SRT Done!

Well, my SRT was completed on Monday, 34 sessions at 200 Gy equaling 6800 total Gy to prostate bed and nodes at Fox Chase Cancer Center in Philly. I got two 1-month Lupron shots beginning 8/23/19 and one 4-month shot just two weeks ago on Oct 26. The whole process was not that bad and I got into a daily routine.

My side effects from RT have been minimal and manageable. At about 4 weeks in (of 7), I started getting bad abdominal cramps, mostly in the morning. My bowels habits changed, as I was going 3-4 times every morning, with cramps. My continence was always good and continued, but at about 5 weeks, I had the feeling that my bladder was not emptying completely. No loss of stream, just a funny feeling. RO prescribed Flowmax, which helped.

My side effects from Lupron are also minimal and manageable. I do get hot flashes that are very mild several times per day, more in the evening. I also must have them in the middle of the night, as I wake up about 3 times per night with night sweats. My libido is very diminished, but not gone. Kind of weird. My fatigue is minimal. Muscle aches, yes, and I have a question for the forum. I have bad middle back pain. I have always had lower back pain, with stints of a week or so on the couch maybe once every couple years. The mid back pain is new and I do not remember having it on my vacation in early August. So, I am lining up this pain with the beginning of Lupron. I am hoping that's what's causing it. Any of you guys out there have back pain with Lupron?

Like I said in earlier posts, I was able to take 3 months paid leave from work and plan to return on Jan 2. I was glad I took it, as I did not want to be running to the bathroom every 30 mins or so every morning. Plus, any side effects are really mitigated if I can just take it easy any time of day. I am alone most of the day, as my wife works and my kids are in school. My RO says most SE's subside in the first several weeks post SRT.

Hopefully, I get a long run out of SRT. Best Wishes to everyone.

J
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Age at Dx: 54 (DOB: 01/28/62)

08/31/15: PSA 2.5;
01/01/16: Urinary Frequency;
02/05/16: DRE Pos Nodule;
02/22/16: Biopsy;
02/26/16: Dx: 7-12 positive; (5) 3+3=6; (1) 3+4=7; (1) 4+3=7; T2B;
03/11/16: Bone Scan Neg;
03/23/16: CT Scan Neg;
03/31/16: Surgery Consult UPENN;
04/08/16: RT Consult/2nd Op Fox Chase CC upgrade to 4+4;
04/14/16: 3TMRI "organ confined", EPE-, SV-, LN-;
06/01/16: DaVinci @ UPENN (Dr. D. Lee);
06/08/16: Catheter Out;
06/08/16: Post-Op Path: EPE+;Marg +;SV-;LN-;G7(4+3) (G4 80% - G3 20%);tumor vol 25%;T3a;
07/01/16: Start 5mg Daily Cialis, 20mg once a week on Friday's;
07/06/16: Decipher: 0.56 (Average Risk);5 Year Metastasis 7.6%;10 Year PCa Specific Mortality 6.9%;
08/01/16: Penile rehab started (Pump);
01/30/17: Decipher GRID PORTOS: Avg ADT Response (21%);Avg Docetaxel Sensitivity (56%);
Lower RT Response (45%);Avg Dasatinib sensitivity (38%);High Genomic Gleason Grade (81%);
High Metastasis Risk (70%);High Tumor Cell Proliferation (82%);Avg AR Activity (56%)];
09/26/18: 99% continence (some stress every now and then); ED no issue (5 mg Cialis/Day);

Post-op uPSA History:

08/31/16: uPSA <.006; (3 months);
12/01/16: uPSA <.014; (6 months);
03/01/17: uPSA <.006; (9 months);
06/01/17: uPSA <.006; (12 months);
09/01/17: uPSA <.006; (15 months);
12/01/17: uPSA .007; (18 months);
03/01/18: uPSA .010; (21 months);
06/22/18: uPSA .015; (25 months);
09/21/18: uPSA .018; (28 months);
12/21/18: uPSA .035; (31 months);
03/22/19: uPSA .044; (34 months);
06/21/19: uPSA .055; (37 months);
07/22/19: uPSA .061 (38 months);
08/22/19: uPSA .073 (39 months)

Nice job, the last treatment is somewhat anti-climatic though. I just watched the machine make its last rounds, waiting for it to hang in the middle of a scan so I would not be done on Friday. The techs congratulated me when I walked in and I just hustled to bathroom after completion like a normal day. Felt good driving home though I was somewhat lost the next week with no early morning schedule to follow.

Nothing serious, but it took my body a few months to settle down after ART and maybe a few months after that to be back to my new normal after surgery. I was peeing wonderfully before starting but started having odd feelings near the end of ART and for a couple of months afterwards like you experienced. Nothing significant but it became clear that the radiation does have some effect on the bladder and colon that takes some time to take effect and then stabilize. My RO said most stuff resolves itself in 2 months and he was pretty much correct.

I suspect the Lupron made your experience much different before starting so no direct comparisons I suppose but give it a couple of months and you should be doing well if my experience can be a guide. By Jan 1st, you should be fine.

Jay congrats on finishing up ART. I have suffered with degenerative disc disease for years so have always suffered with back pain but yes the Lupron did make it worse can remember last winter snow shoeing I would stand against a tree and just scream it hurt so bad but at least I could walk on the soft snow for a while where one trip around Menards and I would have to sit down. I had surgery last spring even when the surgeon didn't think it would work and gosh it was a 1000% improvement he said that the mri didn't show all that was wrong so was glad that he had did the surgery telling me that someday I would need it again probably fusion this time but for now it is doing pretty darn good! So you might want to have an mri done or your back to see if there is some other cause for your pain. I am now having degenerative arthritis in my right hand and wrist but won't do anything until spring have to be able to shovel snow this winter. Using a brace and have gotten a couple of shots in it. That might be an option for you too getting shots in your back I did this for about 4 yrs until they no longer worked.

Larry

Congrats on graduating, Jay. Let's hope you never need more education.