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Posted 12/13/2009 4:49 PM (GMT 0)
 

Well I go for my follow up PSA test on Monday but will not have the results until Thursday so it will be a tough week for us both.  We are praying it has not gone up past the 0.3 if so, we have some important decisions to make.  I am still getting conflicting opinions on whether radiation would help me or I might be better serve with hormone treatment.  One radiation doc I spoke with from Methodist hospital in Houston TX said because my PSA doubling time is so fast that it is probably a local recurrance since cells elsewhere in the body would take longer for the PSA to rise since Path was so good and Bone Scans clean.  Anyone ever hear this?  MJ had been doing major research on the subject and most of it seems to indicate a distant cancer so not sure what radiation would do except maybe mess me up.  I just got over the running to the bathroom and pain whenever I went and it feels good to be almost normal.  Not sure what is ahead but thanks in advance from both of us for your support.

Jerry & MJ   

Posted 12/13/2009 5:42 PM (GMT 0)
Jerry,

Was just in a similar situation as you. First, PSA anixety is always there for us, even when things are going good. I met with 3 radiation oncologisits before picking one. Two suggested salvage radiation without hormone, one suggested radiation with hormone. The one that suggested including it, when pushed for facts, admitted to me that he didn't really know if the HT would help, and he didn't know if I really needed it. He essentially gave me two good reason not to do it.

THe radiation oncologist I did use, and very happy with, suggested a pretty strong dose of IMRT without hormones, in my case, tightly directed in my prostate bed only, focusing on where my one and only tiny positive margin was located formerly. I did 72 gys over 39 sessions. Her view was that she wanted to make sure the radiation got where it needed to go. She believes that the HT be saved if needed in case the salvage radiation failed, and likes to keep the two treatment methods seperate. Some doctors would agree with that approach, others would disagree. I had to make my own choice based on research and asking questions. I am still comfortable with my decision.

She did say, that with my one positive margin, and my pre-surgery PSA doubling time and post surgery PSA doubling times, it pointed more toward a local reaccurance, but of course, she couldn't guarantee that other cancer cells hadn't long slipped away.

Good luck to you in advance. Please keep us posted.

David in SC
Posted 12/13/2009 5:56 PM (GMT 0)
Hi Jerry,
My urologist/urologist, general practitioner and radiation oncologist all had gave similar evaluations for my situation which was there was a good chance that the recurrence was local and radiation would likely be successful. Comments made to support their statements were the initial psa after surgery was low and the increases were gradual. My stats and timing are very close to yours. My wife and I were very comfortable with the RO and our GP said this RO would be his choice. None of them recommended hormone therapy yet until it was determined the outcome of the radiation. The RO is going to take a psa test five weeks into the radiation to see the impact so far. According to him, if it is down from the start... great; if it is more or less the same... typical and continue; if it is still rising.... not the best and rethink the strategy. I did like the inclusion of a check point. As I mentioned in an earlier thread, the RO recommended I start taking 2000 IU D3, and as part of my initial blood work prior to starting radiation, he is including a D3 level test.

Our best to you and others,
Jake
Posted 12/13/2009 6:30 PM (GMT 0)
 

Thanks David and Jakester for the information.  Jakester reassuring that mine could possibly be a local recurrance like yours hopefully is since our Path reports are similar.

Anyone know a good RO doctor in the West Palm Beach area?

Thanks again,

Jerry1

Posted 12/13/2009 8:53 PM (GMT 0)
Jake, I don't have any info to add, but will be thinking of you next week while you're waiting the results, and I will be praying for you to drop into the zero club instead, smilewinkgrin
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