ABOUT ME

[ANILKUMAR-FARMING]

Hi All...!

My Dad has been diagnosed with T3bN1M0 Prostate Cancer in November 2019

Gleason Score is 8. Few Pelvic Nodes are involved as seen in PSMA -PET scan. (Report Attached)

PSA as on 29-11-2019 was 56

Doctors had conflicting opinions regarding going for Radical Prostectomy.

Taking into consideration, the risk of incontinence due to surgery, we opted to go for Hormone Therapy alongwith Radiation Therapy.

First shot of Lupride was given on 28-11-2019

PSA has reduced to 0.7 as seen from the reports on 10-01-2020 due to Hormone Therapy.

Now, Volumetric Modulated Arc Radiotherapy (VMAT) has started since 13-01-2020

Doctor has prescribed 25 fractions.

Seems to be going good so far...!!

[LearnAll]

Please Do Not use all capital letters. its annoying !

[ANILKUMAR-FARMING in reply to LearnAll]

Sorry for that...!!

[Muffin2019 in reply to ANILKUMAR-FARMING]

No caps in my post.

[airmanbear in reply to ANILKUMAR-FARMING]

How did the Fenbendazole work out with your psa?

[Muffin2019 in reply to LearnAll]

No caps in the post in my phone .

[ANILKUMAR-FARMING in reply to Muffin2019]

It was in caps, earlier when I posted. Later, I edited it...

[airmanbear in reply to LearnAll]

Pease write in caps I have a vision problem..

[Darryl Partner in reply to airmanbear]

You can increase the size of your phone or computer typeface in settings. No need for anyone here to rewrite their posts in caps. Also look at your device’s accessibility settings and consider using reading glasses

[Rich_Rad]

Our cases are very similar! Just started Lupron 12/31/19 and soon to start radiation.

Let’s stay in contact.

Rich

[ANILKUMAR-FARMING in reply to Rich_Rad]

Absolutely...! Will be in touch...!!

[Hidden]

Good luck with the treatment. There are guys here that started off the same/worse than you that can provide alot of advice.

[ANILKUMAR-FARMING in reply to Hidden]

Definitely, it is of great help.

[Jimhoy]

Stop YELLING!!!

Sounds like a tact I would take...... oh wait, I did!

Gods speed my new brother!!

Jc

[LearnAll]

Looking at dramatic decline in PSA, it is clear that your Dad is responding very well to current therapy. I would wait and not go for surgery with this kind of super response unless there is evidence in future about increase in PSA

Add some other supportive measures such as vegetarian diet, lot of home made yogurt, cauliflower, cabbage, radishes tomatoes ,spices and herbs , Vit D caps, and walking 4 to 5 miles a day with some weight bearing excercise to minimize side effects of AD and slow cancer progression.

Note that average PSA for a healthy Indian Man is 1.5. As long as his PSA stays below 1.5 after treatment and he is asymptomatic with normal blood count...there is no need to worry too much. I would like to monitor PSA at least once every month and keep record.

[ANILKUMAR-FARMING in reply to LearnAll]

Yes, the response to Hormone Therapy has been fantastic.

Furthermore, Its nice to know that vegetarian diet would help fight the prostate cancer, as our whole family is vegetarian. As advised by you, will try to incorporate and focus more on the veggies in the diet.

Have started Tab. Shelcal CT for Vitamin D, Tab. Neurobion Forte for Vitamin B-Complex and Tab. Folvite 5 mg - for Folic Acid.

Would need to look into the exercise aspect as well.

Thank you very much for your valuable input and time. GoodLuck !

[Muffin2019 in reply to ANILKUMAR-FARMING]

Not a true vegetarian but do eat lots of fruit and vegs and very little red meat but still do chicken,turkey and seafood.soynfs like he is doing well , keep up the good reports.

[Gemlin_]

Do you plan for the combination of the external beam radiation with brachytherapy boost together with the hormones? Would give the best chance for cure. Good luck!

[ANILKUMAR-FARMING in reply to Gemlin_]

Our Doctor had told only radiation and hormone therapy. Will consult with him again regarding Brachytherapy boost. Thank you very much for your input. Highly appreciate it.

[Tall_Allen]

I don't know what is available in India, but if you can get a mixture of external beam radiation, HDR brachytherapy boost to prostate and seminal vesicles, and 2-3 years of hormone therapy, that would give him the best chance of a cure. This would involve:

(1) 25 treatments of external beam radiation (at 1.8 Gy per treatment) to the whole pelvic area, with a simultaneous integrated boost to the left internal iliac and left common iliac lymph nodes.

(2) High Dose Rate Brachytherapy boost to the prostate is preferred because it can reach to the seminal vesicles

(3) 2-3 years of hormone therapy.

