Husband Diagnosed 2 months Ago

compaid said...
Limit drinking to less than 2 glasses a day or none if having radiation treatment appears to be ok . Or go zero alcohol versions mostly. Plenty of good ones about. Avoid grapefruit juice. Seems to be bad for us dealing with cancer. Doubt if minimal amounts like you say is that bad but docs say avoid. It's an irratant.

Thank you. Didn’t know about the grapefruit juice! Hopefully I can get him to just have a glass of wine at dinner on weekends only.

Thank you JBlo and Mumbo.
His glass of wine is a bit more than the normal restaurant pour. I have to stop trying to downplay that in my mind. I was hoping that when I asked the MO if the wine needed to stop she would have said yes. Instead she told us the 3-4 glasses a week should be ok but of course zero would be better.
He ran with the should be ok answer.
Maybe once the radiation begins he will back off of it completely. I will certainly encourage it.
JBlo- we opted not to have the surgery and instead chose the ADT and radiation route. The RO stated that he was confident he and the MO
could achieve the same results as surgery followed by ADT/ radiation. I hope and pray we made the right decision as well.

Thank you Halbert. I have a tear rolling down my face after reading your kind and reassuring words.
You and everyone else in this forum are and will remain in my prayers. ❤️

Yep, the drug plans and their formulary's in conjunction with the auto-pilot nature of doctors electronically placing prescriptions with your preferred pharmacy leads to all sorts of cost problems.

My wife and I try to always get a printed prescription for any new medicine, look it up on GoodRX, and then talk with our pharmacist directly about their best cash price vs. insurance plan cost to make the best decisions. Even if you get the prescription filled at your pharmacy at a higher cost, you can take the prescription bottle/box to another pharmacy and they will get the prescription transferred for you.

You can use GoodRX coupons in lieu of Medicare insurance for a specific drug. It is a cash purchase at their discount rate and the pharmacy does not file against Medicare insurance.

Proprietary cancer drugs sometimes can only be obtained by oncology pharmacies so shopping is waste of time but never hurts to check. Zytiga has a generic equivalent so they have lost that power. If you search for Orgovyx, all you will get is bad pricing. GoodRX has a $300+ price listed at Costco here but if you type it into the Costco member website, it is $169.99 for 250mg. If you search for Orgovyx, all you will get is bad pricing.

If you can change Medicare Part D drug plan, AARP/Walgreens has it much cheaper in MN and other places. Every drug is a new pricing adventure.

My husband had his pre-radiation MRI yesterday. Was told to be used more so to target radiation in areas of the prostate where the bulk of the cancer was. Results posted on the app were pretty alarming. I will paste below. Keep in mind he had a cystoscopy along with his biopsy a few months ago. However a CT scan after the biopsy questioned something in the bladder as well. Very worried and have a call into the radiation oncologist. I haven’t shared any of this with Mark at this point. Don’t want to throw a wrench into his positivity.

CLINICAL HISTORY:
Age: 66 years. Gender: Male.
The indication for the exam from the referring provider was:
"PROSTATE CANCER;." Additional history: History of high-grade
prostate cancer.
PSA level: 54.5 ng/ml (10/11/2022)
Prostate biopsy date: 07/21/2022
Results of biopsy: Gleason 4+4 = 8 involving 12/12 cores.
Prior therapy: Abiraterone and Casodex. Lupron.

COMPARISON:
PET dated 08/29/2022.

TECHNIQUE:
Multiplanar, multisequence MRI of the prostate gland was performed
with the use of an endorectal coil. The sequences were obtained prior
to and after the uneventful administration of 18 cc of MultiHance
intravenous contrast.

The quality of the study is adequate.

