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IMRT therapy and hormone follow up info needed

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Prostate Cancer
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Posted 5/28/2016 3:11 AM (GMT 0)
I`m the newbie...in the weeds guy ....waiting on Dr Patel in Orlando to call about robotic removal....in the meantime , would like to hear from anyone with the IMRT rad therapy with 1(hormone) shot prior , then the rad therapy(9 weeks) and 3-4 months follow up hormone therapy. With my situation at home with dementia wife , I`m looking at this as a possible plan of attack that would let me continue care for my wife. Would like to know ANYTHING out there from you all who have gone this route. I know removal is the preferred way most suggest . David stuck in Fl......
Posted 5/28/2016 4:18 AM (GMT 0)
In the weeds guy...I had IMRT and hormone therapy, but I also had it in conjunction with brachytherapy, so somewhat different from you. But I was also diagnosed an aggressive G9, so I had more aggressive therapy. But to answer your question...

I'm doing great several years out. Low and stable PSA and no side effects to think of.

But...given your wife's dementia and your role as a caretaker, there are many radiation therapies that take less time than the nine weeks of IMRT that you are talking about. If you're looking for an alternative to surgery that can cure you, I really think you should look at brachytherapy or SBRT since they take much less time! You'll need to find someone that practices those therapies--not everyone does. But I really urge you to take the time to do so and we can help.

I know you're in a difficult position--both with your diagnosis and your caretaking of your wife. All of my best as you navigate that. I'm sorry you're in a tough spot.
Posted 5/28/2016 1:18 PM (GMT 0)
Hi Drifter

I just completed all of the parts of my treatment plan. ADT - IMRT - LDR Brachi (seeds) - followed by a second ADT shot (lupron)

So far it appears that I'm heading in the right direction. Next PSA in August 2016

I worked just about every day during treatment. Experiencing Normal, expected side effects like hot flashes, tired at times, some discomfort urinating after seed placement.

I discussed surgery -second opinion - but the side effects from DaVinci were greater in my mind than the radiation risks for a person at my age.

The 'second opinion" surgeon thought that I would have good results with 39 IMRT treatments along with 2 years of ADT.

As others offer advice, they will recommend a second reading of your biopsy slides. This is a good idea

Good luck with your treatment and check out all of your options.
Posted 5/28/2016 6:02 PM (GMT 0)
If you have surgery and everything goes perfectly, you should be able to resume most of your care giving duties within 4 or 5 days..You will have a urinary catheter and collection bag to deal with for a week to 10 days then some degree of incontinence for one to six weeks....

With IMRT it's 40 trips to the treatment facility, usually the same time 5 days a week..Usually, you will be in and out in an hour or less...Find out where your RO sends his patients to be treated, how much travel time?

Brachy (seeds) is also radiation treatment. It comes in two flavors, low dose and high dose. It is often combined with a shorter number of IMRT treatments, a technique that seems to provide the best results.

Hormone Treatment. When first given it's usually very effective. It kills 90% or more of the prostate cancer within a few months..Now the radiation treatment has MUCH less cancer to deal with and the reduced amount has been weakened and is more vulnerable to radiation treatment. The end result is that the RT is more effective at producing a cure, 50% more effective.....

Does radiation kill cancer? No, it does not..It damages the DNA in the cancer cells so they no longer can reproduce. Cancer cells have a relatively short lifespan and if they can't reproduce the cancer slowly dies....The trick is to apply enough radiation to kill the cancer but not enough to seriously damage nearby healthy tissue....It's a real balancing act..
Posted 5/28/2016 6:06 PM (GMT 0)
In your previous thread, I told you that there's no need for a 9-week radiation ordeal, and gave you a list of Florida doctors to interview.
Posted 5/29/2016 1:14 AM (GMT 0)
I was also seeing a Dr Patel in Orlando/Florida Hospital but decided to go IGRT since I'm self employed and could not take the downtime and did not like the idea of them cutting me up. Did about 25 treatments and Brachy boost with ADT. The radiation has it's own set of issues to deal with but they're mostly annoying and you can continue to work/function pretty much normally. Presently taking a break from hormone therapy. It's going to take some time to find out if this stuff worked.

Tom
Posted 5/29/2016 1:30 AM (GMT 0)
If you get 1.8 gray per session( fraction) which is standard, you'd need 38 sessions which is 7 weeks and 3 days. Better than nine weeks.
Bob
Posted 5/29/2016 1:45 AM (GMT 0)

Break60 said...
If you get 1.8 gray per session( fraction) which is standard, you'd need 38 sessions which is 7 weeks and 3 days. Better than nine weeks.

Sorry to contradict, but that's incorrect. The OP is correct. At 1.8 Gy per treatment, the standard primary IMRT plan is 44 treatments or about 9 weeks. You didn't have radiation as primary treatment, you had salvage.

- Allen
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