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Posted 8/4/2011 8:26 PM (GMT 0)
I'm freaking out a little bit. Chuck switched urologists after his first post-op appointment, and we just had our first appointment with the new urologist. He strongly recommends radiation and was really surprised that it hadn't been suggested previously. He kept saying "With that kind of path report...", and it's really made me nervous. Honestly, we thought we were pretty much done, other than getting a new PSA every 3 months. Our first appointment with the radiation oncologist is Monday. I guess he will tell us what to expect, but I'd really like to hear from you guys...any advice? Will he be tired? Is it done every day or weekly or ?  His job is very physical and I'm worried about fatigue and knowing him he will just try to suck it up and keep going, which makes me worry that he'll hurt himself. Any advice is much appreciated...

Michelle

Posted 8/4/2011 8:35 PM (GMT 0)
I did adjuvant (post-op, not waiting for PSA rise) Radiation after my DaVinci surgery. I'm not up to date on your Path report, so will just say that it made sense for me.

I had probably worse side effects than many, as I've had colon surgery in the past, and was not really "continent" when the RT started. As I've mentioned in other posts, many of the guys who were going through RT at the same time at my clinic did better regarding side effects.

But in case you are interested, my "RT Journey" is linked here in my signature, day by day.

Posted 8/4/2011 8:45 PM (GMT 0)
Hi Michelle,
I had a really poor post-op pathology report but I am doing well almost five years later. Like 142 I had adjuvant therapies, too. It isn't uncommon. And the difference of opinions isn't uncommon either. The fact is that since your BF recently had surgery it is still too early to just jump into these therapies. I think a consultation with an oncologist that isn't tied to surgery or radiation treatments is a good way to gather more data and see if adjuvant therapies are right for him. For me they were and we are not too far apart on the post op data.

Most important ~ there's no need to get overly concerned yet. The post op PSA was encouraging. So the surgery successfully beat back the cancer.

Tony
Posted 8/4/2011 9:08 PM (GMT 0)
His stats are in my signature but somehow they aren't showing in my posts any longer...I must've turned it off somehow...

Boyfriend's stats: 52 yrs old
12/29/10: PSA 14, biopsy of 8 cores (all positive) showing 70-80% involvement. Perineural invasion present, extraprostatic extension is present.
Gleason 4+3
1/21/11: CT & Bone scans show no evidence of metastatic prostate cancer.
3/24/11: daVinci radical prostatectomy & bilateral pelvic lymphadenectomy w/bilateral wide resection.
Posted 8/4/2011 9:10 PM (GMT 0)

142 said...
I did adjuvant (post-op, not waiting for PSA rise) Radiation after my DaVinci surgery. I'm not up to date on your Path report, so will just say that it made sense for me.

I had probably worse side effects than many, as I've had colon surgery in the past, and was not really "continent" when the RT started. As I've mentioned in other posts, many of the guys who were going through RT at the same time at my clinic did better regarding side effects.

But in case you are interested, my "RT Journey" is linked here in my signature, day by day.

I just finished reading that...thank you!  I  hope you are feeling better these days :)

Posted 8/4/2011 9:11 PM (GMT 0)
Good grief, I obviously don't know how to use the quote function...although I did fix my siggy.
Posted 8/4/2011 9:23 PM (GMT 0)

TC-LasVegas said...
Hi Michelle,
I had a really poor post-op pathology report but I am doing well almost five years later. Like 142 I had adjuvant therapies, too. It isn't uncommon. And the difference of opinions isn't uncommon either. The fact is that since your BF recently had surgery it is still too early to just jump into these therapies. I think a consultation with an oncologist that isn't tied to surgery or radiation treatments is a good way to gather more data and see if adjuvant therapies are right for him. For me they were and we are not too far apart on the post op data.

Most important ~ there's no need to get overly concerned yet. The post op PSA was encouraging. So the surgery successfully beat back the cancer.

Tony

You think seeing a regular oncologist might be a way to go? I guess at this point I'm just plain scared that they know something we don't and I'm just wanting him to do everything that needs to be done. Plus, there is also the part about our deductible already being met and trying to get stuff done this year if it has to get done. Ugh, I'm just worried..,

Posted 8/4/2011 9:37 PM (GMT 0)
Michelle it's natural to be worried. My wife and I went through the same emotions. After a few teary nights and some love and hope we moved beyond the fear. Another important piece is education. I run a live cancer support group and I see more of this every monthly meeting. But with education you close the gap of what the doc's know and what you know. And that's important to get beyond the fear.

I think seeing a "regular" oncologist is a great idea especially for where your BF is. The first line therapy is done now the next questions are:

1> Was it enough?
2> Is there more that can be done before the disease comes back?
3> Is there any risks to adding additional therapies?
4> Do we have to do anything at this point?

I can almost guarantee you that if you talk to a radiation oncologist he will recommend further treatment. It may be a good choice but more questions need to be considered even before that choice:

5> Should we add adjuvant hormonal therapy?
6> If we go this rout, what would be next if we get a relapse?

On the part about the deductible being met ~ with my insurance that's a good thing. It means I don't have to pay anymore of the deductible.

Hang in there, Michelle. It's still early in the events of a cancer survivor. There's a lot of unknowns but there's a lot a good news, too. Even with where your BF is you can and should plan on growing old together..

:-)

Tony

Post Edited (TC-LasVegas) : 8/4/2011 3:41:19 PM (GMT-6)

Posted 8/4/2011 10:06 PM (GMT 0)
It would help to know what PSA readings he has had since his surgery.
Posted 8/4/2011 10:36 PM (GMT 0)
He's only had one PSA since surgery and it was 0.03...so we were thrilled and thought that was that.
I guess I need to adjust my thinking about being 'done'...seems that it's never done.
Posted 8/5/2011 12:16 AM (GMT 0)
Good job, Michelle.
No unfortunately it's never done but it gets much better...

:-)
Posted 8/5/2011 12:27 AM (GMT 0)
Some doctors would want to jump to radiation at this point based on his pathology and others would want evidence of recurrance before moving ahead. Radiation is a big step after surgery, and it comes with its own risks and potential side effects. With a PSA of .03, in my personal opinion (and based on what I went through), I would not be eager to pull the radiation trigger at this time. Of course, this is between your husband and his doctor(s).

david in sc
Posted 8/5/2011 3:18 AM (GMT 0)
LA2RC, I agree with your new urologist...Time to put away the rose colored glasses. Your pathology does indeed predict the need for further treatment..And the sooner you start it the better..But not too soon. You want to be completely recovered from the surgery before you start radiation if at all possible. If you do decide on radiation, ask the radiation oncologist about combining it with a short course of HT which is a nightmare in itself but it boosts the effectiveness of the radiation by about 30%...
Posted 8/5/2011 4:19 PM (GMT 0)
My stats were comparable (for some reason they show up in my sig only sporadically). I had something like a 70% chance of biochemical failure. My brother's uro was surprised I opted for possible SRT instead of ART; mine was comfortable with it. It was a gamble. I figured the cure rate was close enough between ART and early SRT to make the gamble worth it. I pulled the trigger as soon as my PSA rounded up to 0.2. I started SRT two years after my surgery and will find out if I've headed back to 0 in October. So far I've yet to see any side effects from radiation.
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