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Posted 2/20/2009 7:53 PM (GMT 0)

Don, I appreciate the thorough manner in which you described your treatment. I am sure there are members here that will benefit from reading your post. 


Posted 2/20/2009 11:46 PM (GMT 0)
Don...
I apologize, I meant to say regular radiation.

about IMRT from Robert Marckini's book "You Can Beat Prostate Cancer And You Don't Need Surgery to Do It"
page 89: IMRT still used photon radiation, and that meant a higher probability of collateral damage - side effects.

page 150: Now we all know that IMRT is reputedly very, very good...a very high-tech, conformal radiation system. The scientific and medical communities are in substantial agreement: it is "almost as good as proton beam therapy!" And given the added fact that an IMRT facility costs a mere small fraction (less than $2 million) of what a proton beam facility would cost (maybe $150 million+ now), you can anticipate that many hospitals are going to convert to IMRT in the next few years.

Don...you are right...I am glad the medical community has an arsenal.

I am going back an change that post.

jack
Posted 2/21/2009 4:07 AM (GMT 0)
Don,

First of all, my husband had 25 IMRT and a 90 seed pallidium
implant.

I read where you mentioned having 45 Gray to lymph nodes and 20 gray to prostate. Total dose to prostate 81 Gray. My husband was not told how how many gray he received, the word gray was not even mentioned. May I ask what it means? He didn't even know until the middle of his treatments that he was having IMRT until he asked the radiation therapist one day when he was having a treatment.

When he was diagnosed with Pca, his urologist told him that because of his age, (my husband was 68) he was going to let him choose his treatment. But said that if he had been a younger man, he would have just put him into the hospital and removed his prostate. I didn't know until I began reading this forum that men make their own choice as to what type of treastment they want to have.

Wiggyann

Husband diagnosed 12-7-66
PSA 7.3
eight out of twelve cores positive for adenocarcinoma.
seven cores gleason 3+3=6 and one 3+4=7
Gleason 7
25 IMRT and 90 seed Palidium implant 4-25-67
psa one year 0.5
next psa in April
Posted 2/21/2009 2:22 PM (GMT 0)
Hi WiggyAnn,

Gray is a measure of the intensity of the radiation. Used to call it "rads" in the past. Think of it sort of like a teaspoon of sugar. I had 45 gray to the lymph nodes and 81 gray to the prostate. Typical dose for a single session is 1.2 to 1.8 gray. Sometimes the doctor will say centigray. That is just the gray times 100 I.E. 45 gray would be 4500 centigray.

Your husband had a combined brachytherapy and external radiation modality. From the results you have posted and the time from treatment I would say "whoohoo". Looks like whoever did the work hit the mark.

Best to you and your husband and wishes for continued good news and health.
Don
Posted 2/22/2009 4:24 AM (GMT 0)
Everyone here is making tough decisions based on what they think is going to be the best for them in the long run, and in my opinion, if you are a good candidate for successful surgical intervention in this disease then you should have the surgery despite the possible side effects. If you can get good clean negative margins then hopefully you can eliminate the chances of recurrence and have a shot at getting a total cure. I also think that men with low grade Gleason score biopsies who are young enough and/or healthy enough to tolerate surgery should seriously consider surgery over watchful waiting in order to avoid losing the opportunity of achieving negative surgical margins. If you can get this disease out of your body while it is still contained then I believe you have the best chance of not having it come back. And, as others have said, if you have PSA recurrence after the surgery it is still possible to have radiation to try to finish the job, whereas having surgery after radiation is more problematic. All this being said I absolutely respect and support the decisions made by any fellow PCa sufferer who has taken the time to research and educate himself about the various treatment modes and who makes an informed choice as a result of it regardless of what treatment they choose.
Good luck and zeros to all!
Mark
Posted 2/22/2009 2:09 PM (GMT 0)

mirv said...
Everyone here is making tough decisions based on what they think is going to be the best for them in the long run, and in my opinion, if you are a good candidate for successful surgical intervention in this disease then you should have the surgery despite the possible side effects. If you can get good clean negative margins then hopefully you can eliminate the chances of recurrence and have a shot at getting a total cure. I also think that men with low grade Gleason score biopsies who are young enough and/or healthy enough to tolerate surgery should seriously consider surger
Mark

all I have to add to Mirv Post is DIDO Partner !!!
Posted 2/23/2009 9:06 PM (GMT 0)
As many of you know we are Brachytherapy supporters.  I do not discount the benefits of surgery I just post to ensure that people are aware they have a choice and to investigate each choice and pick what is right for you.

In our case, it was Brachytherapy and we have never looked back.  My husband is back to all of his regular "antics" and doing fine.

 

Posted 2/24/2009 12:23 AM (GMT 0)

Greetings, everyone.  I'll add my 2 cents and it is probably worth about half of that.  Everyone has to make their own informed decision and then go with it.  That is the issue - getting to an informed decision.

In my case, I saw a urologist that had treated me a year earlier for a kidney stone.  He was neither a surgeon nor a radiologist. He did my biopsies and gave me the news that 2 were positive and 2 were marginal.  When he did that he said there were several options and the 10 year prognosis was very similar for all the options.  However, at 10 years all of the options had issues except for surgery.  If it was contained and the surgery got it all, most of us just keep on getting zeros.  Thus, he considers the age of the patient in what he recommends.  If the patient is around 70 then he explains the options and tries to help the patient make an informed decision.  At my age of 55 he indicated he strongly recommended surgery.  He doesn't do surgery or radiation so didn't have a "dog in the hunt" - he would be recommending me to someone else either way.

I chose surgery because based on my research, my urologist was correct.  If I had anything other than surgery I would always wonder what was going to happen in 10 years.  Maybe nothing but there would also be a good chance that I would have to do something else at about that point. 

For me, I am convinced I made the right decision.  My father was about 75 when he was diagnosed and he had radiation.  He is doing fine at 81.  His twin brother, my uncle, also had PC at about age 70 and he had surgery.  He is now in his final days after his metasticized to his bones.  Go figure.  As with all options, you have to pay attention to the percentages.  Just because 90% plus are cured with whichever option, you have to remember the other 10% and the fact that those are real people with real families who love them and want them to be there for years to come. 

I believe the main thing is to make that informed decision and then have confidence that you are doing the right thing and then find the right doctor who is very experienced in whatever option you choose and then go for it and don't look back.

My two cents!  David

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