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If you are considering salvage radiation

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Posted 2/10/2011 4:11 AM (GMT 0)
I thought this was an excellent guide for someone considering whether to undergo salvage radiation or not.

http://www.prostate-cancer.org/pcricms/sites/default/files/PDFs/Is13-2_p8-17.pdf

Posted 2/10/2011 4:27 PM (GMT 0)
bump - at least i thought it would be interesting
Posted 2/10/2011 5:08 PM (GMT 0)
David, you are right it is a great read and filled with many salient points for those who may have to face radiation. It answers a lot of questions that are posed here by folks looking for radiation guidance.

Does a real good job of laying it out about Adjuvant versus SRT.

Thanks for the find,

Sonny
Posted 2/10/2011 6:43 PM (GMT 0)

Thanks, James.  That's a very interesting video.  This is why I visit this board (plus I heard it's a great place to meet single women .... shakehead )

Sorry, Purg, haven't had a chance to read your article yet.

Zen9

Posted 2/10/2011 7:53 PM (GMT 0)
No problem, glad my thread made it easy for the other link to be seen.
Posted 2/10/2011 9:13 PM (GMT 0)
There's a lot of overlap between the paper and the video, but each includes lots of other information. Very timely information for me!

Thanks to both Dave and James.

DJ
Posted 2/10/2011 9:31 PM (GMT 0)
Yes, it's just as good as the last time we discussed it!
https://www.healingwell.com/community/default.aspx?f=35&m=1835105

just kidding. I'm glad to see it resurface, as it really is worthwhile, and I put it on my salvage radiation knol.
Posted 2/10/2011 9:43 PM (GMT 0)
I notice that they believe that if the PSA is detectable with an ultrasensitive test at 45 days after surgery then this means that there may be cancer left behind. So a reading of 0.03 for example when the ultrasensitive can do <0.01 is scary.

Also they believe that negative margins when the PSA is rising is bad news.

This article makes me scared. I hope my husband's next test is flat or lower.

An
Posted 2/10/2011 10:29 PM (GMT 0)

David,

A very timely post for me.  I am still wrestling with the slow vs fast doubling time study.  I also am not sure when to start calculating the doubling time. Is it from the time of surgery, or from the time of the beginning of the rise ?

Goodlife

Posted 2/10/2011 11:17 PM (GMT 0)
An - it was interesting that both my uro and my radiation oncologist both stated that they felt that a PSA reading post-surgery of .05 or higher, was definitive proof that there was still cancer left. Even though there is no connection between their practices. When my original post-surgery reading was .05, my uro was already very concerned.

Goodlife - my doctors figured the doubling time based at the start of the rise, not from the time of surgery. Sure like all things PC, there's no one straight agreement among the experts.
Posted 2/11/2011 1:29 AM (GMT 0)
Galileo, sorry, but that link was not the last time we discussed the "9 Things" paper...I think that this was, though.

It appears that we are on a every-4-months "bump" cycle...that's better than a "bump" every day.
Posted 2/11/2011 1:50 AM (GMT 0)
Excuse me for being senile. Didn't realize that it was a "repeat", but then again, we have had dozens of new folks come through here since last June.
Posted 2/11/2011 4:17 AM (GMT 0)
Hey David, I've been around for about two years, and I've not seen your link before! Fact is there are so many threads here that I only manage to look at a small fraction of them and I'm sure I miss a lot of good stuff. And, I'm sure that's true for many members.

As great a forum as this is, the limitations of the softwear, (which seems to be a pretty generic one used by a number of different groups from bird watchers to rock hounds,) mean that good information can be difficult to locate. Accordingly a timely "bump" is always a good idea for important information.


Sheldon AKA Sleepless
Posted 2/11/2011 4:20 AM (GMT 0)
I think so too Sheldon. The previous link was started last June, thats 8 months ago, I can't possibly remember every one Ive seen or read either, and it wasn't even my link or thread before. Still a good beginner's guide to SRT I think.
Posted 2/11/2011 5:08 AM (GMT 0)
Purgatory -

Thank you for posting this. Your timing couldn't be better. I met and an RO today to discuss adjuvant radiation - the benefits and the draw backs.
I am so torn on what to do - My surgery was in Nov and I suffered bladder spams up until 2 weeks ago. While they were not as severe in the last
month and a half, they still hurt like heel for a brief minute or two when I emptied my bladder. I understand the benefits of doing adjuvant radiation,
but the risks of aggravating the bladder and waking that monster again scares the life out of me.

My Urologist is torn on what to do.
My family Physician sent me to an Oncologist.
Oncologist felt waiting would be the right road, but recommended seeing a Radiologist Oncologist.
Radiologist Oncologist said - you need to weigh the pro's and con's and make the best decision for you.
Me - totally confused and scared crapless.

Thank you for posting this.

Mark
Posted 2/11/2011 4:05 PM (GMT 0)
Mark, remnind me-what's your numbers, psa after surgery, Gleason, cancer classification, treatment, etc?
Posted 2/11/2011 5:13 PM (GMT 0)
Mark, I feel for you.

Due to my complications, I had to deal with dozens of bladder spasms per day for nearly 2 years. I was on the drug ditropan the entire time. The meds helped some, but never prevented the spasms from happening. Hopefully that part is behind you.

It will be a tough call for you to make, as it were for me. With all my stricture problems, I knew that radiation would only make things worse. I didn't expect the radiation to go wrong, like it did, and in the end, destroyed my bladder and bladder neck, which required me to have the last operation which left me with a urinary stoma for life.

Good luck to you as you weigh out the pro's and con's of such a major decision.

david in sc
Posted 2/11/2011 11:00 PM (GMT 0)
Hi James -

Not sure why my signature stats didn't come through on this post.

PSA pre surgery 10.6 - post surgery .003
Gleason 7 (3+4)
Biopsy - 12 of 12 core samples positive.
Clear Margins
Post surgery pathology stage - pT3aPn0
Prostate was 45 grams size 5x3.5x3.4 cm - 32% of the prostate involved and tumor was 2.7 cm.
Extraprostatic extension present
No lymph node involvement
Negative Seminal Vesicles
One other comment on the pathology report - "High grade prostatic intraepithalia neoplasia".

Purgatory -

Thank you - my biggest fear is not the radiation - but the spams coming back.

Mark
Posted 2/12/2011 12:42 AM (GMT 0)
Well, I don't have to worry about bladder spasms or taking ditropan anymore, as my bladder is totally detached from my urinary systems, dry as a desert, and never will be used again. I do, however, still have some phantom spasms pains on a daily basis, but nothing like the constant pain I had for so long.
Posted 2/12/2011 2:54 AM (GMT 0)
So sorry to hear that Purgatory -

Those spasms are probably the worst pain I have ever felt in my life. I feel for ya bud. =(
Posted 2/12/2011 3:15 AM (GMT 0)
The constant spasms were terrible enough before I underwent radiation, but once the radiation did all the damage to the bladder, they were 10 on the pain scale, and happened as often as 4 dozens times aday. Will never miss that horror in my life.
I hope you can stay away from any more of them too.

David
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