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IMRT and HT - PSA

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Posted 7/1/2013 5:19 PM (GMT 0)
IMRT guys,

I have updated my signature. Have now had 4 months HT and 13 of 38 IMRT treatments. I believe I'm getting total of 81gys. Weekly meeting with RO today. She said everything is going fine. I mentioned my 0.4 PSA on 6/18/13, and I said I wanted to reach an undetectable PSA. She said she doubted I would ever reach that with 6 mos. HT and IMRT. It kind of threw me, and I didn't ask why but will. I also mentioned I may ask for 6 more months of triple blockade - she didn't think that is necessary. She and I had discussed adding seeds but, as in previous posts, I noted that Dr. Robert Lee at Duke said with my situation he recommended IMRT only and 6 mos. HT. RO here said I should do well with any option I choose. She said if I wanted to add seeds it had to be before the 25th IMRT treatment. I have seen guys achieve 0.00 with IMRT/HT with 3+4=7, but I have small volume 4+3, and 3+3. I have seen the Seattle review and other studies, however, Dr. Lee says with a decade of improvement in IMRT, he considers it the same as IMRT + Brachy.

Robert

Posted 7/1/2013 7:13 PM (GMT 0)
Robert,

HT is used for several different reasons. In your case, they are just using it to increase the radiosensitivity of the cancer. It's use has been questioned in intermediate risk cases like yours when dose-escalated radiation is applied. The radiation has an irritative effect on the tissues, so it would be surprising if the PSA fell to non-detectable levels right after you started radiation.

- Allen
Posted 7/1/2013 10:27 PM (GMT 0)
Tall Allen,

Thanks for reply. Suppose I was focusing more on the HT. Probably expecting too much too soon. In my career, I was used to getting things done quickly that I had control over. This situation I see is totally different.

Robert
Posted 7/2/2013 12:05 AM (GMT 0)
Time, I agree that you might be putting too much focus on the HTresults. I've been on HT and HT2 for over 6 years now and while it has held the beast at bay, there's no way it's going to bring me down to indetectable. Of course, my PCa has taken a different route than yours. All the best . . . Q
Posted 7/2/2013 2:01 AM (GMT 0)
Q, thanks. Your PSA is obviously way, way down. I had noticed this before in your numbers. Have any of your doctors ever discussed IMRT?

I pray for all the guys on this site and elsewhere. Sorry if I may have seemed unthankful for my PSA, just trying to understand it all and fix it.

Best to you too!!
Robert
Posted 7/2/2013 6:07 AM (GMT 0)
No apologies necessary good buddy. The HT is what knocked the PSA down, just six weeks after first Lupron shot. I'm not too familiar with IMRT, all my onc says about radiation treatments in my case is if I start getting mets. At this point in time, we're just happy that I can handle the ADT2 and that it has been so successful for so long. After six years the hot flashes, mood swings, etc are mostly just background noise . . . the only SE that still bothers me a lot is the fatigue related pain syndromes but the OxyIR and Fentora are handling that pretty darn well. Thanks for the prayers, they do help . . . Q
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