get a second opinion from an expert
  • nels1922
    nels1922 Member Posts: 2
    #5
    hopeful and optimistic said:

    risk /reward
    Did the digital rectal exam show any abnormalities?

    Do you now exhibit any signs of prostate cancer

    Each modality of treatment can have significant side effects, you are scheduled for two

    Having radiation or hormone therapy is not a walk in the park

    I wonder how long it will take for your cancer to advance, causing you discomfort

    Eventhough 90 is the new 70 in some cases, I wonder what your life expectency will be.

    I agree with kongo, get a second opinion from an expert

    I appreciate your replies and plan to consider all. My PSA last was 11.6, DRE did not show any abnormalities, and I don't feel any signs of prostate cancer. Hopefully, my treatments will go well. My doctors have been very encouraging and my radiation oncologist has had over 20 years experience with radiation therapy here. Thanks again for your help.
  • hopeful and optimistic
    hopeful and optimistic Member Posts: 2,346 Member
    #6
    nels1922 said:

    I appreciate your replies and plan to consider all. My PSA last was 11.6, DRE did not show any abnormalities, and I don't feel any signs of prostate cancer. Hopefully, my treatments will go well. My doctors have been very encouraging and my radiation oncologist has had over 20 years experience with radiation therapy here. Thanks again for your help.

    I suggest that you ask your doctors about
    watchful waiting

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