Questions for Operaman

zumbles123 · Regular Joined: 24 Jul 2009 Posts: 15 Location: Powell

Hello. We emailed some time ago. Your pathology and my husbands are similar (without your tertiary 5). I know you started adjuvant radiation in Sept. Can you again mention your post op PSA and subsequent PSA and whether or not these were ultrasensitive. My husbands ultrasensitive PSA came back less than 0001. I did an online consult with Stephen Strum, who suggested monitoring this as opposed to adjuvant radiation because his number was so low, and ultrasensitive PSA's caught things early. However, the oncologist here recommends adjuvant, which, as you know, studies support. My questions to you: how is the radiation going for you? Have you read any studies re: effects of both prostectomy and adjuvant radiation on sexual functioning? I have only found one, and it is vague, at best. My husband is reluctant re: radiation,and we are soon to miss the adjuvant window if we don't decide. Thank you for your time. I hope you are doing well. Claire
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claire1

Operaman · Regular Joined: 01 Jun 2009 Posts: 24

My post op PSA got down to undetectable/0.0 depending on the test. I don't think I took the ultra sensitive one. As you have no doubt found all along the way, it is most difficult to find a definitive answer to much when it comes to PCa. I met with two excellent radiation oncologists, two excellent medical oncologists, and had significant communication with other physicians, including the well known surgeon who did my open RRP. There was very strong support for the adjuvant RT based on my path report. As you might have found there is a significantly better outcome regarding biochemical failure for men who do the Rt as adjuvant rather than waiting for failure and doing it as salvage. Based on these, and my feeling that serious side effects were quite uncommon, I decided to do the ART. I posted about my experience, please feel free to contact me if you have any questions.
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Bioposy March 2008 negative
March 19 2009 4+3=7 PSA 26 positive for 6 out of 12 cores
RRP May 20 2009 Path 4+3=7 tertiary 5
5% Mostly right lobe some left
Stage T3a 1 focally positive margin, clean nodes, clean vesicle, all tests for mets clean
June 22 PSA undetectable, course of Adjuvant RT completed in October with minor side effects, follow up in November

zumbles123 · Regular Joined: 24 Jul 2009 Posts: 15 Location: Powell

Thank you. I will look for your postings
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claire1

Operaman · Regular Joined: 01 Jun 2009 Posts: 24

Let me also add, if I may, that you may be feeling an unnecessary urgency about getting to the adjuvant therapy. I have seen some Doctors recommending a short window, but it seemed to my wife and I that most Physicians were giving as much as a two year window for the decision.

From what I recall there is most certainly an increase in ED risk associated with the RT. You can find the numbers for regular IMRT and pretty much apply them to ART or salvage. It is a concern, and if it is a major concern it may just be good enough reason to wait. What we had to consider was that after the post op PSA it could certainly be possible that I was cured, and RT is a serious and significant treatment to endure. You have to feel that the advantage received by doing it now will be considerable. It seemed well worth it to me. If I was not already cured, chances are mighty good that I am now.

The actual treatment had few side effects for me. It was most inconvenient to have to get the treatment 5 days a week for 6 weeks, but that was really the worst of it. I definitely suffered noticeable fatigue as the course continued. I ride a bike for exercise, and found that my max distance and speed were well down. I also had irritation of the bowls and hemorrhoids on and off. I was particularly uncomfortable if I did not watch my diet. Alcohol, caffeine, spicy food were all noticeable problems and if I had all three at once, a bad day or two ensued. I am now nearly two weeks after treatment and feeling better, mostly recovered. There are some long term late onset side effects. I will be watching to see what if any occur. For me, there was nothing in the treatment regarding side effects that wold have me choose not to do it in retrospect.
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Bioposy March 2008 negative
March 19 2009 4+3=7 PSA 26 positive for 6 out of 12 cores
RRP May 20 2009 Path 4+3=7 tertiary 5
5% Mostly right lobe some left
Stage T3a 1 focally positive margin, clean nodes, clean vesicle, all tests for mets clean
June 22 PSA undetectable, course of Adjuvant RT completed in October with minor side effects, follow up in November

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