Need help with first visit to RO...

[sewinggma]

I am here for my husband..age 68, dx 12/2019 psa was 15.8, gleason 9, had RARP 1/2020. PSA was .2 six weeks post-op, PSA .3 at 3 months post-op and .4 in June 2020. He is still 99% incontinent and is depressed about the whole situation, for that matter so am I. Our urologist has referred us to RO to discuss options. What experiences do you have? what questions do we need to ask, etc? Husband has read some articles on internet that have really scared him about radiation and hormone therapy to the point of him saying he doesn't want any of it! For my part, I am afraid for him and I am not sure of my ability to be a good caregiver (I have never been good with medical stuff even for myself). any guidance would be very much appreciated...bless you all

[Hidden]

I would ask the following straight question: Do you have experience with tailoring my hasbands RT planning if we brought you a PSMA PET CT scan? If he starts beating around the bush head for the next one, RO that is.

[sewinggma]

thanks, I'm going on the hunt for MO

[chalaan]

You got to this site because you have the medical acuity to know that you and your husband want advice and the opinions of people who are battling this disease. That is an excellent first step. Their knowledge and compassion are amazing.

[Tall_Allen]

Here is a list of questions to ask:

prostatecancer.news/2017/12...

Because of his persistant PSA, there is a good chance that his cancer will show up on an Axumin PET/CT, which he should get ASAP. This may show any of these scenarios:

(1) the cancer is only in his prostate bed, indicating it is very curable only with prostate bed radiation

(2) the cancer is in his pelvic lymph nodes, indicating that salvage radiation may still cure it with whole pelvic radiation

(3) the cancer has metastasized to bones or other distant sites, indicating that radiation is useless, and hormone therapy only should start.

(4) the cancer doesn't show up on the scan, indicating that the tumors are still too small to show up. In this case, scenario #2 may still be curative.

While he is borderline for needing hormone therapy with his salvage radiation, he should consider getting it anyway. It will stop any further progression quickly. He can then delay starting radiation for another 6 months, which will give his incontenance more time to heal (immediate radiation may interfere with the healing).

A panel of ROs is recommending that during the pandemic, "hypofractionation" should be used for salvage radiation. Hypofractionation means that fewer doses are used, each with higher intensity. Early studies have shown that it can be accomplished in just 4-5 weeks instead of 8-9 weeks, and that side effects are no worse.

[j-o-h-n]

Tell him to do his Kegel excercises...... Buy depends by the carton. Best price is usually Costco. Tell him to double up on depends when he goes to sleep. Place a waterproof sheet on the bed at nightime....

Good Luck, Good Health and Good Humor.

j-o-h-n Monday 07/20/2020 6:33 PM DST

[Hidden]

Depression is understandable but detrimental even in the short run. Most of us have had a dose of it .. This Uptick is not that uncommon after an Rp . We hoped that he’d be done with pc . But his pc has something else to say . This means from my unprofessional viewpoint that more treatment is needed . None Of us “Wants” adt or Rt .. but for me me the combo put me into remission. He doesn’t want to stop now . Where on the internet was he reading about this .? Was it here on HU?