Radiation Plan

Yeah, he did good after his radiation in 2018 and we were hoping and praying that would be the last of it. But then this year the PSA started bouncing around. Ik we had to wait for it to be at least .2 to see anything. It just makes me angry, in a way. I am thankful that things have gone fairly smooth since he was diagnosed in 2021, but still. It gets frustrating and I want him to stay positive and not let this get in his head. I also have not said anything to him yet as I want all of the information to be accurate. I feel like I am somewhat prepared now, so that helps. This forum is amazing. It truly helps to talk with people who have gone through, or are going through similar things. Very helpful. At the same time I hate that so many are battling this.

We saw the Dr today. He was very nice and very thorough! He felt dad all over, pushed on bones, etc.
It looks like there is a mass in the prostate bed again. It was gone after radiation in 2018. Actually, when the biopsy was done in 2017 of the prostate bed there wasn’t a mass there so this is an unusual case that something came up there again. Dr. said that it was so unusual that he called the radiologist and went over it on the phone with him but the radiologist is certain it is a cancerous mass by how it lit up. Dr thought maybe it was something benign, or tissue. I believe he said it was around 3cm. They cannot do more radiation there since they already did. (Imagine Dad being unusual!)
So there’s that and then there are 3 very small spots on the ribs.
Dr. said this is not horrible and that Dad should live for many more years and something else will likely be his cause of death.
His suggestion is to wait and see what the PSA is at next check. He can start hormone therapy now which will shrink it all to where it is not detectable, or he can wait and see what next couple PSA readings are and then start.
There are 3 levels of hormone therapy so he said they would utilize all of those before chemo would even come into play, which he said would be years down the road.
I think I would want to start hormones sooner than later and knock this out, but we will also meet with the urologist and get his opinion (as oncologist suggested because they work closely together).
So all in all good news even tho some things have popped up.
Hopefully that covered it all but if you have questions let me know!

Exactly what we think. I say start the Lupron and halt it right away. Idk the difference between zapping the small spots or just letting the Lupron stop them, and from what I understand, making them disappear. Maybe that’s it, maybe the radiation would kill it and Lupron just makes it disappear but doesn’t kill it??
The mass in the prostate bed worried me but the dr didn’t seem worried at all and he said the Lupron would shrink it and stop growth.

You have been staying on top of things and with a PSA of only 0.3, one wouldn't expect there to be distant mets. I suppose the good news is that the PMSA scan could detect them at such a low level--previously you would have had no idea. And presumably that also means any mets are early and small and you have a better chance of punching them out.

As to the Lupron, your dad would have to be very unlucky for it not to work. A bigger question might be for how long will it work, but there are guys here where it's worked for 10 plus years and still going. This obviously isn't good news, but it sounds like your dad can keep this at bay for quite some time.

My recurrence started 8 years after surgery in 2009 until it reached 0.13 in June of this year. I had 8 weeks (39 sessions) on IGRT/IMRT. I'll be getting a PSA test in mid December hoping it will go back to zero. I'll turn 80 years in 4 days and hope to avoid ADT.
I would like to know if your Dad's PSA ever got to undetectable. What was the nadir? I wish your Dad's the best.

Dads lowest PSA after radiation was .04.
Good luck to you!

Ed C. (Old67) said...
My recurrence started 8 years after surgery in 2009 until it reached 0.13 in June of this year. I had 8 weeks (39 sessions) on IGRT/IMRT. I'll be getting a PSA test in mid December hoping it will go back to zero. I'll turn 80 years in 4 days and hope to avoid ADT.
I would like to know if your Dad's PSA ever got to undetectable. What was the nadir? I wish your Dad's the best.

Yes, his PSA had gotten to undetectable after prostate removal and then for a couple years after salvage radiation and a couple of Lupron injections with the radiation.