HealingWell
Search Close Search
☰

Father 80 years prostate cancer

Support Forums
>
Prostate Cancer
✚ New Topic ✚ Reply
1 23
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 11/21/2019 3:31 PM (GMT -5)
Thank you Mumbo i appreciate your reasurance. Did you made one?
Posted 11/21/2019 5:36 PM (GMT -5)
My doctor sent me for bone scan and abdomen CT after MRI guided G7(4+3) biopsy results. This is a somewhat standard screening practice with the higher risk cases by urologists to make sure there is no obvious spread prior to treatment. I believe they don't do this very often with the lessor risk levels but it is not unusual to be done.
Posted 1/14/2020 4:40 PM (GMT -5)
Hello,

Just to update how the treatment of my father will be done. The doctor ended up agreeing with me with the fact that he does not need hormone therapy being the cancer in early stages and not having any sign of metasteses in the bones. But i HAD TO DO a honest conversation with him and to consider the risks were not worth to even try since his cancer his not the case for it. I even got a second opinion from a doc who said that my Father would even rather be on active surveilance, not needing any therapy. But we decided it is better to do it now, and not when my Father is 90 years old.

First thanks to all, because all your feedback helped us to do a good research before deciding whatever treatment.

My Father will start radiotherapy soon, he was prescribed by the radiologist doctor simethicone 160mg 3 times a day and picosulfate sodium 5-8 drops a day to maintain the rectum size stable avoiding gases. Is this type of medicantion normal during all the treatment? Would like to have your feedback.

Also was advised to do some diet avoiding foods that generate gases in the digestive system like onions, garlic, fried food, beans, etc.

what about probiotics are they safe? like sacaroumyces boullardy yeast and lactobacillus and others?

thank you all i appreciiate your feed back
Posted 1/14/2020 5:45 PM (GMT -5)
Yes, as Mumbo says, bone scan is not very sensitive. Very questionable it would pick up anything at PSA of 7.5. Some say a PSA closer to 20 is needed. I've had four bone scans during my PCa career, with no detection - even at a PSA of 64. It did pick up on the arthritis in my neck and shoulder.
Posted 1/14/2020 5:46 PM (GMT -5)
Good to hear things are moving along for you and your father. What type of radiation treatment is being proposed? Standard IMRT is 40+ treatments?

Full bladder and empty colon is the rule for standard radiation treatments. If either is not acceptable to radiation oncologist, treatment may get delayed by drinking more water or having a bowel movement/passing gas prior to treatment. In some cases, they send you home to try again tomorrow. It is all about bladder and colon being in the correct position relative to the prostate to minimize radiation exposure. Gas expands the colon and can be seen in the CT scan before each treatment.

Reducing gas and staying away from gas producing foods is usually recommended. The drugs help reduce gas also. The techs recommended gas reducing meds the first week of treatment for me once they noted some gas a couple of times.
Posted 1/14/2020 7:11 PM (GMT -5)
Mumbo, Mattam thank you for answering. Mumbo thank you for the details on the therapy.

Yes i forgot to say, my Father will be doing 3dcrt, is this IMRT? Is it effective? Should i ask the radiologist to be more specific?
Posted 1/14/2020 7:17 PM (GMT -5)
My Father was advised to take the meds during all the months of treatment, Five sessions a week during 2 or 3 months, i am not certain now, is this usual?
Posted 1/14/2020 8:38 PM (GMT -5)
bone scan = ka ching...the rest is twaddle...he will not die of pca in any scenario...How do I know...cause I stay smaat…next...
Posted 1/14/2020 9:56 PM (GMT -5)
In the not too distant future, bone scans may be replaced with scans that can detect mets in both bone and soft tissue, such as 68Ga-PSMA-PET. Although bone scans are still routine for high-grade PCa, AFAIK, they are not standard for care for G6 or G7 (3+4) and considered an unnecessary expense in those cases. Of course that decision can be reconsidered if a slide review results in an upgrade to an unfavorable intermediate G7 (4+3).

Djin
Posted 1/14/2020 10:13 PM (GMT -5)
I have no knowledge of 3dcrt but can search the internet.

https://www.ncbi.nlm.nih.gov/pmc/articles/pmc4865138

IMRT is considered a better choice for PCa to minimize side effects.

