RP w/ PLNR 03/2023
PSA RISING
Nov 7, 2023
0.11ng/mL
<=3.99 ng/mL
Oct 10, 2023
0.09ng/mL
<=3.99 ng/mL
Sep 7, 2023
<0.06ng/mL
<=3.99 ng/mL
Aug 8, 2023
<0.06ng/mL
<=3.99 ng/mL
Jul 6, 2023
<0.06ng/mL
<=3.99 ng/mL
Isn’t it difficult to radiate a mass on prostate bed that doesn’t invade but is abutting both bladder wall and rectum?
seems for All the promotion of radiation, there are no answers
I would discuss this with a surgeron. If you want to radiate, there are spacers which can be applied: genesiscare.com/uk/treatmen...
This is an instance where proton might be a good choice, since it doesn't radiate a lot past it's target. Standard IMRT might not be suitable because it does travel past the target, and in this case - the target and what you're trying to avoid are in intimate contact.
Worth talking to a few radiation oncologists before making a decision on treatment.
Yes, it is difficult -the rectum, not the bladder. It can cause a fistula, which may not heal. How do you know it hasn't invaded the rectal wall?
You cannot use any kind of spacer, of course. And any kind of removal (any kind of radiation,surgery, or focal ablation) can be dangerous. The only option is a temporary diverting colostomy and surgery. They can re-establish the rectum after it heals.
Omg, any other options to remove this mass causing PSA to rise?
What about Lu 177 or another radiogland machine etc
We assume that is why when this mass was only on prostate bed in March and growing in May the medical oncologist said No to radiation,
I waiting started bleeding in July from rectum from diverticulitis
All Physicians feel not PCA related
I’ll find out on 12/04/2023 with endoscopy and colonoscopy.
Really, a bad decision on my part to wait…
Should of went with my gut instinct now I have this freaking mass abutting rectum and bladder…grrr
No one wonder my medical oncologist cancelled the gastroenterologist MRI, didn’t want me stressed any further.
I went for second opinion and decided to be treated by two medical oncologist, so the add on new medical oncologist did an MRI.
I have a second medical oncologist added on to my team, but both have different opinions on how to treat,
First would only treat systemic
Second would do targeted radiation see if PSA lowers than do a change of medication.
So, not sure…which way to go yet.
As a retired general surgeon,I would say this is the most realistic option
Which is the most realistic option?
I think he was agreeing with Tall_Allen regarding temporary diverting colostomy and surgery. It does sound like radiation can be very risky. I know it’s hard to second guess treatments “woulda shoulda coulda” but it’s important to just try to get the best information and options open to you and look forward. I have read about excellent results with LU 177. That may be the way to go. Based on my my understanding, it’s a lethal dose of liquid radiation using the tracer to go directly to the area where needed
Thank you
That is why Lu177 may be an option as you've done chemo already. It might be the best for targeting.
I think that is what my first and so far main oncologist wants both are from cancer care of excellence hospitals
jnm.snmjournals.org/content...
The Lu-177, This looks good, so would this be targeted enough to treat the mass and kill it dead?
Tall_Allen What about the Lu-177, would this be targeted enough to treat the mass and kill it dead?
It might, about 50% complete remission but other may have stabilization.
I had a mesorectal LN and it was radiated with IMRT after a HDR-BT with SpaceOar placed. After four years, no SE's, so yes, it can be done successfully with the right team.
I had this done at the Mayo Clinic Rochester using IMRT. My colon was irritated some by the radiation but recovered in a couple weeks. I feel great and PSA is now undetectable. They were very careful to precisely target every treatment (20) with a scan before radiation was applied.
Speak to an experienced proton radiation oncologist at a center using pencil beam technology. Dr Rossi at California protons in San Diego is the most experienced in the world, he also does Zoom consults, it might be worth sending all of your records to him including all imaging you had done and see what he says. He just treated a hilar lymph node in my chest sitting on the pulmonary artery beneath the right lung and was able to do that without any issues.
Thank you
I had a fistula between the prostate wall and rectum wall caused by focal laser ablation in 2017 by Dr. Eric Walser at University if Texas Medical Branch in Galveston Texas. The fistula blew out a few weeks after the surgery and caused my urine to exit my rectum and feces to exit my penis. My local Urologist at St Francis Downtown Greenville SC put a catheter in and recommend a colostomy and then reconstructive surgery. When I expressed concern, he said, “I’d bet my house it will never heal on its own”. My wife took me back to UTMB where they recommended time for healing. It did but was the most painful and agonizing time of my life. In May of 2022 it had spread to my spine. My psa had never been above 11.
If you go ahead with radiation, make sure they are the very best at what they do. It is very risky.
All the best!
Make sure they place a gel spacer between.
Please read the whole thread. He has NO prostate. Thus gel not applicable.
While am certainly am not a Doctor, I would ask if I were a candidate for a spacer. genesiscare.com/uk/treatmen...
Where would he put it?
He could either ask the the Doctor or put it up your ass!
You understand a gel spacer goes between the prostate and rectal wall.
Hr e has no prostate, hence can’t use it.
Please stop the profanity. You’re not a child, are you?
I read all the replies to you and it sure got me thinking fast . You see i have the same problem as you do by the looks of it . A month ago I had PET SCAN done and it shows that there is something new in the bed of the prostate bed . I asked my urologist what he thinks and he said not to worry about it for now since so many years have past after my surgery . Now he is sending me to oncologist on the 22-nd of this month just in case he said . Now a group of oncologists will decide what treatment I should be put on . I am Bulgarian /Canadian and was operated in Toronto 2002 and never had any chemo or any other radiation done so far . Also I have never taken any drugs so far . I am living in Bulgaria now since I am retired . I feel good all around and do a lot of hard work around the house with no problem . The problem is that 2020 i had COVID-19 AND IT ALMOST KILLED ME ! I did recover not too bad from it but my PSA started going up very fast since than and it went from 12 to 109 last month . In two weeks I will turn 69 . I will keep you posted on what happens on the 22-nd and what the doctors will suggest . Keep me posted with what you do from now on please . Thanks and good luck to you . I will pray for you .
Yes, please let’s keep in touch….
What did you end up doing with your prostate bed
Nothing yet . I am on hormonal therapy since November 2023 and still going .
Plesse read post PSA Rising
Lots of good advice and comments here. Despite the claims for radiation and the vast improvements on delivering dosage and accuracy, it is still a collection of “allowances” for targeting and margins that overlap and ultimately increase the overall “target area”. All therapies are a “judgement call”. I am suffering from post RT proctitis. Not bad but I am hoping it heals in the long term. When in doubt, cut it out comes to mind. I wish you a successful intervention.
Failed RP & SRT; Negative PSMA PET
Not The News I wanted To See :(
K I S S, yes trying to keep it simple. A Lupron vacation after 2 yrs on & Abiraterone(250mg) & Prednisone 5mg? Yes or no?
