My urologist after RT and ADT - Prostate Cancer N...

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My urologist after RT and ADT

thierry
thierry

hi everybody , so as I wrote before , I was diagnosed Pca last february after my biopsy showed two cores among fifteen invaded by an adenocarcinoma , 3 mm and 4 mm , the latter containing 7% of Grade 4 . After Bones and pelvo thoracic returned clear , my urologist , a Young lady gave me the choice between RP ( without mentioning if lymphnodes dissection would be necessary ) andRT plus 6 months ADT , two shots of LUPRON 11, 25 mg , I chose RT plus ADT , and the RO in the same hospital , in Monaco , took the lead and did the treatment protocol At the end of the treatment , in July , i tested my PSA , 0,08 . I did perfectly follow the whole treatment and felt very few discomfort . End of July , the urologist who made the diagnosis , and also inserted Three gold grains into the prostate prior to RT , asked me to visit her in the same hospital , radiotherapy and urology departments being on the same floor . She had Nothing special to do or say , she had my PSA of 0,08 considered as satisfactory , asked me a few questions , how do you feel now… etc , we both wore a mask for Covid , and she suddenly said : You have a cancer , without other explanation , I was so shocked that I did not understand the purpose of such an assertion , but a few days later , i wrote an email to her , explaining that I did not expect such a remark and I would desire no answer . That was the end of eight visits with that urologist at Monaco's Hospital . Now only my RO will follow me , exclusively . What do you think of such a remark at the end ? Regards

31 Replies
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You had a cancer - hopefully, you are now cured.

doc1947g
doc1947g in reply to Tall_Allen

She said: "You have a cancer."

You, of all of us, know that you do not get cured but go on remission.

This whole site keep showing people who get recurrence so I am not expecting a cure but a good break of 5 to 6 years.

I am a Gleason (4-3)=7 Grade 3. Unfavourable Intermediate Risk with a Invasion tumorale périneurale. At 73 and with my Lymphoma, I was not a good candidate for a RP. So I am on VMAT and ADT, for now.

thierry
thierry in reply to doc1947g

Hi , sorry I didn't understand your answer , may be a dash of humour that I didn't catch . Please do explain .

doc1947g
doc1947g in reply to thierry

There is no humour. My own Uro and RO told me not to expect a cure but a break. Slowing down the cancer but not cure it. So far NOTHING cure the prostate cancer.

Tall_Allen
Tall_Allen in reply to doc1947g

"My own Uro and RO told me not to expect a cure but a break. Slowing down the cancer but not cure it. So far NOTHING cure the prostate cancer." ridiculous.

Tall_Allen
Tall_Allen in reply to doc1947g

"You, of all of us, know that you do not get cured but go on remission." Where did you get that idea? Localized prostate cancer certainly is curable. Even prostate cancer confined to pelvic lymph nodes may be curable. Men who have a recurrence are much more likely to visit a site like this than men who are cured.

doc1947g
doc1947g in reply to Tall_Allen

Like I mentionned, my urologist and my radio-oncologist told me that there is NO cure, but treatments that slow the progression of the cancer.

Even localized cancer, ther are always microscopic prostatic cells around that survive to the different treatments.

Tall_Allen
Tall_Allen in reply to doc1947g

They are idiots. I have been cured. Microscopic prostate cancer cells cannot live outside the prostatic environment until they have undergone a biochemical change, called EMT.

doc1947g
doc1947g in reply to Tall_Allen

I could have been that Joan of Quebec. My name is Gilbert D. and I was born in Montreal in 1947. I was born out of the weeding and drop to an orphanage were I was "tried" by many family and finally adopted at 5y 11m by a 50 y.o. parents. At 6y.o. I had to memorize all the prayers in latin.

I guess I was the last generation under the church influence.

It was very hard for me because I had two uncles that were roman catholic priest and one of them was my god-father.

I am partially out of that influence but still a little bit.

BTW I excuse myself about my comment on "No cure for the prostate cancer.

My RO & Uro told me that MY Cancer will just go from remission to remission. I was too advanced even if I was a G(4+3=7) Grade 3 but super agressif and due to my age (73) and my health problems (Lymphoma, Chronic Renal Insuffisance, chronic anemia and etc...) I could not get surgery, so VMAT & ADT.

I know by now that we are all different.

I love your comments.

God bless you.

