Prostatectomy + RT + ADT

1356

Comments

  • Georges Calvez
    Georges Calvez Member Posts: 547 Member

    It is a diagnostic marker to

    It is a diagnostic marker to upgrade 3 elements to 4. That's the nun of most research.

    Correlation

    Hi there,

    There is a correlation between Gleason Score and aggression of the cancer.
    6's almost never metastase, they may grow to fill the gland completely and invade other areas close by but that is about it.
    As you move up through 7a, 7b,8, 9,10, they do become increasingly adventurous with a 9 or 10 being the worst.
    It is possible to have a gland contained 9 or 10 that will have a below the limit of detection PSA after prostatectomy only to find a nasty surprise a few years later.
    Cribriform is a negative marker but it is not the boss by any means.
    One day urologists will abandon Gleason scoring in favour of genetic analysis of each cancer that will then form the basis for the treatment.

    Best wishes,

    Georges

  • Georges Calvez
    Georges Calvez Member Posts: 547 Member

    Hi there,

    I have just had my rendevous with Pooh, we have agreed that my results were excellent and we will continue with the current drug regime of amlodipine, irbesartan, metformin and avorstatin for the next three months.
    Blood test and chat with Pooh around Christmas, early January, no doctors until then, barring emergencies!

    Yippee Ki Yay,

    Georges

  • Georges Calvez
    Georges Calvez Member Posts: 547 Member
    19th December 2019

    Hi Everybody,

    Santa has come early for me and the wife as I have just logged another less than the limit of detection, I have updated my timeline above to reflect this.
    This makes it 18 months since my first undetectable and three months since my last injection of Firmagon.
    Things are starting to normalise, I am still taking irbesartan and amlodipine for my blood pressure but I have dropped down to around 110 -120/ 70-80 which is quite low, my blood sugar is falling as well, my cholesterol level is unknown at the moment but hopefully that will fall from slightly over 2 to a bit below or more.
    I intend to continue with the metformin and avorstatin if Dr Pooh will let me, there are straws in the wind for slowing down metastases for both and I have goodish medical reasons to stay on both so why not?
    Medical discussions with Pooh after the holiday! :-)

    Happy holidays peeps!,

    Georges

  • hewhositsoncushions
    hewhositsoncushions Member Posts: 411 Member

    19th December 2019

    Hi Everybody,

    Santa has come early for me and the wife as I have just logged another less than the limit of detection, I have updated my timeline above to reflect this.
    This makes it 18 months since my first undetectable and three months since my last injection of Firmagon.
    Things are starting to normalise, I am still taking irbesartan and amlodipine for my blood pressure but I have dropped down to around 110 -120/ 70-80 which is quite low, my blood sugar is falling as well, my cholesterol level is unknown at the moment but hopefully that will fall from slightly over 2 to a bit below or more.
    I intend to continue with the metformin and avorstatin if Dr Pooh will let me, there are straws in the wind for slowing down metastases for both and I have goodish medical reasons to stay on both so why not?
    Medical discussions with Pooh after the holiday! :-)

    Happy holidays peeps!,

    Georges

    Congratulations!

    Congratulations!

    Have multiple drinkies on me!!

  • Georges Calvez
    Georges Calvez Member Posts: 547 Member
    Thanks!

    Christmas drinkies coming up!
    It would be an ungentlemanly thing to refuse.
    I trust you are well?

  • VascodaGama
    VascodaGama Member Posts: 3,638 Member
    Your second zero

    That is great news and surely a Christmas present.

    You say nothing about it but I would think that your T is back in normal levels. The effect of Firmagon wares off faster than Lupron but the pituitary takes time to recuperate. Let's hope for continuing low levels of the PSA.

    Congratulations.

    VG

  • Josephg
    Josephg Member Posts: 368 Member
    Congratulations!

    Congratulations, Georges.  Christmas comes early for you.

    I wish you continued success on your journey.

