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Received go ahead for HT + IMRT + LDR BT

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Posted 7/19/2018 10:35 PM (GMT 0)
Met with my RO yesterday and got his concurrence going ahead with my preferred treatment of the triple play (my uroflow and retention tests results were sufficient to proceed with seeds) -- this was a welcome relief and a good thing!

I will have been on Lupron three months next week. I will have two scans next week (as soon as insurance authorization goes thru), one for purposes of seed planning, and the second for IMRT planning; and will get the next Lupron shot as well.

Then about two weeks after that, I will begin 25 sessions of IMRT, 45 Gy and entire prostate bed given Gleason 9, 5 weeks Monday thru Friday, and then seeds after IMRT.

It felt very good to finally be locked into the treatment approach and to know that radiation will be beginning soon -- there had been some level of anxiousness since getting upgraded to G9 (from G8) by Epstein second opinion to get going with treatment sooner rather than later.

One day at a time, slay this beast!
Posted 7/19/2018 11:14 PM (GMT 0)
It's great to have a plan ready go. This should do it for you.

Go get it done.

Andrew
Posted 7/19/2018 11:33 PM (GMT 0)
It feels so good to get started on a treatment. You get to put your energy toward something other than trying to figure out what to do. Good luck to you from someone with the same treatment (other than HDR brachy) who is doing well!
Posted 7/20/2018 12:31 AM (GMT 0)
CADogsRUs-

Congratulations on getting that part done.

I was curious about the two scans - why could they not use the same scan for both?
Posted 7/20/2018 1:05 AM (GMT 0)
Good luck CAd. Great to have a clear path, it leads to a clear head. And here’s hoping it will lead to a great result.
Posted 7/20/2018 12:19 PM (GMT 0)
Hi Ca

I had the exact same treatment. Good luck.

Al
Posted 7/20/2018 2:18 PM (GMT 0)

Tall Allen said...
CADogsRUs-

Congratulations on getting that part done.

I was curious about the two scans - why could they not use the same scan for both?


If I recall correctly, the seed "scan" is a volume study (ultrasound) where as the IMRT planning scan will be the CT scan. I did not think to ask why the CT scan could not also be used for seed planning -- but I will likely ask the nurse case manager.
Posted 7/20/2018 5:24 PM (GMT 0)
CA,

Yay!!! Much like the others here, I've been following your journey closely and I'm psyched to hear that you've finally been given the final go-ahead on the 'triple-play'. I know how much you wanted this particular treatment approach, so that's great news!

And yes, regarding two separate scanning or planning events, the RO who will be handling my triple-play plan has also scheduled two (2) separate pre-planning events or a total of four radiation-related visits. My particular plan has the seeds occurring first, followed by IMRT (rather than the other way around), and like you, I'm not quite sure how the two "planning" visits differ in terms of scans that are to be conducted, but the four total visits scheduled for me are as follows:

1) Pre-Planning (Seeds), I'm told this visit will be mostly releases, authorizations and documentation, etc. **
2) Seed Implantation
3) Pre-Planning (IMRT), X-Ray/CT Scan
4) IMRT (28 Sessions, 5-6 weeks)

** The RO's chief nurse has indicated that a 3T-MRI done back in early June will be used for volume and mapping of the prostate for seed implantation, but I suspect that some other scan(s) (maybe ultrasound?), are likely to take place at that time too. Not sure.

Anywho, once again, kudos on the great news. Please keep us posted on your progress and best wishes to you moving forward.
Posted 7/20/2018 5:32 PM (GMT 0)
Ultrasound is best for volume but CT is almost as good. MRi is not as accurate for volume. They often do the planning for seeds intra-operatively. It's a good idea to get a f/u imaging study done about a month after I-125 seeds or 2-3 weeks after Pd-103 seeds to make sure coverage is still good after swelling goes down.
Posted 7/20/2018 5:51 PM (GMT 0)
My seeds will be after IMRT, so apparently IMRT doesn't affect the seed volume study or I would think they would hold off on volume study until after IMRT.

FYI, my RO informed me he's done approximately 500 seed implants -- this was mentioned when he was going over all the various possible side effects and one was "about 1 in 1000 but I've had 0 in 500+".

Balladeer: Thank's for your good words. I've been following your posts and journeys as well. I've been tempted to post here and there that you were over worrying or over thinking a couple of times, but we each are wired differently and in the end have to do and think what's right for each of us. Hopefully, your treatment away from your current area will go absolutely perfect for you!

Off to see the MO for an appt today -- I think it's just a check in to see how the Lupron is going before next weeks next 3 month Lupron shot.
Posted 7/20/2018 6:04 PM (GMT 0)

CAdogsRus said...
Balladeer: Thank's for your good words. I've been following your posts and journeys as well. I've been tempted to post here and there that you were over worrying or over thinking a couple of times, but we each are wired differently and in the end have to do and think what's right for each of us.


Ah-haa! Too funny. "Over-thinking"? "Over-worrying"? Me????? No doubt! The unchained mind is a terrible thing to witness. Just ask TA. I can literally 'over-think' something right into the depths of unfathomable chaos! wink
Posted 7/20/2018 7:35 PM (GMT 0)
Good luck!
Posted 7/20/2018 9:51 PM (GMT 0)
Good for you CAdog!
Having the uncertainty of your chosen treatment plan behind you is quite a relief. I know it was for me.

Good luck going forward!
Posted 7/20/2018 10:43 PM (GMT 0)
Sounds like a great plan. I wish you luck with the treatments. Take care. -JR
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