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Old 04-21-2008, 02:06 PM   #1
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Just beginning the journey

Husband recently got diagnosed with prostate cancer. Dr. is recommending hormone therapy for a couple of months followed by radiation therapy. Everyone reacts different to treatment, we are not sure what to expect. We are both worried about the quality of life after treatment; he is worried about our sex life (I am 18 years younger); I am worried about emotionally losing him and the life we have built together. I think we are both in shock and in a little bit of denial right now, although appointment with Radiologist will shock us into reality I am afraid. How do you make informed treatment choices without letting your emotions make them for you.

 
Old 04-21-2008, 02:56 PM   #2
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Re: Just beginning the journey

It's not unusual to have these feelings and questions after the diagnosis, but once you learn of the alternative treatments and the success stories that are many, you can gain a different perspective.

While we're not doctors, many of us on this board have gone through the entire process. If you let us know your husband's age and other details of the
diagnosis (Gleason score, PSA) and anything else of significance that the doctor has told you, we'd be happy to give you our thoughts.

There are several good books, and that can be a start. I myself feel fortunate
to have had proton beam therapy, as this form of radiation is very targeted and results in fewer side effects than many of the other alternatives.

 
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Old 04-21-2008, 05:42 PM   #3
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Re: Just beginning the journey

Quote:
Originally Posted by MaryLiz50 View Post
Husband recently got diagnosed with prostate cancer. Dr. is recommending hormone therapy for a couple of months followed by radiation therapy. ... We are both worried about the quality of life after treatment; he is worried about our sex life (I am 18 years younger); I am worried about emotionally losing him and the life we have built together. I think we are both in shock and in a little bit of denial right now, although appointment with Radiologist will shock us into reality I am afraid. How do you make informed treatment choices without letting your emotions make them for you.
Hello MaryLiz,

I'm sorry you and your husband have had to join with the rest of us going through this journey. Shock and denial are reactions that most of us remember well - pretty typical, but it should get better. I was diagnosed with a challenging, high-risk case in December 1999, and my wife and I despaired that we would ever know a joyful day again. We were both surprised when we experienced joy again within a few weeks, and we have lived a good and fulfilling life since then, though it hasn't always been a cake walk. I hope it will be comforting to you both to consider that many others have gone down this road, and there are so many success stories.

I hope you don't mind a longish response. The bottom line is: inform yourselves and start a supportive lifestyle program.

To start with your last question first, there are some excellent resources for becoming informed, and there are degrees of information that we as patients and mates want, sometimes one of us more than the other. Some of us just want enough information to have an overview of the options but really want to put the decision making on automatic pilot, with the doctor calling the shots. That's like kicking the tires and trying the doors when you buy a car, but without wanting to know what makes the car go. On the other hand, many of us want to know what options are available, and to know the key ideas and facts behind these options; we are the patients who want to be empowered, and we want to be partners with our doctors in our care and to be in charge when it comes to key decision making.

I have a strong bias: I'm convinced that being empowered is best, by far, if the patient or partner is up for it. Too many doctors we first consult for prostate cancer have a strong bias in favor of the treatment they usually provide. In other words, while giving lip service to other options, unfortunately most (not all) urologists will overwhelmingly strongly recommend surgery, and most radiation doctors (not all) will overwhelmingly strongly recommend radiation. That has been proven by formal research.

Frequently neither group will suggest active surveillance, cryo surgery, or other alternatives as reasonable options even when they are appropriate as potential alternatives in the patient's circumstances. Frequently doctors will put too little effort into assessing the key details of the patient's cancer or in winnowing out treatment options that are not among the better choices when the patient's individual circumstances are considered. There is a two-pronged strategy to counter that: (1) become an empowered patient, and (2) get a second opinion, which for many of us is actually a second, third, fourth and fifth opinion from doctors in different specialties. Getting additional opinions is par for the course in prostate cancer and very important; the disease is simply too complex for any doctor to master all of the ins and outs of all of the treatment options.

There are some good books for a basic orientation, written in language and with a style that is easy to understand for the new patient. For example, the series updated by Dr. Sheldon Marks, MD, "Prostate & Cancer," is excellent. Another similar book is "100 Questions & Answers About Prostate Cancer," by Pamela Ellsworth, MD, John Heaney, MD, and Cliff Gill. These books will get you to the kick-the-tires, check-the-doors level. You will get some sense of the odds of success with various treatments, but you won't learn the details about tailoring treatment options to the patient, something that is vital to maximize your chances for success.

For true empowerment, I'm convinced the best general book, by far, is "A Primer on Prostate Cancer," by Dr. Stephen B. Strum, MD, and Donna Pogliano, wife of a survivor and well-known PC activist and PC educator. It is thorough and has wonderful graphics and charts. On the downside, some readers will find it too technical, though Mrs. Pogliano did a fine job of channeling Dr. Strum's technical approach into language that most of us can understand. I believe it is one of the least biased books available in covering the span of available diagnostic/staging technology and treatment options.