  • Georges Calvez
    Georges Calvez Member Posts: 547 Member
    Early days

    Hi Vasco,

    Some of the effects of Firmagon like the insomnia have disappeared but others like the leg pains at night and an occasional night sweat are still there so things are improving slowly.
    I think it is eight months on average to recovering some testosterone after eighteen months of Firmagon and 45 percent never recover anything so fingers crossed!
    I will see Dr Pooh early in January when I will ask her for a blood glucose, HbAc1, lipids, cholesterol and testosterone blood test for March.
    It is not cold but it is very grey and wet with constant rain in Northern France so that is a bit depressing but two sleeps to Christmas dinner and we are past the solstice now!

    Best wishes,

    Georges

  • Georges Calvez
    Georges Calvez Member Posts: 547 Member
    Happy days

    Hi gentle readers,

    So off I went for my chat with Pooh with a line graph and a pie chart of my blood pressure over two weeks to show her.
    She was so impressed that she kept her copy to show the other doctors!
    My blood pressure has now fallen to the point where it is in the range 113/72 - 127/81 with an average of 122/75, blood sugar is looking a bit high but I suspect that it will fall a bit further as my testosterone comes riding over the hill to save the day.
    So I continue with the regime; morning, 300mg irbesartan and 500mg metformin, evening 10mg amlodipine, 20mg avorstatin, 500mg metformin.
    It should be noted that avorstatin, irbesartan and metformin have shown some activity in slowing down the proliferation of prostate cancer cells.
    I am also taking a large calcium chew and several hundred units of viatmin D per day to try and stave off the dreaded osteopenia!
    I have a prescription for an assay for blood glucose, HbAc1 and testosterone in my pocket plus the PSA test from Tigger for the end of March.
    Things are OK but they could be better, they can always be better! :-)

    Best wishes,

    Georges

  • VascodaGama
    VascodaGama Member Posts: 3,638 Member
    Things are OK and can always be better!

    Yes it seems that all is OK with you. In any case, better than 122/75 is hard to get. I am close to a median of 131/82 that is also good for a 70 years old. Unfortunately I never cared much in the past about blood pressure and that disregard while on ADT took me to a CKD stage 3. This will never get better.

    Hope the good news continues.

    Best,

    VG

  • Georges Calvez
    Georges Calvez Member Posts: 547 Member
    Blood pressure

    Hi Vasco,

    My blood pressure soared quite quickly when I started Firmagon and I was telling various doctors that I was suffering from headaches, etc but none of them thought of measuring my blood pressure.
    Eventually I went to see Dr Pooh who measured it and was aghast to find that I was hitting 180/110 plus, straight off she issued me with 150mg irbesartan and when that failed to have much effect I doubled the dose to 300mg on my own initiative and then we added some amlodipine to the mix as well.
    Since then it has been in a long decline to the present level now that I have stopped Firmagon.
    I would honestly advise any man starting ADT to borrow or buy a tensiometer, they are about EUR 60 for a really good one that allows connection to your computer, charting, etc.
    You may not need it, some men have no or only a small rise in blood pressure but some men suffer a real climb like myself and Vasco that may leave you ill or even dead so it is a small price to pay for an insurance policy!

    Best wishes,

    Georges

  • Georges Calvez
    Georges Calvez Member Posts: 547 Member
    Legs pains

    Hi there,

    It is now close to five months after my last shot of Firmagon and the leg pains in the night have finally left me.
    I have a lot more stamina as well, I can trot up the stairs without effort.
    I still get the odd hot flush so I do not think it has left me entirely yet.
    In theory there should be no Firmagon in my system but has the whole FSH, LH, GnRH, testosterone thing restarted is the question?

