80% Shrinkage - Now the Plan - Radiate plus Keytruda?

[DMohr011]

Hey All,

Not many times a man will brag about 'shrinkage'! I just had scans done and my 71cc size tumor reduced to 12cc. Been on ADT since January, big corrections made with diet and exercise and taking pretty normal supplements.

Doc, I and Wife extremely pleased, but still realize this is still very high risk and aggressive PC. From the scan summary: ...."but still has extracapsular spread, contact with the right external sphincter and likely involvement of right neurovascular bundle."

No other spreading was found.

Moving forward: Meeting with Radiation next week. Surgery is not an option, as this damn thing is still touching/attached to rectum. So radiate it is.

I am also a candidate for Ketruda due to my Lynch genetics. This would be in addition to radiating.

Doc said we have three choices: Radiate, Radiate + Keytruda, or wait, continue on with ADT and see what the beast looks like in August.

I am opting for the dual treatment, and not waiting.

What all should I consider with this choice?

Much appreciate your wise input.

Good news like this makes me want to go fishing!

Dave

[Muffin2019]

Wish you the best on the journey, keep posting

[DMohr011 in reply to Muffin2019]

Thank you for the support!

[Tall_Allen]

Congratulations on the shrinkage. I agree that ADT+radiation+Keytruda sounds optimal. The radiation increases the antigen presentation, which may help Keytruda work better.

The only outstanding question is which kind of radiation and exactly what should you radiate? Brachy boost therapy has the best outcomes for very high risk (T4) patients like yourself. On the downside, it also carries a 19% risk of serious urinary retention.

prostatecancer.news/2017/03...

In your case, whole pelvic external beam radiation is certainly necessary:

prostatecancer.news/2019/05...

Your rectal tumor poses a problem. Obviously, SpaceOAR is not an option. But the rectal wall is easily damaged by radiation and the last thing you want is a fistula. Your RO will have to take great care in irradiating this. Great care= scrupulous contouring, more frequent low doses of radiation. Especially important to avoid fiber and laxatives, have a comfortably full bladder, and avoid all supplements.

[DMohr011 in reply to Tall_Allen]

Thank you TA for your input! Urinary issues seem to be a big part of me, having two TURPS done and now on antibiotics for a UI that just appeared. I will let you know what the Radiation peeps think is the best option!

Much appreciated!

Dave

[DMohr011 in reply to Tall_Allen]

Met with Radaition and find out they need to wait at least until September - need 6 months after the last TURP. Just too much risk of serious urinary problems. Thankful this tumor is shrinking without spreading. (knocking on wood)

The type of radiation is to be proton. He feels they can use much lower doses around the rectum area.

Fingers crossed I don't have to have any more TURP procedures. I guess I could consider a more permanent catheter if things start clogging up again? I've had a tough past couple of days pissing but hoping that's b/c of a UI infection....

Summer off? OK!

[TottenhamMan]

I have experienced shrinkage also, but in my case it is my testicles. After 6 months of ADT and 6 weeks of EBRT my family jewels are the size of small grape tomatoes. Although, that’s where the comparison ends. Grape tomatoes are full of juice, whereas my testicles no longer have any juice. My advice is to go full on and attack it on all available fronts. Full frontal assault and attack on both flanks. Kill it Dave, kill it.

[DMohr011 in reply to TottenhamMan]

Now that is funny and totally relate, but sucks!

That's what I am thinking too, hit it with both. I feel great today and have set some time aside this June/July for this. But it better not F up my August kayak fishing trips along Oregon coast! Hope to get er done by then.

I have some Cialis for sale too! The wife is actually OK with the lack of sex. After being chased around for 35 years she said likes the break!

[Shooter1 in reply to TottenhamMan]

Grape tomatoes wow. My jelly beans in a bag were snip snipped Mar of '18. No more lupron for life.... Just my choice just at the beginning of my journey on my 10 yr. plan. Additional surgeries 2 years in on my now 8 yr plan. New scans coming up at the 7 yr mark and counting down. Lots of life left. Life is good.

[DMohr011 in reply to Shooter1]

That makes total sense to me as my sex lymphs are out of order and have been since November, way before ADT. Tottenham and I are the rookies in the room as our Journey has just begun. Life is good, I like that!

Northern Idaho is so beautiful, plenty of lakes. I was in Coeur d'Alene two years ago and loved it. Best Farmers Market! I fished the lake, caught plenty of smalls, floated around the floating restaurant! North of there seems is where the real life and lakes begin.

[Shooter1 in reply to DMohr011]

We like it. Just couldn't move up when we wanted to acct needed job related med insurance for the high priced chemo and xtandi.. Who has money for a $6000/mo. copay?? Now VA is picking up the costs... being a disabled VN era vet finally gives me some much needed benefits. Life is good.

[DMohr011 in reply to Shooter1]

Thank you for your service Shooter. You Vets deserve all the care that you need.

I hear you about the health insurance. My premium is high, my deductible is high and it's going to force me to keep working to keep my plan. But it's paying for my Mayo care and that is well worth it, today.

[MateoBeach in reply to Shooter1]

Semper Fi. And you can get free PSMA scans at the Los Angeles VA. What a deal

[j-o-h-n]

For the umteatime I'm taking Keytruda for my lung melanoma and it's working. Shrinkage has its advantages.....

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 05/13/2021 9:29 PM DST

[DMohr011 in reply to j-o-h-n]

Thanks john! I totally forgot you were on Ketruda! Must be my ADT fog.....!

[j-o-h-n in reply to DMohr011]

No problem..... For awhile I forgot I was married............... (oh was that a pleasure)........

Good Luck, Good Health and Good Humor.

j-o-h-n Friday 05/14/2021 4:49 PM DST

[MateoBeach]

Triple therapy sounds good: RT, Keytruda and fishing.

[DMohr011]

Hell Yes, Meteo! Happy Friday!