Post-Surgery Oncologist Consultations

[Dreamweaverman]

Hey Fellas, So I had 2 consultation visits this week. One with Weill Cornell and the other with Sloan Kettering. Both radiation oncologists basically gave me identical diagnosis's and recommended that I first do a Positron Emission Tomography (PET) scan. This type of scan is the most sensitive scan to date and can detect how tissues and organs are functioning as well as metabolic activity. The other option is to do both an MRI and Bone scan. If all is well and they don't see any other areas in my body producing the antigen, then they recommend I do 8-weeks of targeted radiation to the prostate bed as well as Hormone therapy for a minimum of 6 months. Whew! I know all of this is certainly a mouthful, but I am determined to stay positive about it all. Lastly, I want to put in a plug for the Manhattan support group which I got a chance to visit on Wednesday night. Great group of guys with a plethora of knowledge and information. I will definitely be returning. Sending good energy and vibes to all of you.

[JohnZi]

Hi Dreamweaverman. All the best on your healing venture! I will soon be accompanying you on a very similar treatment trajectory, i.e. ADT and radiation. After radical laparoscopic prostatectomy surgery in December 2016 (GL 7), there was no lymph node involvement and clean surgical margins with some extra prostatic capsular extension, but no invasion of other tissues. For 18 mo my PSA remained stable @ 0.00. Then this April it moved to 0.01, then in September the needle moved to 0.04, then in October to 0.06; my last one this week remained at 0.06. May I ask what yours have been before the decision was made to move forward with ADT and radiation? I explored getting a PET scan such as the C 11 Choline PET with Dr. Kwon @ Mayo or the Axium at other sites so that I could get a systemic look for PCa in more than my pelvis before treatment beginning with MRI imaging with just a pelvic MRI scan. But Dr. Kwon at Mayo or other isotope whole body PET scan specialists said PET scans wouldn't be useful or effective until my PSA reached at least 1.5. So in this situation my radiation onc says treating earlier will lead to better outcomes. He strongly believes that with my surgical picture, we just need to focus on the pelvis and surgical sites. It's a bummer that in my case even the more sensitive scanning instruments available wouldn't help. I'd really like the reassurance of being able to rule out other possible PCa in other parts of my body. Maybe one day these instruments will be more sensitive and prevent possible over treatment, but not yet. In any case, I'm very glad you're getting the support you need and the peace of mind and spirit that comes with it!

[Dreamweaverman in reply to JohnZi]

Hi John, Sorry for delayed response. The holidays have me pretty busy. In response to your email, my PSA was 0.7. For the Doctors here at Sloan Kettering and Weill Cornell, it is way too high and is an indication of active cancer somewhere in the body. I am scheduled for a PET scan on Monday, Dec 3rd, and have consulted 3 oncologists. It is highly likely I will begin Hormone treatment by mid to late December and (8 weeks) radiation therapy sometime in January. I am posting a conversation with a medical oncologist today, to get some feedback. It was a very interesting scenario.

[JohnZi in reply to Dreamweaverman]

NP, Dreamweaverman. Yes, busy times. I'll be sharing a very similar treatment regimen. As I mentioned, mine was stable at 0.00 for 12 months, then inched up to 0.01 in April to 0.04 in September and then in October to 0.06. Something was going on. So, I had a pelvic MRI two weeks ago. It showed no further mets; so that was good news. We decided to start ADT last week, get a Lupron injection tomorrow, and begin radiation treatment January 8 for 8 weeks. Am also taking calcium 1200mg & Vitamin D3 800 units- daily while on ADT. Again, all the best to you.

[JimVanHorn]

Hi Dreamweaverman, I had to realize that each of us have a slightly different PCa, in different places of the prostate, different insurances, different doctor's opinions, and different ages with different other diseases. So we listen to others and do our best to fight this monster. I had 42 radiations in 2007, then a bone scan showed metastases in 2011. I had 30 more radiations, started Lupron (3 month) with Casodex for 3 weeks. Now it has been 6 1/2 years and I am cancer free. I am off all cancer therapies, but am on active surveillance. So keep checking everything out and make a good decision, thank you for your insight and keep truckin'.

[Dreamweaverman in reply to JimVanHorn]

Thanks, Jim, SO happy to hear of your recent results. It keeps me optimistic.