FINDINGS:
Lesions:

Lesion 1:
location: The prostate gland is near completely replaced by
infiltrative malignancy. T2 hypointensity extending beyond the
posterior aspect of the prostate gland also likely represents tumor.
Size: 4.0 x 3.7 x 4.6 cm.
T2WI: Circumscribed, homogeneous moderate hypointense focus/mass;
T2WI score: 5
DWI: Focal markedly hypointense on ADC and markedly hyperintense on
high b-value DWI.; DWI score: 5
DCE: Positive (early or contemporaneous enhancement)
Extraprostatic extension: Present nearly circumferentially. There is
likely involvement of the urethra.
Overall PI-RADS score: 5

Prostate:
Size: 26 cc
PSA density: 2.1 ng/ml2
Benign prostatic hyperplasia: Absent
Hemorrhage: Present in the left peripheral zone and right seminal
vesicle.
Other prostatic findings: None

Neurovascular bundle:
Tumor invasion of neurovascular bundle bilaterally.

Seminal vesicles:
Right: There is tumor involvement of the right seminal vesicle
Left: There is probable tumor invasion of the left seminal vesicle.

Urinary bladder:
There is likely involvement of the base of the bladder. Additionally,
there is polypoid mass arising from the left posterolateral bladder
wall in the region of the left ureteral orifice measuring 1.5 cm with
associated diffusion restriction.

Lymph nodes:
No pelvic lymphadenopathy

Other pelvic findings:
A 0.6 m nodule along the left anterolateral bladder is indeterminate
but appears slightly increased in size compared to prior head
concerning for malignant involvement.

Skeleton:
No suspicious osseous lesions

IMPRESSION
* Lesion 1: PI-RADS 5 - Prostatic mass essentially replaces the
prostate gland and there is near circumferential extraprostatic
extension. There is involvement of the bladder base, bilateral
neurovascular bundles and seminal vesicles.
* Polypoid mass arising from the left posterolateral bladder wall
measuring 1.5 cm may represent a primary bladder malignancy; consider
cystoscopy for further evaluation.
* Indeterminate nodule anterolateral to the bladder may represent a
small lymph node.
* Calculated prostate volume of 26 cc.

Pitgirl…Sound information helps the treatment team make informed treatment decisions. That includes both good and bad findings. At some point we put ourselves into the hands of our treatment team. The folks at Hillman are one of the best teams available and I believe your in good hands.

On the subject of drug costs my wife and I have found Good RX to be good way to reduce drug costs. We both take Celebrex and through our insurance the cost was $285/90 days. With Good RX the cost was $28/90 days. Shopping around can save money. Best wishes Terry.

Pitgirl, i am late to this thread, i apologize, i have been MIA on and off for a while for various reasons.
Yes, thats a tough MRI. still, the Lupron will help stop the growth in its tracks, and the radiation will do its thing to help towards a good outcome. I am not an expert, so i dont want to speculate, but i'll just wonder out loud, if the doctors, in view of the extensive regional involvement of the cancer on MRI, might recommend adding chemo, such as taxotere, carboplatin, or both, in conjunction with the ADT, either during, or after, the radiation. Let us know.

Listen, this sucks, there's no way around it. But the advances in treatment of advanced prostate cancer in the last 5-10 years have been enormous, and there is every reason for you and your husband to hope for a good outcome.
One of our longtime members, Todd1963, was diagnosed at age 42, with a PSA of 3200! He had mets to his bones, and the cancer was all over the place. Today, he is in his 50's (late 50's i think?) recently retired and living large, enjoying life to the max. and he was diagnosed more than a decade ago. IMAGINE THE BENEFIT YOUR HUSBAND WILL HAVE, OF THE ADVANCES MADE IN TREATMENT SINCE TODDS DIAGNOSIS.

So, while this MRI is a punch in the gut, and you are allowed, maybe even expected to be upset about it, don't let it destroy your positive expectations. As Terry said above, put your and your husbands hopes in the hands of the doctors, they will do their thing, and i have a feeling, in a couple of years the two of you will be enjoying life, very much. Life will be different. But it will be good.

Good luck girl, your husband is lucky to have you..