Primary radiation treatment can be 40+ treatments so at least two months. There are RO’s doing it in 25-30 treatments at a higher dosage which seems to work ok with proper precautions but is a newer protocol.
Posted 1/15/2020 12:06 AM (GMT -5)
Thank you all. What about this study?
Comparing IMRT vs 3DCRT it says:
It depends... Altough they say IMRT can protect the surrounding tissues better because of the doses, in the end it could be choosen 3dcrt? I dont understand, can anyone help to understand this comparison?
What do you think?
Quote from:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3804479/
"When the doctor decides to give to treatment planning volume a total dose which creates the possibility to have dose for the organs at risk under the dose limits it will be preferable to use 3D CRT technique because it is less time consuming for QC and more comfortable for the patient which in this case has to stay less time in the machine during the treatment. For the cases when the doses which have to be given to the treatment planning volume will be large, around, 70 Gy it will be use IMRT technique as the best solution for keeping the doses to organ at risk in the permitted level."
Posted 1/15/2020 12:21 AM (GMT -5)
Also this study seems to say that, up to 74 Gy, the 3dcrt is more safe? Is that right? Or am i reading wrong?

"https://ejrnm.springeropen.com/articles/10.1186/s43055-019-0021-z"

"The selected plan also is more safe on patients up to 74 Gy compared to IMRT and RapidArc plans, reducing normal tissue-irradiated volume and reducing toxicity as one of IMRT disadvantages is the presence of secondary malignancies due to the large irradiated volume with low doses during treatment"
Posted 1/15/2020 12:25 AM (GMT -5)
Finally i also found this study wish says no difference in safety and outcomes between IMRT and 3dCRT:

"https://www.healio.com/hematology-oncology/prostate-cancer/news/online/%7B14f379fe-38bb-4691-8541-70464cec1db1%7D/imrt-3d-crt-confer-similar-patient-reported-outcomes-in-prostate-cancer"

Quoting:

"Intensity-modulated radiation therapy was not associated with improved patient-reported bowel, bladder and sexual function outcomes compared with 3-dimensional conformal radiation therapy given in similar doses for prostate cancer, according to study results."
Posted 1/15/2020 12:37 AM (GMT -5)
I've not heard of 3dCRT being used on PC. That's new to me.

8 years ago I had IMRT/IGRT with a RaidArc. I've had a few bowel issues that were treated and cleared up, but nothing more.

Likely he'll do just fine.
Andrew
Posted 1/15/2020 12:41 AM (GMT -5)
Thanks for reassuring Andrew.
Posted 1/15/2020 9:16 AM (GMT -5)
Keep in mind that IGRT/IMRT and SBRT are most current forms of radiation treatment and have the most precision/accuracy of the beam. I believe 3DCRT is older technology with less control.
Posted 1/15/2020 9:32 AM (GMT -5)
Here's a 2019 Brazilian comparison study of 3DCRT and IMRT for PCa:

http://www.scielo.br/scielo.php?pid=S1677-55382019000601105&script=sci_arttext

"Materials and Methods:
Between 2010-2017, 485 men with localized prostate cancer were treated with conventional radiotherapy schedule with a total dose ≥74Gy using IMRT (231) or 3DCRT (254). Late gastrointestinal (GI) and genitourinary (GU) toxicity were retrospectively evaluated according to modified RTOG criteria. The biochemical control was defined by the Phoenix criteria (nadir + 2ng/mL). The comparison between the groups included biochemical recurrence free survival (bRFS), overall survival (OS) and late toxicity.
...
Conclusion:
IMRT reduces significantly the risk of late GI severe complication compared with 3D-CRT using conventional fractionation with a total dose ≥74Gy without any differences for bRFS and OS."

Judging by recent studies, 3DCRT appears to be more popular outside the U.S.

