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ADT and SRT Journey Part 2

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Posted 4/6/2018 12:49 AM (GMT 0)
Gary you sure got that right!

Larry
Posted 4/6/2018 7:19 PM (GMT 0)
No kidding on the time and money invested in the machines Gary. And the hospital is doing a good job of recouping their investment.

Just got my statement for March - each Tx is $1,846.00 plus the weekly $593 to meet with the doc. So $1,846.00 X 39 Tx = $71,994 plus all the other costs. They will recoup their capital investment in 1,462 treatments. At 2 treatments per hour, 5 days a week, that's 4,160 treatments or billed at $7,679,360 per machine per year. But then again, that is based on the statement rate, I have no idea what they really get from insurance per treatment.

18 down, 21 to go.

Rob
Posted 4/7/2018 4:24 PM (GMT 0)
Just got my final bill from lupron shot in oct till finished radiation in feb. $166,000.00 makes me again realize how very very fortunate I am to have insurance. I always hope that they make a little extra to help give treatment to people that don't have insurance!

Larry
Posted 4/7/2018 7:46 PM (GMT 0)
Latest RO visit notes -

ASSESSMENT: pT3aN1M0, GS4+3=7, iPSA=6.2 (2/2/16) adenocarcinoma of the bilateral prostate gland, involving 50% of gland, +ECE at left infero- postero and right mid-postero locations, +margins at right apex, right postero-lateral (4 mm length) locations, -SVI, +LVI, s/p robotic- assisted prostatectomy on 4/20/16 at U. of Miami. Postop PSA was 2.41 on 6/2/16 and 2.2 on 7/12/16. He is s/p casodex starting on 7/27/16 with PSA dropping to 0.6 as of 8/11/16, and Lupron starting on 8/17/16. PSMA Gallium PET-CT on 7/25/16 showing uptake in pelvic nodes (8 mm L internal iliac, potentially in bilateral external iliac nodes near distal ureters). He is s/p salvage VMAT IMRT, 70 Gy in 35 fx with 63 Gy in 35 fx targeting pelvic nodes suspicious on PSMA Gallium PET-CT and 53 Gy in 35 fx to the elective pelvic nodes at risk using a SIB technique, completed on 12/19/16. He is on long-term ADT (Aug 2016 to current).

Bobby Mac
Posted 4/8/2018 3:47 PM (GMT 0)
Hello ADT+SRT Team-

It's been awhile since I've posted as I've had to refocus all my energy on work. I'm in Month 5 of the Lupron and experienced what everyone has in terms of side effects including shrinking of my testicles. However, that has changed in recent days as my testicles (or scrotum) have swelled to now a very large size. Naturally I'm concerned and will contact my RO tomorrow. Anyone heard of such thing? I'm wondering if I'm fighting an infection.
Posted 4/9/2018 1:38 AM (GMT 0)
Hey AZ guy

I'm on month 6 of a 6 month Lupron..
My testicles haven't shrunk much... they've pretty much stayed the same.

I getting more hot flashes thou ... perhaps there are some weird things that happen at the end of a lupron cycle?...

Has anyone noticed weird activities at the end of their lupron? ... also, once your official cycle is over, how long does it take for hot flashes to go away? ...

Zzarth
Posted 4/9/2018 3:19 AM (GMT 0)
oh yea I got shrinkage! of everything LOL! The hot flashes have kinda slacken this week but go in a couple of weeks and get my next 6th month shot. Oh boy can't wait!

Larry
Posted 4/10/2018 9:51 AM (GMT 0)
Kickin’ the can again... with thanks to the elliptically inclined logoslidat for the loan of the dots... over the hill, 21 down of 40... asked tech today how truebeam can zap me from below through the table without scattering the protons, she explained about the carbon table, cool stuff... someone posted about lupron and high blood pressure, the usual answer stress at the clinic is total bs in my humble uneducated opinion not based on any clinical studies whatsoever... i’m shooting 150s instead of the usual 120s and 130s, my medical team says stress of treatment, but then why was my bp normal in january during nuclear stress test when i was aware cardiologist suspected widowmaker?... btw, love my ro, he threw out his back golfing in korea last month, you have to be insane to golf in korea in march, we spend more time each week talking about his back than my pca, hurrah!... i’m on extended sabbatical from all threads but this one, don’t want to abandon my friends in similar straits... ’ta luego...
Posted 4/10/2018 10:37 AM (GMT 0)
Good Morning SP, I had the same guestion about the beam going thru the table hard to imagine how it can do that. We talked about the cold and snow go figure hey Minnesota in the wintertime what else is there to talk about? Well one of the technicians was getting married on the golf course in May I told her hope the snow is gone my then! LOL. Just saw that we could get possibly upwards of 15 inches of snow here in Northern Minnesota this weekend. I'm ready to trade in my snow shoes for LOGO's surfboard!!

