oncologist appointment

[Radars]

I have a oncologist appointment on the 23rd Sept I am a bit mixed up with what questions to ask him, he did my treatment in 2014 rt/ht,my problem is that my testosterone has never recovered and now I have severe osteoporosis, I have locally advanced p/c t3b no mo with invasion of seminal vessicles, my psa is 0.04,I only weigh 8st, I wonder if it is worth me asking about bat therapy, anyone know the best questions for me to ask on how he can help me, thankyou.

[Tall_Allen]

I know things are called by somewhat different terms in the UK vs US. In the US, a "radiologist" is a doctor who reads scans (e.g., CT, MRI, PET), while a "radiation oncologist" is a doctor who delivers radiation as a cancer treatment. A "medical oncologist" is a doctor who prescribes medicines for cancer. Anyway, you may want to talk to an experienced radiation oncologist about salvage radiation to your seminal vesicles. They can do it with HDR brachytherapy. A world expert is Peter Hoskin at Mt. Vernon Hospital in Northwood. It might be a curative therapy:

redjournal.org/article/S036...

A PSMA PET scan can ascertain that your recurrence is only in that one place.

[Radars in reply to Tall_Allen]

thanks yeah, he is a radiation oncologist, he did my radiotherapy at st James hospital in the uk, when I had radiotherapy in 2014 the seminal vessicles was included,

[maley2711]

Since your RT with ADT, have you had some type of scan that shows current PCa in seminal vessicles ? If so, doubt you could reradiate the same areas?

[Radars in reply to maley2711]

I haven't had a scan since I finished treatment in 2016 the seminal vessicles were included in the radiotherapy, so surely they wouldn't do radiotherapy to the seminal vessicles again.

[j-o-h-n]

Make a list of questions from what you've seen here on H.U. and lay them on your Doctor(s). Note: Search back though old history on H.U.

God Bless!!!

btw 8 stones is equivalent to 112 LBS.

Good Luck, Good Health and Good Humor.

j-o-h-n Monday 09/18/2023 7:40 PM DST

[Seasid]

I am really not an expert but I would ask for a baseline parametric MRI of the prostate and also for a psma pet scan in order to see the spread of your cancer.

I believe that you could maybe have an HDR brachytherapy depending on the radiation received. Your RO should no that. But before doing anything just do the scans.

Best wishes from István

[Radars in reply to Seasid]

I have just had my 6monthly psa check 0.04,when I was first dx in 2014 it was t3b no mo invasion of seminal vessicles ,I don't think they will do rt to the seminal vessicles again as that was included in my radiotherapy.

[Seasid in reply to Radars]

Just do your scans first. If you have recurance you could treat it but I am not a doctor and you should do your scans fist and ask your doctor for his opinion. I just don't know.

[Radars in reply to Seasid]

I haven't got recurrence my psa is undetectable, so I can't see them giving me a scan.

[Seasid in reply to Radars]

That is really good for you. Your MO should confirm that in order to be on the safe side. Ask him about hormone replacement therapy about his opinion about that.

As we know that would be great for you but first ask your MO as testosterone can wake up the cancer if you are not fully cured.

I wish you luck.

[Seasid]

Are you sure that your seminal vesicles are irradiated? They usually do that if there is a recurrence after initial prostate irradiation.

Could you double check this?

[Radars in reply to Seasid]

when I had my radiotherapy in 2014 I asked if they also treated my seminal vessicles and they said yes.

[Seasid in reply to Radars]

Just double check that.

[Radars in reply to Seasid]

had a meeting with my oncologist regarding my locally advanced prostate cancer t3b no mo they did my seminal vesicle in my rt in 2014,and he said I no longer have p/c,I find that hard to believe after all this time, and that I need to take a calcium supplement for my severe osteoporosis, any thoughts.

[Justfor_ in reply to Radars]

My wife suffers from a very mild osteoporosis, borderline to osteopenia. Her doc put her on weekly Binosto (alendronate sodium). A Calcium supplement alone wouldn't be potent enough according to her doc.

[Seasid in reply to Radars]

Could you ask for hormone replacement therapy?

[Seasid in reply to Seasid]

That would help you with osteoporosis.

[Radars in reply to Seasid]

my oncologist would not commit his self regarding testosterone, he said I will have to go through my gp and then urologist which they have refused before, according to my oncologist i am cured because of my years of undetectable psa,but urology different story the last time I asked about trt he said that there maybe some sleeping cancer cells, will try again soon.

[Seasid in reply to Radars]

You could ask an endocrinologist about hrt. He could help you with that but in a same time you should ideally be under the supervision of some competent oncologist. It could be MO or even RO if he is very competent. Maybe find a professor of Oncology who could order scans like parametric MRI of the prostate and even pet scans like PSMA pet scans etc.

If your PSA stays low than you could just continue on the testosterone. The best would be to find some competent professor of Medical Oncology who ideally has some experience with bipolar androgen therapy (BAT). You don't need BAT only if the cancer start to grow.

My oncologist would probably have a knowledge to advise you. I can't. Could you come to Sydney to see him or maybe you could just arrange a teleconference with him? He works in a St Vincent's Hospital in Darlinghurst NSW 2010 Australia.

His email address is:

[e-mail]

[Radars in reply to Seasid]

I am in the uk,I don't know what to think now that my oncologist to say I no longer have p/c,I will ask for a referral to a endocrinologist.

[Seasid in reply to Radars]

Contact professor Joshua via email and ask him for opinion. That is what I would do. After that you will have a better understanding how to proceed. Sorry I am not a professor of medical oncology and I have zero experience with your case. I just know that you would like to get your testosterone levels back hoping that it would improve your quality of life and that it could maybe even save you taking bone strangthening medication for your osteoporosis. You should ask this questions from someone competent in dealing people in a situation like you. Ultimately it is up to you. I am just reading your posts and believe you want a much better quality of life.