Dx 1.5 years ago with Gleason 9, Mets to bladder and pelvic bone. PSA at Dx was 3.45! PCa was found during a TURP surgery. Started Lupron and Erleada. PSA has been undetectable since. Testosterone is basically zero 🙄. Recently had 37 rounds of RT to all sites, and Brachytherapy. Will be having 10 more rounds of RT next month (EBRT). Any thoughts on my treatment decision path? Good or bad?
My treatments to date: Dx 1.5 years ago... - Advanced Prostate...
My treatments to date
Your treatment is aggressive.... But it is needed as your PCa seems aggressive based on initial low PSA (3.5) and Bladder Metastasis (Visceral met)Keep PSA and T near zero like it is right now.
Next treatment will probably be Taxotere
Why weren't the 10 rounds of RT next month (I assume those are for the pelvic metastases) done at the same time as the 37 rounds of RT? And why so many? It's usually done in many fewer treatments.
Thanks TA. The 37 rounds of EBRT were focused to all areas of PC (prostate, bladder and pelvic bones) Then (directly after these 37 rounds) brachytherapy seeds were implanted into my prostate. Final 10 EBRT sessions will focus on my lymph nodes (even tho scans claim PC is not detectable in my lymph nodes.
Thoughts?
Brachy boost therapy is usually done with only 20-25 TOTAL external beam treatments. That would include the pelvic lymph nodes, the prostate, the bladder, and the pelvic bone metastases. However, if you're in the US, your RO is compensated by the number of treatments, which is probably why he dragged it out.
Your pelvic LNs don't have to show up on a scan to warrant treatment. With your risk factors, they should be treated.
Agree, he is getting very aggressive with me, as I wanted. He is a very successful RO that does PC only, really good success rates.
He uses 4D Doppler ultrasound, DART radiation, and his specialty is Brachytherapy. I believe he “sees” PC and “hits”it better than most.
Sounds like hype to me - he is clearly making a lot of money off of you
Have you heard of a PCa doc named Snuffy Myers?
Yes, of course. He's retired.
When Snuffy got PCa himself, he went to the RO I am going to.
Snuffy was hardly an expert at radiation oncology. It sounds like you've been fed a lot of kool-aid. I know Dattoli reduces the dose per treatment in order to bill for more treatments. I don't think there is any harm in it to the patient, nor in separating treatments for the different areas (other than outrageous medical bills). The trend in radiation treatment has been going in the other direction for some years now - towards moderate or extreme hypofractionation. It has been proven to be equally effective and no more toxic, while being more convenient and cheaper for the patient. However, it puts a real dent in RO billings.
BTW- nearby is one of the original innovators in brachy boost therapy, John Sylvester.
TA is on the ball...........
Ask the doc "how does he like his new mercedes?"
Good Luck, Good Health and Good Humor.
j-o-h-n Sunday 03/14/2021 6:07 PM DST
I am not as concerned about the cost as I am the right treatments. Thankfully, good healthcare.
Good attitude....for someone in China...........
Good Luck, Good Health and Good Humor.
j-o-h-n Sunday 03/14/2021 6:34 PM DST
Sorry.......... I'm not either..........
Good Luck, Good Health and Good Humor.
j-o-h-n Sunday 03/14/2021 7:13 PM DST