Advanced Prostate Cancer
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Waiting to Seed

Hi, I'm 54 and was diagnosed with Gleason 9 PSA 43 Prostate cancer on 9/11/17. It took me a while to get the Oncological team together. I just started Lupron therapy a few weeks ago and so far the symptoms are tolerable. Right now I am awaiting the results of an MRI that will determine if I am a candidate for radioactive seeding. Of course, my doctor is on vacation and won't be available to read it until Tuesday. If there is too much cancer, then I'm not a candidate.

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Eric, I think it's more a question of WHERE the cancer is rather than HOW MUCH. Seeding is usually limited to the prostate itself...although a few artists have seeded lymph nodes, I think.

herb

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Check to see if there is HDR (high dosage radiation) in your area. I believe it's quite new.

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High Dose is where they put tubes into your prostate, check for placement, and then slide radioactive seeds into the tubes. I think that they can vary the position of the seeds in the tubes, and then they remove the seeds before you leave the (hospital). I don't know how much of this is new. Some of the techniques might be.

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I don't think it is all that new. I read some time ago that a previous CEO of Intel received this treatment after he did extensive research on the most promising treatment options. I believe it was successful for him.

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Yes. That's the technique I'm waiting to see if I'm a candidate for. The cancer has grown out along the seminal vesical and may be too far outside the prostate for the therapy to be effective. Still, I'm going to a very skilled Doc by reputation. His partner actually called me last night, long after hours to reassure me that there wasn't anything new or particularly "bad" about my MRI. He said he'd have to wait for his partner (The seeding wizard) to evaluate the MRI for Brachytherapy. It's my understanding (I could be wrong) that the seeds remain in and cook off the cancer over time.

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Hi Eric, Please see my history in profile. Oncologist recently told me she wouldn't have recommended brachyterapy (radioactive seeding) for intermediate risk cancer, since I had been reclassified from Gleason 6 to 7. You might consider getting an opinion on treatment options from an independent Medical Oncologist - other than the doctor who would perform your brachytherapy.

All the best. Many helpful and knowledgeable folks in here to help.

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Eric, I tend to agree with Dr_Who & LF27, it may be in your best interest to obtain a second opinion. From what I understand if the radiation should not capture all the effected tissue, surgery after radiation is extremely risky due to excessive bleeding so it’s typically not recommended, yet with surgery as an initial choice of action, radiation can still be performed and would not cause any unnecessary risk. I underwent a laparoscopic robotic RP and during the same procedure my doctor removed 55 lymph nodes from the immediate area. Five of those came back positive. My pathology report was also updated as most typically are after surgery where they can actually dissect the tumor. I went in as an 8 and came out as a 9. So, you may wish to discuss any of your concerns further with your doctor or possibly even obtain a second opinion, most respected physicians welcome it. By the way I was diagnosed at age 54 as well, just about a year ago, November 2016.

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Hi guys. Thank you for the advice. It turns out I am not a candidate for brachytherapy because there is some cancer on the seminal vesical. That is also why the first surgeon told me I was not a candidate for surgery.

However, I took your advice and a second surgeon in Seattle is looking over my chart. I agree, as I am learning. I think surgery first is a better course. I had my markers put in but I told the radiologist they'd have to wait with radiation until I get that second opinion. Thus far I am told that having the markers in for a month or longer before radiation won't make a lot of difference.

I did meet the radiologist, a very nice doctor. He was very encouraging.

Stay in good health everybody.

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Best wishes to you and your wife, Eric. My Canadian-born hubby is also a former ice hockey guy. Y'all are a tough breed. :)

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