    Best wishes,

    Georges

  • VascodaGama
    VascodaGama Member Posts: 3,638 Member
    Important itens in blood tests for guys on ADT

    Georges,

    I had a similar experience when diminishing the side effects of ADT. I could feel them vanishing along a period of 4 months. The last one to be accomplished was body hair. It took about 1.5 years to have them back in my arms and legs. The first symptoms were in regaining of energy and loss of artritis like pain. Then it was followed by firmer testicles and libido.
    The best you can do is to get those items in the list when having the blood test. I do PSA every 3 months, Testosterone every 8 months and the T3, FT4 and TSH annually. My urologist question on the need for these markers that are usually in women's related case screenings, but he understands its value in CKD patients, which may be a cause from prolonged ADT. Surely I also check the traditional items for kidney and liver screening, etc, twice a year. Vitamin D was tested before starting ADT together with a DEXA scan and now I do it every three years.

    I have been waiting for your numbers. I want to see your PSA by the time your T returned to normal levels (>240 ng/dL).

    Let's celebrate.

    VG

  • Georges Calvez
    Georges Calvez Member Posts: 547 Member
    Six month anniversary

    Hi there,

    My six month anniversary since my last shot of Firmagon is coming up at the end of the month.
    Almost all the short term effects including the leg pains have disappeared although I still suffer from the odd hot spell.
    Obviously balls are still very small to the point of being barely balls at all and my abdominal and chest hair is marked by its absence.
    Interestingly the hair on my head is thicker and darker and my beard is as luxuriant as ever.
    As you know France is in a two week lock down but I swung past the lab the other day and it is operating but completely deserted.
    French doctors like to hand out blood tests to all and sundry at every routine visit as they are paid for by the state, it looks like the doctor is doing something and once in a while it does catch something like my PCa.
    But as no one can go to the doctor for the moment unless they are very ill with something apart from coronovirus, this gravy train for the labs has dried up.
    So I will be popping in next week for PSA, testosterone, etc.

    Wish me luck as you wave me goodbye!,

    Georges

  • Josephg
    Josephg Member Posts: 368 Member

    Six month anniversary

    Hi there,

    My six month anniversary since my last shot of Firmagon is coming up at the end of the month.
    Almost all the short term effects including the leg pains have disappeared although I still suffer from the odd hot spell.
    Obviously balls are still very small to the point of being barely balls at all and my abdominal and chest hair is marked by its absence.
    Interestingly the hair on my head is thicker and darker and my beard is as luxuriant as ever.
    As you know France is in a two week lock down but I swung past the lab the other day and it is operating but completely deserted.
    French doctors like to hand out blood tests to all and sundry at every routine visit as they are paid for by the state, it looks like the doctor is doing something and once in a while it does catch something like my PCa.
    But as no one can go to the doctor for the moment unless they are very ill with something apart from coronovirus, this gravy train for the labs has dried up.
    So I will be popping in next week for PSA, testosterone, etc.

    Wish me luck as you wave me goodbye!,

    Georges

    Six Month Anniversary

    I'm glad to read that your side effects from Firmagon are greatly receding.  Great news.

    Like you, while I was on hormone therapy, I noticed a thickening of my head and facial hair.

    I wish you the best of outcomes on your PCa journey.

  • Georges Calvez
    Georges Calvez Member Posts: 547 Member
    edited March 2020 #57
    Nervous day

    Hi there,

    I have a nervous day ahead as I have been for THE blood test this morning.
    Results for PSA, glucose and HbAc1 tonight, testosterone at the end of the week.

    Best wishes,

    Georges

  • Georges Calvez
    Georges Calvez Member Posts: 547 Member
    edited March 2020 #58
    Scores on the door

    Hi there,

    First up

    PSA < 0.05 aka under the limit of detection.

    Time for a celebration.

    Cheers,

    Georges

  • VascodaGama
    VascodaGama Member Posts: 3,638 Member

    Yes. How about a G&T for toasting. The result is super.

    The value of T will give you peace of mind.

    Congratulations

    VG

     

  • eonore
    eonore Member Posts: 173 Member
    edited March 2020 #60
    Great news

    George's,

    Congratulations!

    Eric

     

  • hewhositsoncushions
    hewhositsoncushions Member Posts: 411 Member
    edited March 2020 #61
    Good news at a bad time

    Good news at a bad time