My husband had the daVinci on August 1 and has had two PSAs done since then. The first was .23 and the second .35 -- not horrendous numbers but obviously not terribly encouraging either. He will have radiation, but won't be scheduled to start until around February 1st to ensure he is well healed and hopefully regain as much continence as possible. Yesterday the urologist called to discuss starting him on hormone therapy -- oral meds for two weeks, then a shot once every 4 months for approximately two years.

Has anyone else experienced this course of treatment? Does anyone know if any research has been done on this particular treatment strategy?

I'm currently having proton radiation in Jacksonville (you can look at my many posts on this on this board). At Loma Linda, California, where they've treated over 7,000 prostate patients, they sometimes want high-risk patients to have hormone treatments for several months prior to the proton treatment. At University of Florida Proton Therapy Institute, where I am, they recommend the treatments be done after the radiation (for those that need to get this therapy).

I don't know what concrete information there is to say which method is better- good question though.

They do proton radiation after surgery I know, as I've met a couple people doing just that. You might want to check into this type of radiation, as less damage is done to healthy tissue than other forms of radiation, because the protons do not have an entry nor an exit dose of radiation- mostly just where it's targeted.

As a response to your question, I have just experienced within the last 6 months, Davinci surgery, Hormone Therapy, and lastly Radiation therapy. I had Davinci on April 24 after a biopsy that indicated a positive dre and an 8 gleason score. The post op path was worse, gleason 9 (4 + 5), positive margin, seminal vesicle involved. No lymph nodes involved and negative bone scan. I was referred to a medical oncologist at one of the premier teaching hospitals in the country (Barnes-Jewish) affiliated with Washington University. That doctor advised me that I should be receiving HT asap. I was started on HT in late June and then scheduled for RT with the IMRT Novalis shaped beam system in September. I just completed 35 IMRT treatments with absolutely no side effects. I have now had two Hormone shots (Lupron) June and September, next one scheduled in December. These will continue for a two year period at which time I will hopefully have undectable PSA that will stay that way for sometime. I also have minimal side effects with the Lupron, mainly hot flashes which are mild as I take Megestrel help with them. If I can help further let me know....Jerome.

I'm currently having proton radiation in Jacksonville (you can look at my many posts on this on this board). At Loma Linda, California, where they've treated over 7,000 prostate patients, they sometimes want high-risk patients to have hormone treatments for several months prior to the proton treatment. At University of Florida Proton Therapy Institute, where I am, they recommend the treatments be done after the radiation (for those that need to get this therapy).

I don't know what concrete information there is to say which method is better- good question though.

They do proton radiation after surgery I know, as I've met a couple people doing just that. You might want to check into this type of radiation, as less damage is done to healthy tissue than other forms of radiation, because the protons do not have an entry nor an exit dose of radiation- mostly just where it's targeted.
Thanks, Daff. I didn't know much about the proton radiation until I read your posts, and discovered this was now available in Jax. My husband is being followed at Shands in G'ville, and I don't think they have proton therapy there. We are an hour from G'ville, and more than two hours from Jax -- insurance is really resistant about distant treatment, and we've had to fight to even get Shands in G'ville. I also don't know if DH may be disqualified from this therapy since he has already had LRP, but we will certainly discuss, and do some more research. Thanks for the info.

As a response to your question, I have just experienced within the last 6 months, Davinci surgery, Hormone Therapy, and lastly Radiation therapy. I had Davinci on April 24 after a biopsy that indicated a positive dre and an 8 gleason score. The post op path was worse, gleason 9 (4 + 5), positive margin, seminal vesicle involved. No lymph nodes involved and negative bone scan. I was referred to a medical oncologist at one of the premier teaching hospitals in the country (Barnes-Jewish) affiliated with Washington University. That doctor advised me that I should be receiving HT asap. I was started on HT in late June and then scheduled for RT with the IMRT Novalis shaped beam system in September. I just completed 35 IMRT treatments with absolutely no side effects. I have now had two Hormone shots (Lupron) June and September, next one scheduled in December. These will continue for a two year period at which time I will hopefully have undectable PSA that will stay that way for sometime. I also have minimal side effects with the Lupron, mainly hot flashes which are mild as I take Megestrel help with them. If I can help further let me know....Jerome.
Thanks, Jerome. Your experience sounds very similar to my husband's. Prior to surgery his PSA was 8.17 with gleason 8. Post op his gleason was 9 (4+5), positive margins, focal extra capsular invasion, but no seminal vesicle involvement, no lymph node involvement, and no apparent distant mets (negative bone scans and negative abdominal MRI). At the appointment last week, the surgeon spent a great deal of time with us, and was really upbeat that despite the rising PSA there was no need to be unduly worried -- as long as the PSA remained under 1 DH was still in good shape, and that radiation therapy would take care of the few remaining cells. When we got home a few hours later, the surgeon had left a long phone message about deciding that it was imperative that HT be started immediately. So it kind of shook us up -- this whole experience is a roller-coaster. About the time you start to believe that everything's good, something else jumps up and knocks you back down.
He did start the HT last week, and so far has only experienced hot flashes and disrupted sleep. We think that Dr Zlotecki (radiation oncologist) at G'ville Shands uses the IMRT Novalis, but not positive about that. Thanks very much for sharing your experience -- it's good to know that someone else has been through this.