Larry
Posted 4/10/2018 10:44 AM (GMT 0)
Larry, i just saw on sportscenter that it was 35 degrees at the twins game... brrr!... cools down to 75 at sunrise here on Guamsmile
Posted 4/10/2018 10:44 AM (GMT 0)
SP, thanks for the update! Glad all is going well with your treatments!! I go for my simulation this Thursday.

As to BP, when I received my three month Lupron shot last Friday my BP was mid 140’s over mid 90’s (same as when I received my first one month shot a month earlier). Unlike when I received my one month shot which I was really nervous about this time I felt fine, relatively stress free. The only counter I have to this is when I check at home with either of two machines I have my BP is usually mid 110’s to mid 120’s over mid 70’s. I’m not really sure what to make of the difference in readings. turn

Mike
Posted 4/10/2018 10:52 AM (GMT 0)

Skypilot56 said...
Just saw that we could get possibly upwards of 15 inches of snow here in Northern Minnesota this weekend. I'm ready to trade in my snow shoes for LOGO's surfboard!!

Larry, I hope winter ends for you soon!! All the snow you’ve been getting this winter reminds me of something my predecessor at work told me when he retired. He wanted to place a snow shovel on the roof of his car and start driving south. After the first person he passed asked him what that was on the roof of his car he’d drive one hundred miles more just to be sure and call that home lol

Mike
Posted 4/10/2018 11:01 AM (GMT 0)
At the cardiologist, the RNs took bp the old-fashioned way, pumping the cuff by hand and listening thru the stethoscope. One of them told me the automatic gizmos are notoriously fickle, they don’t trust ‘em. Sounds like uPSA assays. In any event, I haven’t studied the question carefully so I can’t say whether her view is independently verifiable.
Posted 4/10/2018 11:32 AM (GMT 0)

Saipan Paradise said...
.....so I can’t say whether her view is independently verifiable.

It isn’t, none of them are!

Glad you’re still with us, Richard. Prepare your stress meter for the, “once SRT is over, after surgery, what are my new PSA expectations” thread.

That should be a doozy. smilewinkgrin
Posted 4/10/2018 1:35 PM (GMT 0)

AZ Guy said...
... I'm in Month 5 of the Lupron and experienced what everyone has in terms of side effects including shrinking of my testicles. However, that has changed in recent days as my testicles (or scrotum) have swelled to now a very large size. Naturally I'm concerned and will contact my RO tomorrow. Anyone heard of such thing? I'm wondering if I'm fighting an infection.


My scrotum was almost the size of a grapefruit after RALP but returned to normal size and remained there even through Lupron (as far as I recall.) However several years ago my scrotum was quite swollen and it was diagnosed as a hydrocele, I had surgery to drain it.

I had to have an ultrasound done before the procedure, there I was on the table with a young and pretty tech about to violate my privacy. I think we were both a bit embarrassed . shocked
Posted 4/10/2018 1:48 PM (GMT 0)
Thanks for that John TX. The hydrocele could be it...or hernia. Back to the urologist!
Posted 4/11/2018 5:03 AM (GMT 0)
OMG Hot Flashes!! ... I'm 6 months out from my 6 month shot, and OMG, the hot flashes are horrible!

I thought they would be going down by now... no? sad

anyone know how long it usually takes for this stuph to go away?
Posted 4/11/2018 10:36 AM (GMT 0)
hey Zzarth are you done now with the Lupron or do you have to get another shot? My hot flashes have not been as bad this last week or I am getting use to them. I go in another 2 weeks for another 6 month shot. What's bugging me is I have been leaking some I don't even feel it till it leaks a couple of drops. Been trying to practice kegals and cut back some on my coffee we'll see if that helps otherwise I'll probably have to start wearing a pad. Yuk!

