Progress Summary of my journey

[GranPaSmurf]

(08/18/2019)

Last week, I saw my Radiation Oncologist. I signed all the forms to enter a study targeting oligometastatic prostate cancer patients - if early radiation treatment of the metastatic lesions improves survival times.

Of interest is that the prostate shows regression after about 2 ½ months of ADT.

The T6 lesion, however, does not. This brings into question the type of tumor being detected.

I have a biopsy of the T6 lesion next week.

At this point, I'm encouraged.

The primary tumor is noticeably regressed after minimal ADT.

Several weeks of daily radiation treatment to at least the primary tumor will start in a couple of weeks.

The PSA, though initially low, seems to be tracking with the primary tumor.

The single metastatic lesion at T6 will either be treated with radiation or, if found to be a new tumor type, is caught early, hopefully responsive to (chemo?) treatment.

Maybe the light at the end of the tunnel isn't a train after all.

ALKALINE PHOSPHATASE (08/15/2019)

Your Value

90 U/L.

Standard Range <116 U/L

PSA, TOTAL (08/15/2019)

Your Value

1.12 ng/mL

Standard Range <4.00 ng/mL

PSA, TOTAL (06/17/2019)

Your Value

1.2 ng/mL

Standard Range <4.00 ng/mL

((after only about 3 weeks of ADT treatment))

PSA, TOTAL (03/29/2019)

Your Value

2.14 ng/mL

Standard Range <4.00 ng/mL

((before any treatment))

[ed note] as an old Med Tech, having run and reported over a gazillion lab tests - I'm always uncomfortable with interpretations made from changes to the right of the decimal point.

Exerpt from CT Chest Scan (08/15 /2019)

Unchanged mixed lytic and sclerotic lesion of T6 vertebral body without new osseous lesions

Exerpt from CT Chest Scan (5/22/2019)

Mixed sclerotic and lucent lesion in the T6 vertebral body corresponding to increased radiotracer uptake on bone scan, likely representing osseous metastatic disease.

Exerpt from CT Abdomen Scan (08/15 /2019)

Interval decrease in in the size of prostate gland

(08/15 /2019)

((Lupron, 6 month, given May 29th, 2019))

[6357axbz]

Is this Dr. Tangs trial at MD Anderson? I’m in that trial.

[GranPaSmurf in reply to 6357axbz]

Probably. San Antonio affiliated with M D Anderson. Do you have any coaching or tips for me?

[6357axbz in reply to GranPaSmurf]

I hope you get selected for the group that gets the extra treatment, i.e., you get your mets zapped in addition to IMRT to the prostate. The Stampede trial did show improved OS for oligos who had radiation to primary tumor in addition to ADT. I believe that is now considered standard of card, at least at MDA. Try to get in the habit of exercising regularly if you’re not already. Greatly helps with any side effects from IMRT. Mine were minimal. Normal poop function was altered a bit but nothing serious. Most important is to get your “water ritual” down. You drink water prior to each daily radiation treatment to fill your bladder to just the right amount to lift it away from the prostate to keep it from getting damaged. I’ll send a link to one I found helpful in a subsequent post. I started with that and modified it a bit to customize for me. In general stay well hydrated during the day and night.

[Hidden in reply to 6357axbz]

Just be the first patient to start the day. If you miss your water in your bladder you screw up everything for a while. I was first at 4am only missed once because the wrath of the techs is mean.

[tango65]

Good plan. Best of luck.

thelancet.com/journals/lanc...

"In summary, radiotherapy to the prostate did not improve survival for unselected patients with newly diagnosed metastatic prostate cancer, but, in a prespecified subgroup analysis, overall survival did improve in men with a low metastatic burden. Therefore, prostate radiotherapy should be a standard treatment option for men with a low metastatic burden. These findings also raise the possibility that local treatment to the primary tumour should be explored for patients with small-volume metastatic disease from other malignant diseases."

[GranPaSmurf in reply to tango65]

AhHa. So maybe no - but probably yes.

We play every card that comes to us, right?

[tango65 in reply to GranPaSmurf]

I agree, best of luck

[6357axbz]

Google, “Bladder and Bowel Preparation for Prostate Radiation”. It’s published by the Rogel Cancer Center, Michigan Medicine

[GranPaSmurf in reply to 6357axbz]

Thanks - good reference. I don't think I can follow the 20 ounces rule. These days, I'm in the 'when you gotta go...' club. I admit (only here) I 'lost it' once recently. Who knew that interior detailing for my daughter's new Buick would be so costly?

[6357axbz]

For those who can’t hold it long enough they issue clamps. During the simulation they do to get everything set for your RT they determine the min and max level of bladder filling necessary to optimize your treatments. Each day before treatment they give you a quick ultrasound to determine if you bladder is in that range. If it isn’t you stay in the locker room until your bladder is adequately filled. If it’s too full they tell you to release some. It’s not all that bad. Even the clamp guys, eventually got it figured out.

[GranPaSmurf]

OUCH!

My RO told me about a guy that 'lost it' on the table, down into the electronics. The 'million dollar Aaaa' - SMOKING!

My penis is so shrunken that just finding it to clamp it will be an adventure.

[Hidden in reply to GranPaSmurf]

Send out the search party ! What penis? Keep laughing at out irony GranPaSmurf!, Good luck in treatment . May it work well for you ..

[j-o-h-n]

Use a cork until you turn blue.... oops never mind you're already blue....

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 08/18/2019 9:52 PM DST