Pathology Report In

Dr. called with Pathology report, he just gave a few details and will cover further at follow up in his office.
Told me I had microscopic positive margins in 2 locations, confirmed Gleason 8, lymph nodes clear and recommended adjuvant radiation at about 7-8 weeks post surgery. This is pretty much what I was expecting prior to surgery.

I have a few questions:

1. Is Cyberknife compatible with adjuvant radiation to the prostate bed?
2. Criticism of the Cyberknife data seems to center on the relatively few years (6-7 years) of data, the Cyberknife appears to have good results with many fewer sessions. Thoughts?
3. If not Cyberknife, what? There is cutting edge state of the art available here in Dallas.
4. ADT either before or with radiation, better?

I am sure there will be more questions as I proceed.

Semper Fi
Walt

Walt, before you decide too abruptly on a treatment plan, as a G8 you should form a medical team consisting of 2 urolgists/surgeons, a radiation oncologist and a medical onco to quarterback the team with you reserving your rights to override whatever plays the medical onco calls.

You may very well end up on Lupron that is tough on cardio so keep you cardiologist in the loop. If you also end up on Xgeva or Zometa to counteract the adverse impact Lupron has on the bones, have your dental work up to date before starting them as extractions can cause lock jaw like symptoms when on Xgeva or Zometa.

The medical onco is less biased with respect to the problem of a hammer seeing all problems as a nail just waiting to be hammered, in this case urologists recommnding surgery and radiaiton oncologists opting to zap.

Have as many as possible of your medical team from national PCa centers and not all from same practice to avoid any potential conflicts of interest such as them being bonused to get patients to use the costly equipment the practice just ordered. Unfortuantely it happens.

LupronJim