Good news and bad news

The GOOD NEWS is that I'm going out with my wife and some very good friends at the weekend for a meal at a very good Indian restaurant.

The BAD NEWS is that this will probably be my last spicy meal for a while, as I am going to need radiation therapy and my urologist said that my bowels will react badly to spicy food for a while.

I went for my latest PSA results yesterday and I was up to 0.4 from 0.1 in November 2009. (I'm now about 8 months after surgery) He didn't do a proper calculation to work out my doubling time, but we both could see that it is about two months, which is not good either.

So I have an appointment with the radiological oncologist next Tuesday (I vote we call them "radiators" or something easier to type and say). This will be for what my sister - a nurse - described as the "complicated and uncomfortable" appointment, so I'm guessing it's about working out whereabouts inside me they are going to attack etc.

A bit of a shock, and I also noted that when the receptionist from uro phoned up radio to make my appointment she asked for it to be as soon as possible.
I'm not that surprised though, given I had seminal vesicle invasion and some tumour in the bladder neck. This is also the "Plan B" that the very first uro I saw told me would be used if surgery wasn't 100% successful.

I asked my uro yesterday if there was any way of telling if my PSA was being generated by one large clump of cells in the prostate bed or by several individual cells spread about all over the whole area and he said no. He said this much PSA would be being produced by tumour cells that would be too small to be detected on a scan, but if they waited till it was big enough to be detectable on a scan then it would be too far advanced to respond well to radiation.
The radiotherapy is thus almost be being used as a detection tool. If after radiotherapy the PSA drops then the conclusion will be that the tumour was in the area treated, if the PSA stays up then it would mean it was somewhere else, and we'd have to work on "Plan C".

The uro said that the "radiator" will also deal with the question of hormone therapy.

I go up and down to the hospital by train, so it looks like I'll become a radiation commuter during the coming months, and am very grateful to have read about those of you at HW who have been there before me, as it helps me appreciate that I'll get through it even if it may not be too pleasant at times.

Alfred
(On my computer my profile has been appearing in code so I hope I have been able to corrected it)

Alfred,

So sorry to hear the news. Definitely have some strong and quick recurrance going on, but more imporantly, sounds like you are get spot-on advice from your doctors. Now is the time for agressive salvage radiation, with or without HT if reccomended. How long a train trip each way? Trying to visualize that point.

Once they have that first visit with you, the rad. oncl (hows that for shorter) will work up the treatment plan for you, and you will know how my gys' they want to deliver over how many treatment periods.

Good luck, ahead brother, and let's hope this radiation can knock out the rest of the buggers from you.

David in SC

Alfred, so sorry to hear of your news...my heart dropped when I read your post. I believe that you will get through this just fine...

Keep us posted please.

Alfred,
You and I will be going down that road together. I'm just now trying to get an appt. to have the calypso markers put in, then have to wait two weeks for the start. Let the fun and games begin.

Alfred, not the news you wanted, but you already know what is ahead, as so many here have gone before you. Keep us close during your treatment..

Alfred,
The "calypso" is an implanted marker system to use with the radiation equipment. My urologist says no HT at this point (the Rad. Oncologist wants to use it, I don't, two against one).
Reading the "diary" of the train trip brings back memories - I used to work often in Amstelveen and took the train from the airport / around the area. Maybe again some day.

A friend in England emailed me today after I'd told her about my latest news.
Her husband is my age and he also had to have salvage radiotherapy aftyer an RP two years ago follwed by rising PSA.
She says he had hormone therapy before and during radiotherapy and has now been <0.1 for over a year, but that the side-effects of hormone therapy were quite tough for a while.

(And I'm already developing a "tummy" since the da Vinci.)

PCa Calypso:

"You wake all night and you pee all day
HW brothers are the ones who know.
Hey Mr Oncologist make me get better
Radiation come and da PSA go!"


Alfred

Alfred,

Truly not the best news of the day, but with your attitude, it will certainly make it easier for you. Besides,you really meet some nice people on the train. Maybe you should start a blog about radiatior commuter experiences.

Best of luck, and keep a stiff upper lip eh ?

Alfred, better now than in five years. At least they'll know pretty much where to attack this demon.

You will come out of this Ok. Try to stay positive and put it all in God's hands.