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Post RP treatment for stage 3 high risk PCa

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Posted 4/5/2014 7:01 AM (GMT -5)
Bob,

I've had surgery, adj radiation, spot radiation, hormone therapy, and a few other fine drugs...I'm currently not on HT. I've experienced both sides of the equation. None of these therapies is like going through chemo, for instance....where I think QOL issues are a bigger issue.

So really, what QOL issue(s) concerns you? Sex? Hot flashes? Gaining weight?

Jerry
Posted 4/5/2014 2:14 PM (GMT -5)
Jerry

My urinary tract is as good as it can get after RP, and after 13 years of BPH related problems. I don't want radiation to screw that up or cause rectal problems.
Since everything I've read says there is only a slight 5 yr. progression free survival advantage of HT + RP vs. just HT, and RT confers no overall survival advantage, I don't see any reason for risking the side effects of having RT.
So now I need to find a good oncologist since I assume they are the ones that prescribe HT. Or is a urologist the go-to guy?
Bob
Posted 4/5/2014 3:24 PM (GMT -5)
Bob,

I would think a urologist would give you the Lupron, or equivalent, shot...at least mine did...If your talking additional drugs like Casodex , Avodart, etc... these can be prescribed by either.

I wonder what the stats look like for your radiation concerns...does that happen often? I've had zero side effects so far from all the radiation I've had.

I hear what you're saying...
Posted 6/23/2014 9:35 AM (GMT -5)
Reporting back here on further treatment in case anyone is following, although I have also done so in another thread.

After psa went to .3 eight months post op from .2 at five months, I decided to bite the bullet have ADT and SRT in accordance with guidelines that indicate that two successive readings of .2 is considered biochemical recurrence. Being stage pt3b I could have elected to have neoadjuvant ADT and SRT but chose to wait for recurrence.

So far the three month 22.5 gm. Lupron shot SEs have been tolerable: mild Hot flashes, mild fatigue, diarrhea and urinary frequency. Diarrhea has been the biggest pain in the ass due to worsening hemorrhoids (no pun intended), but Imodium has helped. No SEs yet from SRT after 34% (13 of 38) of sessions completed.

Next decision is how long to continue with Lupron
Bob
Posted 6/24/2014 6:58 PM (GMT -5)
Hi Bob. This will be my next big decision. RT in a couple of months or SRT later on. I saw the radiation oncologist today, he was all for the adjuvant radiation.

It's certainly been an interesting thread to read through.

I hope you're keeping as well as can be expected and the diarrhoea clears up.
Posted 6/25/2014 5:45 AM (GMT -5)
Ronnie44
It's pretty clear that us pt3b guys will need more treatment after RP. At least we don't have the infected prostate to give us trouble later and we know exactly what we're dealing with. Good luck with your next treatments. They aren't all that bad after all ( at least so far)! I find the decision regarding duration of ADT to be the most perplexing; there is no consensus on this subject. Trials are underway now but won't be completed for a long time...too late for us.
Bob
Posted 6/25/2014 8:40 AM (GMT -5)
Bob,

it looks like you were considering ADT only and then decided on ADT + SRT. What finally convinced you? I am having similar thoughts being a Gleason 9. Mostly I am wondering if the potential benefits of SRT outweigh the risks.

Best wishes for your treatment,

Tom 

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