Larry
Posted 4/11/2018 12:48 PM (GMT 0)

Zzarth said...
OMG Hot Flashes!! ... I'm 6 months out from my 6 month shot, and OMG, the hot flashes are horrible!

I thought they would be going down by now... no? sad

anyone know how long it usually takes for this stuph to go away?

Ask your Doc for Venlafaxine (trade name Effexor), it really helped to reduce the intensity of my hot flashes and sweating. She had to double the dosage for it to be significantly effective. I had my Lupron (six month) end of July and my sweats seemed to be worse in December when I was having radiation. Oh my, what a fun time cry
Posted 4/11/2018 3:18 PM (GMT 0)
Hey guys;

I'm finally over the hill ( in one more way) - 20 down 19 to go.

This seems like a really long forced march to me.

Cheers!

Rob
Posted 4/11/2018 5:20 PM (GMT 0)
Zzarth,
I have heard that if you have 6months of Lupron, it can take up to 6 months to exit your body. I was on for 18months with my last 6 month shot being last Aug. 2017.My hot flashes were pretty intense but the venlafaxine did help. Still get hot flashes just not as often and not as intense. The worst SE I have is fatigue, which makes things pretty tough. Everone is differant as some start feeling relief very soon post ADT, others it can take longer. ( so I hear)
Dealing with PC treatments is a life changer for sure. Having ADT+IMRT as primary treatment, another SE that is tough for me is ,now that treatment is over all I can do is wait.
I know I'm a differant guy than before Dx and some of that may never change but I am learning to except these changes and am trying to get back to living my life the best I know how.
Hang in there (I know you will) as we have been on this journey about the same length of time. The Lupron will wear off eventually. (at least that's my hope!)


Battle On Brothers!



The Artistic One - mark
Posted 4/11/2018 5:56 PM (GMT 0)

Saipan Paradise said...

AZ Guy said...
I had asked my RO if he thinks it would be prudent for me to go longer than 6 months with ADT. He recommended that I don't, stating that ADT has its own longer-term negative side effects (cardiovascular and bone weakening among others). And this is with a higher Persistent PSA.


Yeah, that's why I'm wanting to see the evidence for 6m v. 9m or longer.
Has anyone on ART/SRT consulted an MO about length of ADT? I'm wondering if an MO might have a better handle on this than an RO.

Thanks for the post Saipan Paradise ... yes, my RO is suggesting I not only continue with ADT, but also consider throwing in some Chemo ... eventhough I never had a PET scan prior to show METS ...

That said, I decided to discontinue all treatment for now... and see where I stand.

@Skypilot - I have the same leaking problem... I sometimes throw some toilet paper in my unddies if I don't have a PAD and I really need something to reduce the wetness

@John_TX - I current have only high deductible health care... so I'm not planning to see a doc for a few months.. are you still having hotflashes? ...

@Artist Mark -- so are you saying 6 months AFTER your 6 months if over, or a total of 6 months?

Also, any suggestings on when should I get my PSA tested again? ... I had my Luptron shot in OCT, My radiation in Dec, Jan, Feb ... and now it's April ...

Best
Zzarth
Posted 4/11/2018 6:14 PM (GMT 0)
Zzarth ,
Were you getting 1 month shots,3month shorts? If one month ,then you would wait one month and then start counting. It would mean then 7 months (about). Like I said .. everyone is different it could take less or longer. I'm no expert but that's my understanding
Posted 4/11/2018 6:35 PM (GMT 0)

Zzarth said...
@John_TX - I current have only high deductible health care... so I'm not planning to see a doc for a few months.. are you still having hotflashes? ...I had my Luptron shot in OCT, My radiation in Dec, Jan, Feb ... and now it's April ...

Best
Zzarth


My T level recovered fairly quickly from Lupron, I think it was in the low 300s about March or about nine months after the injection. Once my testosterone recovered, the side effects dropped dramatically. As I recall hot flashes were the first to stop but it took maybe another 10 or 12 months to be completely back to my old self.
Posted 4/11/2018 7:24 PM (GMT 0)
I got a 6 month shot in OCT ...

Also, Ive gotten sick with a chest cold twice now since my radiation ended in FEB .. is getting sick after treatment common?

Zzarth
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