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Posted 9/17/2012 9:08 PM (GMT 0)
Could someone please tell me if they think Bill is a candidate to have radiation seeds implanted? I was under the impression he couldn't have any more radiation after his salvage radiation after the surgery, but his family doctor made the suggestion to him. God bless all, Dana SO diagnosed 4/15/09 age 47 1/15/09=PSA 10 Dx 4/15/09=Right side= Gleason 4+4=7, 40% involved, 5 out of 6 cores positive, perineural invasion present Left side+ Gleason 4+4=8, 60% involved, 5 out of 6 cores positive, no perineural invasion present T2c 5/14/09=Robotic surgery at Cleveland Clinic by Dr. Gong pre-op PSA 15, MRI shows extracapsular penetration Pathology 5/21/09-T3a, N1MX, positive margins, 1 out of 13 lymph nodes positive, left nerves spared 7/7/09- pad free 7/10/09- PSA 1.1 7/25/09-PSA .2 11/9/09- PSA .3 salvage radiation 10/10- PSA .02 1/7/11- PSA .01 3/12 PSA 1.3 6/12 PSA 2.5 7/12 PSA 5.4
Posted 9/17/2012 9:13 PM (GMT 0)
your husband doesn't have a prostate so what does the doctor propose to seed?  if your husband has had his prostate removed followed by salvage radiation the disease is probably systemic so you either misunderstood the doctor or else i would be looking for another opinion ASAP.  sorry for what you guys are going through and i wish you the best.

ed

 

Posted 9/17/2012 9:23 PM (GMT 0)
Thanks for the reply F8. I need to say first, Bill and I are just friends. The doctor told him he thinks the cancer is in the surrounding tissue and that the seeds could be strategically placed to kill the cancer in that tissue. Do you think he's misinformed?
Posted 9/17/2012 9:27 PM (GMT 0)
 Do you think he's misinformed?

either he is or i am. i had seeds and beam radiation.  i never heard of what the docotor is proposing but i will say it sounds highly suspect cool !

ed

Posted 9/17/2012 9:30 PM (GMT 0)
I just asked Bill to clarify-I think he may have been told there was leftover prostate tissue, but I'll confirm.
Posted 9/17/2012 9:36 PM (GMT 0)
he had surgery three years ago and then a recurrence.  the salvage radiation was aimed at leftover tissue and any spread into the prostate bed (maybe even wider).  and now the doctor thinks there is leftover tissue?  do i have this right?

 

Posted 9/17/2012 10:56 PM (GMT 0)
Dana, I have not heard of this either but, then again, I'm not a doc.  However, with Bill's stats and rising PSA I would strongly suggest that he refrain from taking advice from his family doctor -- rather consult with an experienced prostate oncologist ASAP.

Jim

Posted 9/17/2012 11:00 PM (GMT 0)
Dana,
I would say his doctor is well past being misinformed and borderline on malpractice. Your friend has confirmed lymphnode invasion and salvage radiation after a failed surgery with psa still rising. There is no way a psa of 5 is coming from the prostate or the prostate bed after surgery and SRT. His disease is systemic.
His best bet at this point is to find the best prostate oncologist you can as this has to be now treated as a systemic disease and not a local disease. At this stage a family doctor is way beyond his area of expertise.
I'm surprised that with confirmed lympnode invasion he was not put on hormone therapy immediately as it was already confirmed that the cancer was outside the prostate.
Good luck.
JT
Posted 9/17/2012 11:51 PM (GMT 0)
Thanks everyone-I really appreciate your time in responding. Bill said the family doctor said there was residual tissue. He has a doctor he's been seeing at Cleveland Clinic. But his next appointment there is in November. In the meantime, he saw his family doctor and they were discussing his pc and Bill told him he doesn't want HT, and that's when the family doctor suggested the seeds. Last time he was at Cleveland Clinic, the doctor there said he wanted to wait and see if the number gets higher before doing anything, that it sometimes can bounce up and then go back down and he didn't want to treat just a number. He was sent for a bone scan and they couldn't find where it was coming from, the Cleveland Clinic doctor said the number would have to be higher for them to find where it is.
Posted 9/18/2012 12:40 AM (GMT 0)
Dana,

If you can afford an out of network Choline C-11 PET scan at Mayo Clinic or go to Sarasota, Fl to the Sandlake Imaging facility, it may be possible that your husband's cancer could be located and have radiation applied specifically to that site.  If you can not afford to do this, I would advocate hormonal therapy.  If he would choose intermittent therapy, he would be on hormonal therapy for 12-18 months, then off until the cancer returns.  In quite a few, males will have cancers that do not return or recur after a long while.  I would have him read the Dr. Strum question and answer document regarding hormonal therapy submitted here last Friday.  It was excellent.

God bless

Paul

Posted 9/18/2012 1:14 AM (GMT 0)
Thank you Paul. I will send him the link.

Best wishes and prayers,

Dana
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