[ANILKUMAR-FARMING]

As you have mentioned, whole pelvic area for the radiation, our Doctor is of the opinion of radiating only the prostate and seminal vesicle part and controlling the cancer in lymph nodes by ADT. He said that radiating the lymph nodes would cause problem to good organs nearby. But, I personally feel radiating the full pelvic area would be better in order to cure or control the disease.

Thank you very much for the specifics and direction regarding to the treatment that should be given. I would discuss this with our Doctor at the earliest. The information that you have provided means a lot to us. Highly appreciate it.

Thank you again for your time and help.

[binati]

My case is a little more extreme. I had PSA of 258 and Gleason 5+5 on biopsy with seminal vesicle invasion and one ECE seen on the MRI. PSMA Pet Scan did not show any nodes or any other lesions anywhere in the body. I started Firmagon (ADT) immediately and after 4 months the PSA was 1.47. I was advised IMRT 39 sessions @ 78 Gy covering pelvic bed, pelvic lymph nodes, seminal vesicles and prostrate. I have completed this from Nov to Dec. The ADT continues and doctor wants me on it for at least 24 months total or more. I am 74 years old without any comorbidities and was advised against RP to avoid side effects. Thankfully, there have been very minimal side effects with the IMRT for about a month and I am almost back to normal now. I have no urinary urgency at all during the day. At night I get up once mostly. There is a checkup 3 months after RT completed with PSA and blood tests and at 6 months with PSMA Pet Scan and some other tests. I have had a Dexa scan in 7 months after starting ADT which shows normal bone density. Let me advise you that your Dad must exercise daily with walking at least 5-6 km and preferably take up weight training under a good trainer. This is to prevent loss of muscle and not necessarily to become a body builder. He should also keep his weight under control with a Body Mass Index of less than 23.5. Ideally should not put on weight on the waist. Blood sugar should be checked as it tends to go up with ADT. I am from a diabetic family so was mildly pre-diabetic but so far with exercise and food control seems to be still only borderline. Best of luck to your Dad.

[ANILKUMAR-FARMING in reply to binati]

We are advised to be on ADT for 2 years. Further continuation will depend on the reports at that time. Have finished the 6th Fraction of VMAT Radiation Therapy today. No side effects of radiation seen so far. But the Doctor has said they might come as the treatment progresses.

Will focus on the exercise after completing the radiation. My Dad's age is 62 years, Height- 178 cm and weight is 85 kg. The body mass index is higher than 23.50 will need to work on that as well.

Good thing is that he has no diabetes and blood pressure. I suppose this will help him to recover quickly from the side effects of radiation.

Thank you for the guidance and time. Will be in touch.

Goodluck with the treatment...!

[binati in reply to ANILKUMAR-FARMING]

If done accurately with great discipline the radiation can be effective and minimum of side effects. I chose the best radiation oncologist in Delhi just for this reason. My brother in law whose wife is a Professor at MDA(Houston) was keen that I should go to MDA but I demurred owing to major logistics issues and of course cost. It costs about 8 to 10 times of Indian cost. I also consulted with a top radiation oncologist in Mayo who is a friend. The advice was to go with standard of care for high risk PCa and that is what I did. My RO says that she wants me to be on ADT for at least 3 years if not more. Let us see how I weather the first year!!. Best of luck for your father's treatment. I hope it is successful and he goes into a long, long remission.

[RonnyBaby]

I had a similar Dx in 2017, although it could be argued that it is 'slightly' worse.

Mine was a G9 with PSA @ 300 +, but the T3B N1, M0 is the same as mine.

2 1/2 years later (post treatment) I am doing well. I'm on an ADT holiday, which I hope to be permanent.

The type of radiation offered to you is different (EBRT) than mine, but radiation as opposed to surgery, which was not an option for me.

You have reason to be optimistic - at least it has been caught early enough to still hope for a cure or at least something that is manageable.

I'd suggest you do some reading on the applicable PCa topics to ensure that the right questions are asked and that key decisions are understood fully.

Keep us posted - we wish you well in your healing efforts.

[ANILKUMAR-FARMING in reply to RonnyBaby]

As you said, Asking the right questions is of prime importance. There is a lot of literature available to study. But making the final decision when our life is on the line becomes little difficult.

Considering the Quality of Life, We avoided Radical Prostectomy (Risk of Incontinence) We have started with ADT and Radiation, but the question still keeps haunting me about skipping the surgery. Only time will tell....!

Thank you very much for help and guidance. All the Best

[RonnyBaby]

There are no guarantees but it is possible to look at trends and patterns. You maybe have made the right decision.

[Gnatah1]

Hope all goes well keep us informed.