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Posted 8/19/2018 11:07 PM (GMT 0)
Chilling and waiting for another test sounds like a great plan.

Do keep us updated when you get the test.

Andrew
Posted 8/20/2018 3:15 PM (GMT 0)
I ended up thinking that the "CyberKnife" might be a good route if needed. So, I reached out to one of the experts and sent him my pathology report as well as my psa history: I am really relieved with this comments:
Mr. Tinsley,

Thank you for your interest in First Dayton CyberKnife. Dr. Hughes is indeed an expert in SBRT.
I shared with him your email and this is his response:

“There is no reason to “freak out.” The PSA levels are certainly consistent with no evidence of disease. The sensitivity of the PSA test is not accurate to even 2, let alone 3 decimal places. I would not worry about salvage treatment unless the PSA is in the 0.4 ng/mL range, if ever. CyberKnife is not appropriate but rather IMRT with concurrent androgen deprivation therapy.”

He also recommends that if you continue to have concerns or any returning/increased symptoms to see your trusted urologist as soon as possible. There can be several causes of a slightly variable PSA or urological symptoms.

All the best,


Kathy Corbett, CMM, CMOM
Practice Administrator
(937) 293-2273
2632 Woodman Center Court
Dayton, OH 45420
Posted 8/20/2018 3:31 PM (GMT 0)
Brian: Just curious? Where did the "First Dayton Cyberknife come from" Hadn't seen that you had mentioned that one nor have I heard that location discussed elsewhere here at HW. That said of course I have not read every post. Just curious why you might consider them when you have such great resources closer to home.

Roger
Posted 8/20/2018 4:28 PM (GMT 0)
I was not thinking of going to Dayton Ohio, rather I was just searching Google on the CyberKnife technology. I stumbled across this doctor/site and emailed them my situation. The doctor was kind of enough to read my email and respond. What surprised me was his response about the CyberKnife and if it could be used after a RP w/o a prostate. I was under the impression that it could be used. However, his response is in line with also what Dr. Catalona said that "salvage radiation" treatment for post RP, is going to require IMRT vs CyberKnife as I was trying to figure out how they would point the radiation beam when you have no prostate left. So, the expert at Dayton Ohio confirms that I just need to chill out, get this out of my head and just get back to continuing my 3 month schedule of checking my PSA with Dr. Porter at Swedish. And should I ever need further treatment, Swedish is where I will seek it. But for now, going to be going back to Day by day. :0)
Posted 8/20/2018 4:49 PM (GMT 0)
Tennis and Roger-

I'm also in/near Seattle and am now seeing the doc's at SCCA. Have had RALP, RT and will have a PetScan next week at the SCCA. I am apparently in relapse territory.Tennis, you will like Dr Yu, I think. We're talking EXPERT here. If you want to email let me know, I would enjoy corresponding with you both as to local experiences.

Jim
Posted 8/20/2018 5:01 PM (GMT 0)
I cancelled my dr Lu. I did correspond with him on email and he looked at my pathology report and said “ pretty decent “ and nothing until 0.03.
Keep in touch [email protected] thx
Posted 8/20/2018 5:14 PM (GMT 0)
I'm going to keep posting this: chill, retest, and wait till .03.
Posted 8/20/2018 5:26 PM (GMT 0)

InTheShop said...
I'm going to keep posting this: chill, retest, and wait till .03.

Yes, I feel the same, unless you just want to of course, no need to jump just yet. But of course continue to watch it closely. I am high risk, and I hung at <.01 for 18 months, then at .01 for a while, then hung at .02 for a while, and suddenly jumped to .06. Then another at .06, then backed up a bit to <.01. I am approaching 5 years. Butit does suck, doesn't it?
Posted 8/20/2018 5:36 PM (GMT 0)
Perhaps TA or one of the other "knowledgeable" guys will fill in the info I don't have here, but I recall some work being done by a Dr. Wong ( I think ) at Mayo in Rochester dealing with more acturate scanning techniques that can allow for pin point use of Cyberknife in SRT.

Forgive me if I am in error but that is what my memory is telling me. It seems that, up until Dr. Wong's work, in the past after RP it wasn't possible to know where the cancer cells were lurking. But..if it can be determined where those cells are then Cyberknife or similar platforms can be used.

Again I apologize if I am giving erroneous information but the technical side of PCa is not my strong suit.

Roger

Jim: Good to hear from you. Maybe the three of us can get together someday. Perhaps we could get a "westside" gathering together someday for all of the HW folks.
Posted 8/20/2018 5:45 PM (GMT 0)
That's what we're doing as well, testing every 3 months and taking action at 0.03. RO is in agreement.
Posted 8/20/2018 6:46 PM (GMT 0)
The only use for SBRT (CyberKnife or other) for SRT that I am aware of is a clinical trial at UCLA. There are some good reasons NOT to use SBRT for this purpose, and it should not be done outside of a clinical trial. There is some early data that suggests that moderate hypofractionation may be equal to conventional fractionation in both oncological and toxicity outcomes.

/pcnrv.blogspot.com/2018/01/salvage-sbrt-after-prostatectomy.html
Posted 8/20/2018 7:59 PM (GMT 0)
Is this the Tall Allen from the HealthUnlocked? If so, high again! Yah.. sounds like the CyberKnife is not the route in my case, rather IMRT per several renowned doctors. But.. hoping I don't need it ever! Both of these website forums are great! Brian
Posted 8/20/2018 8:17 PM (GMT 0)
not sure, but just got this link: https://prostatecancerinfolink.net/2018/08/20/early-data-from-the-props-imaging-trial-prior-to-srt/

Brian
Posted 8/24/2018 10:57 PM (GMT 0)
Update with me. I believe in God period. With that said, as many if you know I have been freaking out about my two year psa test coming back at 0.014. My plan was to see dr Yu at SCCA and then gr Cirman and dr k Ray somebody. And also my urologist recommend dr Eulau. Well, I canceled everyone appointments and felt that I had an intervention which I am at peace about. I had sent my pathology report to the folks at 21com or something like that name. I had forgotten I did it's. Well two days ago I get an email from dr John Sylvester who said basically screw the urologist and go see a dr Alex Hsi at either Evergreen hospital center or the Pouslbo cancer center. That is when I knew it was a sign and he is the guy who just did a pelvic mri on my dad!! And my dad told him about me too. So on 9/7 in am taking a ferry ride to Poulsbo to meet with him. He is apparently one of the best regarding prostAte care and new technology he help start the cancer center there too.so I feel much less anxious and if I do need treatment I will get it there. Thx Brian
Posted 8/25/2018 1:32 AM (GMT 0)
The best in my view is the decision you can live with and not second guess later. Sounds to me like you have it figured out for yourself which is great.

Jim48: my email is in my profile send me a msg and then I will have yours. We can talk.

Roger
Posted 8/25/2018 4:34 AM (GMT 0)
May peace be with you always.
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