Djin
Posted 1/15/2020 11:19 AM (GMT -5)
Just spoke with a different specialist well known in my country here on europe. I showed him all the studies showing that IMRT has less toxicity risks compared to 3dcrt. Be agreed with it, but said that the dose and the rectum position and many other variables must be measured and sometimes 3dcrt altought more conventional than IMRT has the same toxicity and effectiveness has IMRT depending each person and prostate câncer conditions. 3dcrt is also more fast and less complex. He was very kind explaining me that it was no problem doing 3dcrt altough when the rectum is too close to the prostate in nature, IMRT is used without doubt. In the end he was kind enough to provide a recent study were the two systems have no difference on tox, effect parameters depending of the circimstances like dose, physical conditions and other as i mentioned above. The study is here:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4490066/

I would appreciate your comments about this study. See the conclusion and give me your toughts.
Posted 1/15/2020 11:24 AM (GMT -5)
https://www.ncbi.nlm.nih.gov/pmc/articles/pmc4490066/
Posted 1/15/2020 12:13 PM (GMT -5)
lotsa good info for forum and isitlyme...none of it relevant to Dad's situation... a way for forum members to show and share their knowledge...again none relevant to Dad...it does show 2nd opinions are sought to get what the threader wants to hear...much like posing questions to forum members and when a member presents what they don't want to hear...being offended...hurt feelings and rolling eyes from most forum members...some times...edits and/or down right removal of the "offensive" post (usually with little notification or none)...intentions are great...both parties doing what they feel is what the other person wants/need...when in truth neither person wants or needs what is given.. a final quote with just the beginning...the road to hell yada yada yada...my response may be misunderstood...as well my intentions which is just another paradox of paradigm and so ot goes
Posted 1/16/2020 4:37 PM (GMT -5)

logoslidat said...
lotsa good info for forum and isitlyme...none of it relevant to Dad's situation... a way for forum members to show and share their knowledge...again none relevant to Dad...it does show 2nd opinions are sought to get what the threader wants to hear...much like posing questions to forum members and when a member presents what they don't want to hear...being offended...hurt feelings and rolling eyes from most forum members...some times...edits and/or down right removal of the "offensive" post (usually with little notification or none)...intentions are great...both parties doing what they feel is what the other person wants/need...when in truth neither person wants or needs what is given.. a final quote with just the beginning...the road to hell yada yada yada...my response may be misunderstood...as well my intentions which is just another paradox of paradigm and so ot goes

Logoslidat are you angry with someone or something?

All the info given so far by all to me were usefull and some were also the opposit of what i thought, but they helped me to search for the right info. So i dont know what you mean.
Posted 1/16/2020 6:18 PM (GMT -5)
Logo is an acquired taste...he is not mad at you...you can find justification for any position if you look long enough...always keep your father in mind...mumbo out
Posted 1/16/2020 6:31 PM (GMT -5)
I agree. Thank you. Recently i found on a news site that medical error was the third major cause of death on America. But i believe things are not different in all parts of the world for sure. From my experience i've seen that, been there. Being much more cautious with doctors since i read that and it was really nothing i would expect to hear or find.. my instinct says now: triple check, be it with 10 opinions, be it on forums or whatever. Thank you all for the help.

Post Edited (isitlyme) : 1/16/2020 4:35:54 PM (GMT-7)

Posted 1/16/2020 8:48 PM (GMT -5)
Iisit…..you just proved my point...…...........ironically and what amazes me is you saw from my words an indictment on poor lil you rather than your dad...my main point...your dad has nothing to worry about...you have nothing to worry about...whats that all about...I could tell you but you already know don't you...look daughter its about your dad...he is the one with the disease...not you...he is my concern not you...simple as that...( I do not see any mention of any mental acuity with your dad...that insert of data would be critical if there were)the rest of the forum is more "polite" than I and would never be as frank as I am...I could give a rats behind about traditional sources of decorum...ya know what I mean jellybean>>> Harsh...shocking....consider it an inoculation(they sting)but with most..things get better...you may be " immune try see your dads pov and encourage him to partake then...when WE say "we " decided...it will mean something...he is going along with you be cause it is what YOU want...can you grasp that...ok onward and up ward...much ado about nothing...to be or not to be yada yada blah blah ...ps don't justify it weakens...yes I love argument..as in a court of law...its how we learn...regards...pretending to be an angry and ma aaad logo as a symbol of solidarity
Posted 1/16/2020 8:48 PM (GMT -5)
That is a good example of a study that is probably misleading and repeated many times. There is no accounting of people who die of medical errors so some researchers try to extrapolate the value from some minimal data and compare it to a listing put out by the CDC who supposedly gets a good reporting of death by cause from those who report to them, apples vs. oranges. It happens too many times but add all the cancers, accidents, suicides, etc up and it is a big number.
✚ New Topic ✚ Reply
123