P.S. I tried to send this by message but it would not work, so here it is.

thierry
thierry in reply to doc1947g

Thank you for your messages , you really deserve to feel great and to have the strenght to cope with what happens to both of us . I also went to Catholic school until the age of 12 , In Monaco , St Jean Baptiste de la Salle . I think we both have a rich past and that helps us . We must follow a light diet , no sugar , no fats , less meat , but cereals , fruits , berries , eggs , fish , no smoking , and no alcohol and some physical exercices , whatsoever , no need to go to the gym or practicing a particular sport , just exercing one hour or two each day , yes Everyday . Not hard at all . Best wishes

doc1947g
doc1947g in reply to thierry

Bonjour Thierry,

I went to a "Classic College with Jesuit Priest" and even at the University we had a lot of the teachers that were priest.

I always thought that France has liberate itself fromthe power of church. Maybe I am wrong. It could also depend of our familly.

Tall_Allen
Tall_Allen in reply to doc1947g

Thanks for that comment about my novel. Doing research in Quebec was a lot of fun for me. Fortunately, at the time, my French was pretty good, and people in Quebec City and the countryside were willing to meet me halfway because I was American. The Church still has great influence in remote areas although they don't influence provincial policy as they once did. In this time of heightened nationalism, I do wonder whether the Quebec separatists will renew their efforts.

doc1947g
doc1947g in reply to Tall_Allen

I think that the separatists (Like I was) are tired and are slowly giving up any separation. And you are right about the remote areas but they too are slowly stoped to go to church every Sunday.

I personnaly did stop about 30 years ago.

thierry
thierry in reply to Tall_Allen

Hello Tall Allen , since this last visit , on July the 29th , 4 weeks after the end of my 38 x2 Gy sessions of RT , and on the same day of my second shot of Lupron 11,25 mg , which I did not want to perform , and so bizarrely the RO did not mind too much about , but this urologist that I did not see after the three gold grains implanted on April the 8th , insisted to do , four months later and therefore ,since that day , I feel good , but I have a bad feeling of Failure . On another side , my RO doctor which is finer and responds everytime I call her , told me this Morning , that I am still castrated , 29th of July plus 3 Or more months , that ED was normal at this stage , and that 50 % of men after RT would not recover easy erections without medicinal help , and that ejaculation would pratically be reduced to a very small amount or no amount at all after RT . I thus discover some worrying effects that were not told at the moment of the choice , and radical prostatectomy would not have been worse , but I did not have enough courage at that time . I Have only one person to blame : myself . Best regards

Tall_Allen
Tall_Allen in reply to thierry

The odds of ED after prostatectomy are much worse, and dry ejaculations are assured. Here is what I tell patients to ask themselves when choosing:

prostatecancer.news/2017/12...

I was given a non-chalant notice,as if figure it out for yourself.We found a Mass.WTF is a Mass?,then another woman who I thought was (in training) says to me,you are Gleason 7,Then added "We thought for sure you'd be a Gleason 8 or 9",what a simpleton.That really irked me.I don't like Doctors,and I can say that from way too much experience with them.Now,I am much more firm with them,Why(?)because you have to be?I think what your doctor told you is summed up it two words"It STINKS"

It is a puzzling remark, but she has not provided an explanation. You are in remission. Time will tell if you are "cured."

Sometimes doctors say the dumbest things; human, I guess. Fortunately, you don't have to stay with her.

Good luck.

EdinBaltimore

I’d say that Tall Allen is correct about the fact of who visits the site. I frequent here and Inspire since I am in treatment at the moment. Once I remember a thread on Inspire where the discussion turned to a member who hadn’t been on the site in years but wanted to see how everyone was doing. He said basically most men if their treatment goes well and life goes pretty much back to normal they don’t frequent the boards anymore. I think that is true.

thierry
thierry in reply to ODave

Hello , you certainly right , fully right , our concerns should not take too much of ourselves . I am too easily worried though I feel fine , so I was Learning guitar before with pleasure , and that illness made me give up , since January . I still do some light gym early in the Morning , one hour plus half hour swimming and that helps me a lot . And my doctor , the RO , very kindly told me , you seem to be an unhappy guy , you are still Young , and you should not be unhappy . Regards

I feel the ED rates after short term ADT are probably not necessary if a man on ADT has erections to keep the necessary blood flow and muscular tone. Doctors aren't aware that castrate men can and do have sex so don't urge the erections as they would post surgery. I am just finishing 6 months lupron and am fully functional. Just takes some foreplay which my wife and I enjoy.

