HealingWell
Search Close Search
☰

"SRT Only Concerns"

Support Forums
>
Prostate Cancer
✚ New Topic ✚ Reply
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 12/9/2013 5:30 AM (GMT 0)
After reading posts on cancer after RRP, I'm concerned about my decision to only have SRT done. As indicated in my signature, I was diagnosed with a PSA 9.6 November, 2011. Clinical stage T2b and had surgery in late December, 2012 with pathologic stage T3b, according to my uro, I was GS6, according to UM Cancer Center, I was GS7 (3/4). My PSA was .11 September, 2013 and my uro recommended SRT. With the current situation with Obamacare, we chose to begin SRT before the end of 2013 (I have had 37 treatments and have 2 left, last treatment is scheduled this Tuesday). My question, have I exhausted all of my efforts at a chance for a cure at this time or do I still have any options left? My RO recommended SRT only, but after reading the posts regarding cancer after RRP, I'm concerned about making the wrong decision.
Posted 12/9/2013 5:45 AM (GMT 0)
Don't beat yourself up second guessing. You made a decision and are nearly done. The question that would better to ask now is, "Did the SRT work?" If it did - which you won't know for awhile - then cool, you're done and get to live more life.

If it didn't there are still options with HT. Sometimes HT and SRT are done at the same time, sometimes not. Yes, you've likely exhausted all the 'cure' efforts but you don't know yet if the SRT worked or not. Give yourself some more time to see what happens to the PSA post SRT before worrying.

Even if the SRT fails, you've got a lot options and lots of more years on this planet.

Hang in there,
Andrew
Posted 12/9/2013 5:59 AM (GMT 0)
Hopefully your 3 is the preponderance of cancer and they got it all. I would not HT till you have an SRT failure, if that evens happens. Whats your age?
Posted 12/9/2013 6:42 AM (GMT 0)
Thanks InTheShop and Logo for your response. Logo, I'm 58. I'll be 59 in February. I really like my uro and RO, I like the Cancer Center and the technicians, I have met the most awesome patients through this journey. At the beginning of my radiation, my wife and I had the "HONOR" of meeting a 77 year old man that was diagnosed with pancreatic cancer and given 4 months to live over a year ago, he drives himself from Holland, MI to Grand Rapids, MI (40 miles one way) daily still. We have shared many tears with him and pray for him often. The hardest thing at the beginning of this journey was finding out I had cancer, now I think it's finding out others have cancer. We live about 40 miles from the Cancer Center, also, and my wife and I make each day a "date day" when we go. Our favorite restaurant is about 15 minutes away from the Cancer Center, where we used to go on dates 30 years ago, we became good friends with a young girl that just got unofficially adopted 6 months ago at the age of 17 and has been homeless, living on the library steps for years before then. We do much Christmas shopping while we're there, yesterday was my wife's birthday and I bought her the ugliest cosmetic jewelry ring that was on sale for $20.00 that she picked out. I honestly think they should have paid us $20.00 to take that ring off of their hands, she shows it off to everyone. We have never had more fun. In one way, cancer has changed my quality of life, but in another way my quality of life has never been better. There is a latin phrase, "non destiti nunquam destitam" which means never give up, no matter what.
Posted 12/9/2013 9:17 AM (GMT 0)
Eaglekeeper-

UMich actually did a study on whether or not concurrent ADT improves the outcome of SRT. They found it did for high risk patients only. Your pT3b puts you at high risk, but other studies seem to show that it may depend on the kind of seminal vesicle invasion. I'm sure the ROs at UMich took all this into consideration in making their recommendation to you.

Concurrent androgen deprivation therapy during salvage prostate radiotherapy improves treatment outcomes in high-risk patients.

The only other thing to be done at this point is assure that your prostate bed and seminal vesicles received at least 70 Gy of radiation. You can double check that with your RO.

One of the benefits of not being on ADT is that you may be able to see if the SRT was effective much more quickly because you don't have to wait for the ADT to clear your system. Should there be a recurrence, you can consider whether it's worthwhile detecting and going after it in the pelvic lymph nodes. But hopefully, it won't come to that.

- Allen
Posted 12/9/2013 9:26 AM (GMT 0)
I too was a six before surgery in 2009 and upgraded to a 3+4 after plus seminal vesicle invasion. And when my PSA went up from 0.1 to 0.4 8 months after surgery I had SRT. (And just SRT no HT at the same time)
My SRT finished in June 2010, (just before my 50th birthday) but they did not test my PSA until November of 2010 to let the radiation have plenty of time to take effect.
So I think all you can do at present is sit tight and wait several months till a PSA test can tell you what's happening/happened.

I was told that, should things not work I would still ahve the option of HT, but this was something I should not be worrying about at this stage.

And the good news was that SRT got my PSA down to "Less than 0.1" and now I'm actually "Less than 0.01".

So yet more waiting, and the best thing to do is just enjoy the holidays etc and do stuff to help ignore the worries till you know the PSA.

Alf
Posted 12/9/2013 3:13 PM (GMT 0)
MY RO wanted concurrent HT, but my uro & medical onco did not, for the reason TA mentioned above. I elected to not do the HT at the time.
Posted 12/9/2013 4:35 PM (GMT 0)
Eaglekeeper,

I was also T3b. I think I fall somewhere in between on the did/didn't have HT scale. I had three months of Casodex 50mg per day during SRT. So I did have HT, I did not have the longer term treatment with Lupron or Lupron plus Casodex that many guys have had. In any case, my SRT has been successful for 3 1/2 years so far.

Jim
Posted 12/9/2013 5:10 PM (GMT 0)
Been there done that. I had my 2.5 year since SRT visit with the doc today and all I got was, "see you in a year." (I'll see my uro again in six months)

One of the problems with this disease is that, no matter what you do, you could always have done something different. Surgery or radiation or HT or watch or or or....

I know surgery was the right choice even though I later had SRT. Do I know why? Nope. But I know it was the right choice just as I know that SRT was, later, the right choice. What treatment is done is the only thing I can control. I study it out. I pray about it. I choose. I make the right choice. If I start questioning all my choices I'll never sleep easy. Now, at least, I don't worry until my next round of PSA anxiety in six months.
Posted 12/9/2013 10:54 PM (GMT 0)
I went the SRT/HT route. I had 12 months of ADT3. I spent a long time on the decision and so far it has worked out. I am 3.5 years past SRT and 2.5 years post ADT3 and PSA is still undetectable. Would SRT alone have done the trick? I'll never know if the ADT had any effect. Don't second guess yourself. I hope you SRT is all you need. Best of luck. BB
✚ New Topic ✚ Reply