External Radiothereapy

[Nuray]

Hi folks,just completed my first week of Radiothereapy?got four and half weeks left?i want to get aggressive treatment towards my cancer recurrence?all Dow my current PSA is 0.13 still considered low and within the guide lines?after finishing Radiothereapy folks want to start Chemo ASAP folks?why wait till the cancer strikes first??and input would be appreciated folks??

[YostConner]

Although the standard of care in the U.S. is not to use chemo early (it's different in some countries), there are indications that early chemo treatment can be useful. Do you have a cooperative medical oncologist?

[Nuray in reply to YostConner]

Hi yostconner,no I don't have cooperative Onc unfortunately?our most experienced Onc all gone private,our free health service here ok?but when it comes to cancer?most experienced Urologist consultants are for the privileged few?i think most we can hope for with cancer is a good remession at best? At its best is a cure?but cancer recurrence?think we should take control of are own life's?? Rather then following the normal protocol service which most Onc and Urologist take..

[Dr_WHO]

More common is to start hormonal therapy before or during radiation (as was the case for me). You may want to discuss the use of something like Lupron before you finish radiation. Also, there is some data pointing to positive outcomes with the trifecta: radiation, Chemo and hormonal therapy. In any case, good luck!

[Nuray in reply to Dr_WHO]

Hi Dr who,yes I totally agree in your view to?aim also on Prostap injections?which I demanded from my Onc doctor to?to early to see if any changes will be in my favour Dr who? But positive thinking and taking your own decisions and helpful knowledge from some gentlemen on this forum is a big plus👌

[JamesAtlanta]

There was a study about 2 years ago (called the Stampede study) that concluded starting chemo early extended life expectancy almost a year. The study came out right after I was diagnosed, 2 years ago next week, and I had 6 rounds of chemo (plus radiation on my spine and started Lupron). My PSA went from 227 to undetectable. And remains today at 0.8. When I visited MD Anderson a couple of months ago they said this is the standard approach now. I'd recommend it I'm glad it started it early

Hope this helps. Our prayers are with you! 🙏

[Dr_WHO in reply to JamesAtlanta]

Yes, I tried to get my team to give me chemo in addition to radiation and hormonal treatment. No go for me.

[motosue in reply to Dr_WHO]

What was their reasoning?

[Dr_WHO in reply to motosue]

Wish I could tell you. While competent, they tend to treat everyone the same. It is very hard to get them to change from their established treatment options. For example, I am still fighting to get scans in addition to PSA tests even though the pathologist stated at least 30% of my cancer does not produce PSA.

[Nuray]

Thank very much, for your input James,I also totally agree with aggressive protocol on prostate recurrence cancer?why wait for your Onc to give you watchful waiting till cancer spreads to most organs?think it clear thinking that's going to give you precious time to spend with you loved ones??no ones knows which way cancer will go?and you can't underestimate cancer Mutations either?aim going to express my views to my Onc, in londons Barts hospital this my wishes and direction I want to go?

[jorton in reply to Nuray]

Get a referral to Marsden for a second opinion they will agree with this protocol of docetaxol followed

By radiotherapy and you will get it

[jorton in reply to jorton]

My brother in law Gleason 9 mets to pelvis just had docetaxol and now on radiotherapy this is what we did

[Burnett1948]

Burnett1948. I am in a similar situation but I am not as adventurous as you. I had Radiation in 2009 after my PSA reached .4 following my surgery in 2005. It is now 1.5,; I have told I have biological recurrence. My Gleeson was 3+4=7 back in 2005. To help me understand whats ahead of me what was your Gleeson score when you started treatment? Thanks.

[Sisira]

Your willingness to start chemo ASAP ( If you know the side effects and know how to handle them ) and the attitude "why wait till the cancer strikes first" will definitely help you to hold the bull by its horns. With this attitude 50% of your cancer is cured! and for the balance 50% you must have a good oncologist (Who will listen to you and who treats with the intention of healing). Efficacy of radiation is said to be higher when combined with hormone therapy ( I have done so ) and also early chemo therapy is more synergistic with hormone therapy ( I didn't take chemo since my favourable pathology didn't require ). Since the treatments you are talking about are aggressive, it is somewhat difficult to evaluate them related to your specific case in the absence of a clear picture as to your diagnosis and pathology. Your age and overall health too are vital information. Nevertheless you have collected some useful advice from our brothers here. Best of luck for fast forward!

[hadleycash]

Before doing chemo, I would recommend getting genetic testing done. I did, as I am a Gleason 9, and turned out to be BRAC 2 positive. When I become castrate resistant, my next step will be adding in a PARP inhibitor, which is far more effective for BRAC 2 PC. If possible, I would want to know the genetic makeup of the PC before going into chemo. That said, if genetics don't advise otherwise, the chemo could be a good next move

[Hidden]

Congratulations on making a decision that you will not retreat. I got very aggressive 13 years old with Stage 4 and chemo. Today, even without Lupron for the past 7 years, still enjoy undetectable PSAs.

Attack while your body is strong and the tumor burden low!

Keep kicking the bastard,

Gourd Dancer

[Nuray in reply to Hidden]

Gourd absolutely mate?why wait till the cancer cripples yr body?kick it hard and strong and then hope it blows them all up 👍

[motosue]

Doctor put me immediately on Lupron first , then my other doctor gave me Chemo, then radiation(both external and High Dose) . Took them consecutively from each other. Been almost 5.5 years now and still undetectable.

:-). Thank you Jesus!!

[motosue]

Forgot to mention that my PSA was about 6.5 , Gleason of 4+4=8. Stage 4

[Nuray in reply to motosue]

Hi motosue,my before removing the prostate cancer PSA was 15.1 Gleason 4+3 7 they assured my my cancer was confined within the prostate waited another three months to find out my biopsy results confirmed my worst night mare ?postive margins spread from T2a before surgery to T3a TNM bone clear nodes clear seminal vessels involvement??