Going to see MO on Wednesday with my husband. Stage 4 prostate cancer.
Gleason 4+3. Has spots on his pelvic bone and retroperitoneal. Just completed his radiation July 3 (5 txs at each location) How soon can one find out if the radiation has worked? Is there a period of time we need to wait? Anyone know?
It depends what you mean by "worked." Metastasis-directed therapy is rarely curative, but it does provide local control (to the treated mets). You should see your PSA go down within a month and your bone scan/CT show less active growth. You should continue with your hormone therapy.
Thank you Tall Allen for your response. I seek them out. I did not know that radiation treatment directly to the cancer on the pelvic bone did not kill it completely (if one could only be so lucky). Only ‘less active growth’ can be expected is what you are saying. Ugh
It is a mistake to think the metastases that you can see is all there is. You have to treat what you can't see too. Some doctors, who should know better, make promises that the evidence does not support:
Hello Cloc. This was explained to me by my oncologist. When a cancerous prostate cell goes into the blood stream, it has an affinity for bones around the pelvis. It attaches to the bone, then sinks into the bone (over time) where it is "trapped". This leaves a pock mark on the outside of the bone, but also weakens the bone. So you can look at the bone microscopically and count the pock marks per square milometer, to see how far your metastases has advanced, or an easier test is to do a bone density test. If you need shots for bone density they are available for people with osteoporosis. I used three of these shots in the first few years. When a prostate cell (normal and cancerous) subdivides an enzyme is released which is measured by the PSA test. Testosterone must be present for the cell to reproduce, so keeping a very low testosterone level helps prevent tumors from forming, So I used Lupron shots every 3 months to tell my body to stop producing testosterone. It fools your pituitary gland in signalling your body to NOT make any androgens. Some men are resistant to androgen therapy and must use other drugs. In fact one person said that eventually all men on Lupron will become resistant, So let us know how you are doing and remember this disease moves slowly. In the last 15 years there have been major changes in therapies, so keep checking-in. Also, there are many kinds of prostate cancers (PCa), in different locations in the prostate, different aggression, different treatments, different insurance companies, and different ages. So whats good for the goose may not be good for the gander, we can only share our experiences. So keep truckin'.
Thank you Jim Really appreciate the explanation. The doctor recommended a bone density test. What does the bone density test determine?
Long term use of Lupron causes bones to lose their mineral content. This leads to a condition called osteopenia and then osteoporosis, which can cause fractures. The bone mineral density (BMD) test (usually a DEXA scan) shows how opaque the bone is to X-rays. There are drugs, Xgeva and bisphosphonates like Zometa, that help maintain BMD. Estrogen patches (with tamoxifen) can be used to help maintain BMD. It is also important to maintain a good exercise regime (both weights and cardiovascular).
Wait for a PSA rise or Radiate Now- how did you choose?
First visit in a long time. 
How fast should your PSA drop after the first ADT treatment.
wait time for radiation 
Which scan(s) and how do we ask?
