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Posted 4/19/2012 12:59 PM (GMT 0)
I started a new post because this isn't really the same subject as my last. My question is about radiation therapy.

As I stated earlier, my urologist recommends external beam radiation therapy given that my tumor is very small and G6.

My question is this. Given that my prostate has already generated one tumor, how is it that zapping and killing that tumor can have the same results as removing the whole thing? I mean, it's generated one tumor, isn't it likely that it will generate more in the future?

Charles
Posted 4/19/2012 2:20 PM (GMT 0)
Charles,

Good question really. If the cancer is still contained to your prostate, and assuming they give you a good dose of RT, it should be effective.
If you are having RT for a primary treatment as you suggest, the dose will be much higher than if you were having radiation, i.e salvage radiation, as a secondary treatment. Have you considered having "seeds" done, vs. conventional radiation?

Good luck in your decision

david in sc

P.S.  I have first hand experience, having been through major radiation for non-PC related cancers, and more recently, salvage radiation for prostate cancer

Post Edited (Purgatory) : 4/19/2012 8:51:51 AM (GMT-6)

Posted 4/19/2012 2:34 PM (GMT 0)
 

cwren said...
My question is this. Given that my prostate has already generated one tumor, how is it that zapping and killing that tumor can have the same results as removing the whole thing? I mean, it's generated one tumor, isn't it likely that it will generate more in the future?

Hi Charles,

I believe that I can provide an answer, although I've never had radiation therapy.

A complete explanation lies in the understanding that a biopsy is a "sampling" technique which pulls out very small samples from a small (often 12) number of sites within the prostate.  The total amount of the prostate material drawn out and evaluated by a pathologist amounts to only a few hundreths of a percent of the total volume of the prostate.  Pathologists, therefore, don't know that you have only one foci of tumur, but they may know that from among the samples drawn only one showed cancer.  There may be another one in another area of the prostate which was not sampled.

As a result of this understanding, radiation therapy blasts the whole volume of the prostate, and not any one small area within the prostate.  In fact, areas around (outside) the prostate also receive a dose of radiation in the delivery process...this is a trade-off of radiation therapy, as they try to maximize delivery to your prostate while minimizing radiating your bladder, colon, etc.  Hope that this explanation helps you understand the answer to your question.

best wishes...

 

Posted 4/19/2012 3:01 PM (GMT 0)
Cwren, I suggest you read the thread called "PCRI Insights".  It is now on page 3.  I think this will provide you with some insight into radiation; there is a particularly good article re brachytherapy.  BTW, that would seem to be a good option for you based on the stats you presented.  When you meet with the radiation docs, make sure you have chosen one who is an experienced brachytherapist.

Tudpock (Jim)

Posted 4/19/2012 3:41 PM (GMT 0)
Thank you Tudpock18. I read the newsletter, and it was very interesting. I realize that since I just found out my diagnosis less than a week ago, my emotions are playing a really large role right now. I'm reading everything I can while at the same time, everything I read leaves me reeling. My knee jerk reaction is that I want the dang thing out. I'm only 44. But, my urologists strongly recommends external beam radiation. On the one hand, yeah, the side effects of surgery suck. But on the other hand, I'm not sure I could live with myself knowing I did radiation first and negated surgery as an option if it doesn't work. Lot of hard thinking to do.
Posted 4/19/2012 3:56 PM (GMT 0)
cwren,

While I would first acknowledge that no two cases are identical, as you learn more you will find that it is not common for a urologist to recommend radiation—and in particular external beam radiation—to such a young man in his 40's. It is more common for older guys in their 60s or especially their 70, because they are unlikely to have to live with the "late-term effects" from radiation and would be less able to withstand the rigors of major surgery. Guys in between those ages (between 40's and 70's) are more of a toss-up between the aggressive treatment modes.  With this in mind, I think it would be very important to understand why this urologist recommends radiation for you.

It makes me want to inquire whether he/she (your urologist) has his own radiation treatment facilities as a part of his/her practice? This is a relatively new tactic of a small set of urologists; most radiation therapies (for all cancers) are performed by radiation oncologists. If this is the case with your urologist, we can offer you some interesting reading material which you should digest before making a decision.

I would urge you not to rush into any decision. Prostate cancer (PC) is usually a very slow growing cancer. This Harvard doctor wrote (in the article, "For some prostate cancers, waiting beats treatment"): "If lung cancer is like a fast-moving wildfire, prostate cancer is like a slow-moving sloth."

 

Post Edited (Casey59) : 4/19/2012 10:44:14 AM (GMT-6)

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