Started RT

Hey guys it has been a month or two since I have checked in, hope things are going OK.
started radiation this past week.. 38 sessions through June 1. had a Lupron shot (6 month dose)
late January, took my post RP PSA which was 2.57 down to .17..... Was doing pretty good
til last week, everything is getting real again. I have really appreciated your insights and expertise....
Any thoughts on my PaC and prognosis (outcome probabilities)would be welcome (Decipher test ??).
Thanks.

Hi John - Tough to guess at this stuff with your stats. Decipher would be a good idea for predictive treatment but you already know that you still have PCa thus not much guessing that something else is required. The predictive salvage radiation nomogram calculator requires that your PSA dropped to <0.10, nondetectable, after surgery prior to rising. Once you go on ADT then you cannot determine any valid PSA comparisons which is required as well for predictive outcomes.

Did your Axumim scan show any locations of possible cancer? Your PSA was pretty high after surgery so there must be an appreciable amount of PCa somewhere. That would help determine if the radiation (prostate bed and lymph nodes?) might cure the situation or not.

John - Sorry about using the abbreviations, becomes a habit. There is a sticky note with most of them listed at the top of the home page.

ADT = androgen deprivation therapy = HT = hormone therapy = Lupron shot. Basically chemistry that reduces testosterone which feeds most prostate cancer cells. Estrogen reduction is the comparable situation on the breast cancer side. Reducing the “food” kills or weakens many of the cancer cells which in turn reduces the additional PSA they generate thus you would expect a lower PSA if it works as hoped for. The good news is that it is working as expected thus your PSA will be low when SRT (salvage radiation therapy) started.

The real key will be what your PSA does after radiation Is done. Hopefully it drops to a negligible amount and stays that way. Because you are hopefully killing all remaining cancer cells with radiation (messing with their DNA so they can’t reproduce), it can take a while for the situation to stabilize so you will be watching your PSA just like after surgery.

Your scan results look good in that they found something locally that can be explained and treated and nothing more. Now just sit back and enjoy a couple of months of endless treatments then wait for the PSA tests that follow. Hopefully they will not keep you on Lupron for too long after radiation ends. The PSA tests after you go off Lupron become the most important to see the non-chemically treated results and if they are stable. May a lack of side effects be with you for 37 more weeks.

Hello, John1019 - - -

Hoping your radiation treatments are going well.

I had nine solid weeks of radiation.

The days do click along, the weeks begin to add up.

Once you get a protocol pattern going, it becomes routine.

One thing I discovered --- if I showed up in track pants and a t-shirt, then I didn't have to change into one of those hospital gowns each day! I had to make sure the track pants didn't have metal zippers, of course.

I worked all day, then dashed to the "last treatment of the day" appointment.

So, I just brought a gym bag to work, did a quick change after work, then drove to the radiation appointment ---- in t-shirt and track pants, all READY TO GO!

Be sure to ask for your favorite music during the treatment --- there's something about that ---- "Alexa, play 1970s rock, please!"

Something I added --- one of my favorite lakes was near the hospital. I took a walk there, right after every treatment.

Radiation can lead to fatigue, and walking or exercise is the best way to bolster energy. Walk the dog, mow the yard, ride your bike, stop by the gym, work in your garden ... whatever you like BEST!

My radiologist taught me this lesson:

"The best day to walk, during your series of radiation treatments, is the day you DON'T feel like walking!"

My radiologist was a role model for me --- he rode his BIKE to the treatment center quite often!

Hope your treatments are going well --- one day at a time --- keep knockin' 'em out, John1019!

With my best,
CYCLONE ----- # Iowa State University

For me the biggest challenge of RT was getting my bladder just full enough but not too full. There were a couple of times when I wasn't full enough and they had me wait a little while and drink a glass of water. There were also two occasions when I too full and leaked on the table. Embarrassing, but the staff had seen it all and took it very calmly. There was another guy having RT for PCa at the same time as me. He had a HUGE leak all over the floor on the way to the bathroom after getting zapped. By the end I was able to calibrate my bladder fullness very precisely. Good luck!

I also wanted to provide a word of encouragement. The last two weeks go by fast! I just finished my RT on 4/24. 7 weeks worth!

During the Covid hunker down it was actually kind of nice to have somewhere to go each day. My appointment was early AM, no traffic, really nice people (staff and other patients).

Then we heal and we wait....for tests we cannot study for!

We will pass those tests.