First post here. This blog is somewhat intimidating; I'm in awe of members' knowledge of PCa treatments, and of all the abbreviations sprinkled throughout. I'm 78 years old, being treated at MSK--now on 4 months of Orgovyx; awaiting 20 proton treatments in NY in December.
My journey started this spring, when PSA spiked up to 9 and MRI showed a lesion extending through the capsule, but no node or bone involvement. A biopsy was the next step, of course, BUT my colon and rectum were removed 50 years ago for ulcerative colitis (no problems with my permanent ileostomy since then.) Urologists here (Tucson, AZ) were not experienced in biopsies under these conditions, much less treatment, and I did not feel that there was sufficient experience at Mayo in Phoenix. There was also a long wait for a biopsy.
So I turned to MSK, where I had successful chemo for lymphoma 15 years ago. Dr. Coleman performed the biopsy, which revealed that I'm on the unfavorable side of Gleason 4+3. He referred me to Dr. Zelefsky for radiation. Dr. Z disabused me of the notion that absence of a rectum means there is less chance of radiation harming healthy tissue; quite the opposite, in part because the remaining organs are not in their usual locations. After consulting with colleagues he recommended proton therapy under the direction of Dr. Gorovets. He in turn recommended 20 sessions of proton therapy and the oral ADT drug Orgovyx (approved by the FDA last December). They obtained rapid approval for both from my Aetna Medicare Advantage plan. Three weeks into ADT, there are only minor side effects--mild hot flashes and some reduction of strength in my exercise routine.
Throughout, MSK has been very aware of and accommodating to my living 2000 miles away. When in NY for consultation or treatment, I (and generally my wife) stay at the NYP Guest Facility, which is available to staff and patients of the local East Side hospitals at very reasonable (for NYC) rates, with no city or state taxes.
I have the sense that many on this blog, like myself, extensively research all significant decisions, but once in the care of MSK I decided to respect their medical recommendations, and have not tried to familiarize myself with other courses of treatment to the extent necessary to challenge the experts. I am comfortable following Oscar Wilde's dictum, "I have the simplest of tastes; I am always satisfied with the best." Of course I do ask questions and try to understand the reasons behind their choices.
I echo the views of others that the whole staff at MSK is first-rate; not just the attending physicians, but the fellows and residents, nurses, coordinators,...everyone.
Best wishes for successful outcomes to all.
Frank
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Experiences with combination therapy? (ADT/Brachy/SBRT)
