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When to pass on SRT

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Posted 6/12/2012 7:50 PM (GMT 0)
nellie,

the srt never effected my bowels either. a little sore sometimes, but no runs or anything like that. some guys have a real rough time with that, so thankful there.

david
Posted 6/12/2012 7:52 PM (GMT 0)
Goodlife, your very slow PSADT is very encouraging, but as a G9 it could probably take off at any time. I have the same plan as you in terms of delaying the advance of the cancer as long as possible. However, I am hopeful that if I can push off the widespread mets for 5 years or so, enough new therapies may come along to keep me going with a good QOL until something else gets. There is quite a bit in the pipeline now to be encouraged about. BB
Posted 6/12/2012 8:58 PM (GMT 0)
David, concerning your comment about radiation clinics pushing for it, I do think that's right. I remember a year or so ago when my PSA first hit 0.5 and I visited with a radiation oncologist, he was very honest with me. Told me I could probably wait but if I wanted SRT they'd love to have me as a patient because they had a new machine and needed to justify its cost. I decided to wait, but was grateful that at least he was honest with me.

Mel, I guess nothing surprises me any more with this disease, but I'd think that a doctor whose job was to deliver radiation in the safest and most effective way would know all about when to drink water and how much to drink. I'd compare that to having to tell a truck driver to release the emergency brake before they stepped on the gas, and having them care less about your telling them.
Posted 6/12/2012 9:35 PM (GMT 0)

BB,  Are you and Dr. Myers considering a 2nd round of SRT (to the lymph nodes) should your PSA begin to rise again?  I know he uses Dr. Bravo and Sand Lake for some of his patients.  It certainly sounds like an option for those of us that didn't get the nodes the first time around.  Just curious.

Carlos

Posted 6/12/2012 10:28 PM (GMT 0)
Carlos, the plan is to let the PSA run up a it if I have another recurrence. then do the sand lake imaging thing and spot radiation is tumors are detected and treatable. It's good that more options are becomming available. They may not provide a cure, but they will keep on kncking the beast back on it's butt. BB
Posted 6/12/2012 10:35 PM (GMT 0)
reachout:  There was  a very large study done on SRT that showed if you pull the trigger before it reaches .50, you have a better chance of "cure" that may be another reason he was pushing you.

Carlos:

I'm in the process of looking into the USPIO scan and follow up radiation at Dattoli's.  I've already had SRT, full pelvic, the radiation that Dattoli does in my case would be point radiation targeting specific areas and nothing else.  He calls it DART, an acronym but I can't remember what each letter stands for.  I haven't updated my signature in a while but my PSA has slowly moved to .28 after surgery, SRT and 2 years of HT. 

BB:

This thread almost turned into a free for all but cooler heads prevailed it looks like.  I might run into you at Meyer's sometime because I'm suppose to go thru him to get to Bravo and Dattoli but I'm trying an end run to Dattoli first, I'll let you guys know how it turns out.

Good luck

David

Posted 6/13/2012 2:34 AM (GMT 0)
Reachout:

You are 100% correct. My RO should have known about the details of the water requirement (more specific details)

Mel

Posted 6/13/2012 2:54 AM (GMT 0)
R, Mel,

I think it is almost entertaining to read all the variations of prep advice we all got (or didn't get). OK, no it is not at all. It is scary.

My clinic had signs on the wall and a big water cooler. Signs like "Got water? Had it long? No? Tell the receptionist to let the next guy go first!" or "500 ML 45 minutes before - drink up!".

Every appointment card and piece of collateral paperwork had something of the like printed on the top, bottom, or sides.

My poor bladder would not (and still won't) hold that much, so there were a few trips to the car detail shop for seat shampoos, and it did take a while to get the time right.

The techs were all interested in the stories I passed on from HW. Maybe it was Squid who was using the new (at the time) daily CT? They said that was bleeding edge technology, but there weren't any in my area. Pity that the clinics had finally just ramped up with the latest of the previous generation, so none had the money for the latest latest.

Posted 6/20/2012 5:00 PM (GMT 0)
BB.Fan and Newspaperlover your Stats are very similar to my husbands. We are meeting with 2 RO this week. one does Tomotherapy, and one Varian. Do you have any insight on either. And as far as HT the Uro did not recommend it. But it sounds like all you guys do it in conjunction with the radiation.

Thanks

Posted 6/20/2012 7:41 PM (GMT 0)
LSiL,

I do not have any insight into the two radiation approaches. In my case, because my leading indicators are not good, my wife and I pushed for the maximum treatment possible:

Radiation to the prostate bed.
Radiation to the pelvic lymph.
HT, six months Lupron + Casodex, starting two and a half months before start of radiation.

There is a massive nationwide study underway, randomizing men in these three options. I decided not to enter the study because I might have wound up with just one or two of the three options. I preferred to go all in for the max possible, even if HT may suppress PSA, so that I have to wait six months or more to know if radiation worked. I could see no reason not to do the max when I still have a shot at this thing. Best wishes.

NewspaperLover
Posted 6/20/2012 8:59 PM (GMT 0)
LSil, I also don't have any insight into Varian vs Tomo. I know that other members have done a good deal of reseach and perhaps they will chime in. I did 12 months ADT3 with SRT. I did not have my pelvic node irradiated. I can always do it later if necessary. I am happy that I did the HT with SRT. In my case it wasn't likely that PCa was local only, so it made sense to me to hit it system wide.
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