Hello , I think we do have , or had , the same problem , I , 68 yo , looking much Younger , was diagnosed Pca ,in Feb 2020 , after rising PSA from 3,8 , to 4,8 and 5,2 over Twelve months , MRI showed a Pirads 4 lesion , ovalair , 11mm , apex left lobe with close capsular contact . Biopsy showed two cores among 15 infiltrated by an adenocarcimoma , 3 mm in the left apex and 4 mm in the left medium and 7% of Gleason 4 in this last one , which made Gleason 7 , or Group 2 WHO 2016 . I had two choices , RP or RT plus short term Lupron 11,25 . L chose this last one . My treatment started in last May 38 sessions in total which delivered 76 Gy on Prostate and 54 on Seminal vesicles , on the two proximal thirds . Today , theorically , I have 35 remaining days of ADT / Lupron effects . I feel fine , erections may occur but seldom , and no semen at all . But I feel fine and better than I thought . Tell me more about you , did your RT was OK , and your feeling about the next months ? PSA checked every three months ,? then every six months ?, mine is currently at 0,08 . Hope an answer . Best regards

I did IMRT and 6 mo lupron. Other than the annoyance of having to have a specific amount in the bladder each RT session and the menopausal effects of lupron, it has been a relative "walk in the park". Sex on lupron requires intent and focus. Work at producing erections and orgasms, though the latter can take some time. I produce at least one very firm erection a day and go for orgasms up to three times a week.

PSA and (at my insistence) testosterone check every three months.

Salut Thierry,

Diagnosed on March 3rd, 6 biopsies out of 12, positive with an averace of 12 mm G(4+3=7) Grade 3.

VMAT 3 Gy X 20FX= 60 Gy Hypofractionnated and Lupron Depot 22.5mg/12 weeks X 2.

Here in Quebec, Lupron 11.25mg is given to women who have Endometriosis problems.

As of today (Sept 24, 2020 I am 11 weeks post VMAT and 16 weeks per-ADT.

Main problem is Weakness and Fatigue plus burning sensation during miction.

Otherwise, life is gread.

Dieu te bénsse.

thierry
thierry in reply to doc1947g

Hi Doc , to answer your question , Lupron in France is called Enantone , and the11,25 mg seems to be regularly used for Pca , Under the monography of Tadeka , a japanese lab . So you have two more months of Lupron , which is the double dose compared to mine , I have one more month to go . I think we both expect the SE to vanish and that is encourageing . I have tried Tadalafil 5mg each day , Under prescription , with no effects , the RO told me that I am still Under chemical castration and I should not worry . We have to be patient , and we might have a better year end and probably a better 2021 year . My next PSA plus Testosteronemy will be in November now .

doc1947g
doc1947g in reply to thierry

I started my ADT 4 weeks after you du to a screw-up on April 4 th 2020 from young nurse who would not listen to me when she was not mixing the Eligard and did not even gave me the whole injection, so my RO had to prescribe me the Lupron Depot 22.5mg/12 weeks X 2 starting May 31st 2020. With all that I did not get the benefice of 8 weeks pre-VMAT but just 1 week. VMAT started on June 8 and finished on July 7th.

Yes 2 more months and then probably another 3 to 6 months of gradualy decreasing effects. So if I am lucky I should be CLEAN of the ADT for my next birthday in April.

Monday I am seeing my RO for the results of PSA & Testosterone.

And I just check my mail to discover that I receive my 11 months of Pomi-T which help keeping the PSA low or at least slowing its progression.

Have a good weekend.

Salut.

I was looking at the cost of our Rx.

Yours cost 329,67 euros or 513.86 CA$

Mine cost 770.38 euros or 1200 CA$

Thanks l'état, I just paid 60 CA$ for both injections

and 150 CA$ for the Eligard which was officialy 1600 CA$.

Just came back from my RO, He told me that my enphysema has worsen. Now the good news:

PSA = 0.03 Testosterone = <0.2 nmol/L.

Next R/V in march 2021 in alternance with my Urologist.

Tomorrow morning at 11:40 am tele-R/V with my GP.

thierry
thierry in reply to doc1947g

Hi , mostly good news , because emphysema is not so difficult to manage . May be you were a smoker . Anyway Psa and testo are excellent . Two more months to hold . Do Have willingness and confidence . Regards

I started to smoke when I was 11 y.o. and I quit about 13 years ago.

My RO told me to expect the ADT SE to be still there at our next R/V in march 2021.

But it was not a surprise. He told me he hesitated to put me on a 18 months ADT, but the way my PCa react, he thinks that the 6 months should be enough, but if the PSA should happen to increase before 4-5 years, then ...

Have a good day.

BTW do you read your messages ?

Just click on my avatar then on Message.

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