There are other excellent books that are strong on particular treatments. You mentioned radiation with a hormonal blockade boost as the approach you both are currently considering. I believe the best book is by Dr. Michael Dattoli, MD, Jennifer Cash, ARNP, MS, OCN, his chief nurse, and Mr. Don Kaltenbach, a well-known PC survivor, activist and educator working with the team, 2005, "Surviving Prostate Cancer without Surgery - The New Gold Standard Treatment That Can Save Your Life." In fact, the Dattoli team recently had a paper published by a major medical journal (Cancer, 2007 summer) with their encouraging findings on their 14-year results using external beam radiation, seeds, and hormonal blockade, where appropriate. A book edited by some radiation experts from Seattle (Blasko, Grimm and Sylvester) also has some excellent chapters on radiation. There are fine books on other treatments which our fellow board participants may mention.

It appears you are both sensing the importance of mutual communication and awareness of worries and concerns, and I think you have already won half the battle by realizing the importance of relationship issues. An outstanding book on that is out of print but no doubt available. It is "Prostate Cancer - Portraits of Empowerment" by Nadine Jelsing, 1999. It reviews the experiences of ten prostate cancer patients and includes inputs from several of their wives. The Dattoli/Cash/Kaltenbach book is also good on addressing relationship issues. Regarding concerns with intimacy and specifically sex, books and resources from Ralph and Barbara Alterowitz are helpful, such as their "The Lovin Ain't Over. The Couple's Guide to Better Sex after Prostate Disease." Another interesting first hand account is "In Sickness and in Health - Surviving Prostate Cancer Together," by Mary Carolyn Cook Gervais, 2005, which details her and her husband's journey through surgery, radiation, and hormonal blockade. There are a few factual flaws, but overall it makes many excellent points. Dog lovers and skiers will find it especially entertaining. An old classic is "His Prostate and Me" by Disiree Howe, wife of the former chairman of Penzoil, Richard Howe. Both are extremely active in educating prostate cancer patients and their mates. I especially like her answer about the worth of empowerment: "Those who know the most do the best." There are other good books. There are some approaches with a low impact on sex and intimacy that might be appropriate, such as active surveillance and one-time triple hormonal blockade (dip in interest in sex for about a year, then recovery).

The other key tactic that can help overcome emotion and shock is to start a lifestyle program that helps counter prostate cancer. The three essentials are diet/nutrition/supplements, exercise (especially aerobic and strength), and stress reduction. I posted about the basics in a thread entitled "Nutrition and lifestyle tactics" on March 6, 2008. There is good evidence to support all of the tactics, though none of the tactics yet have conclusive evidence of effectiveness. One of the great things about a lifestyle program is that it is something you and your husband can do on your own, and you can start now. Just being able to fight back helps overcome the emotion and shock of diagnosis. It helped me and my wife when we were trying to get our feet back on the ground in early 2000, though I thought I might turn red from the can of tomatoes my wife insisted I consume each day.

It would help us respond if we knew more about your husband's case, to the extent you are willing to share them,including key facts that you both should know. They include: overall health, any serious other health concerns, age, PSA now, PSA trend (especially the PSA about a year before diagnosis), Gleason Score (like 3+3=6) and whether it was reviewed by an expert in prostate cancer rather than a general pathologist, the stage (mostly based on the DRE, like T2a, T3a, etc.), the number of biopsy cores that were positive, the percent of cancer in the positive cores, and any CT, bone or other scan results (often unnecessary in low-risk situations).

Good luck to you both, and take care,

Jim

 
Old 04-27-2008, 04:19 PM   #4
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Re: Just beginning the journey

Jim - Thank you for your words of encouragement. My husband is 67 and other than this extremely healthy. His last PSA was 55, his Gleason score was a "high 7." The doctor said his cancer was on one side, the other is cancer free. His cancer was found because his PSA was rising and his doctor erred on the side of caution and scheduled him for a biopsy. The cells apparently are scattered. He chose radiation therapy as his treatment, hormone therapy and 45 radiation treatments. While they gave him a 90%+ chance of surviving 10 years and we are not worried about him living, it colors everything else in your life. We try not to talk about it alot, we don't want it to overwhelm our lives with this but that has been hard. I find myself feeling very sad and crying for no reason (I know I need to stop doing that) and he spends his time telling me not to worry and not to cry. I ordered a couple of the books you mentioned, I am looking forward to getting them and am encouraged that you and your wife are doing so well. I hope we can be as strong in the upcoming months as you two are.

Thank you again.

 
Old 04-28-2008, 07:05 AM   #5
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Re: Just beginning the journey

Quote:
Originally Posted by MaryLiz50 View Post
Jim - Thank you for your words of encouragement. My husband is 67 and other than this extremely healthy. His last PSA was 55, his Gleason score was a "high 7." The doctor said his cancer was on one side, the other is cancer free. His cancer was found because his PSA was rising and his doctor erred on the side of caution and scheduled him for a biopsy. The cells apparently are scattered. He chose radiation therapy as his treatment, hormone therapy and 45 radiation treatments. While they gave him a 90%+ chance of surviving 10 years and we are not worried about him living, it colors everything else in your life. We try not to talk about it alot, we don't want it to overwhelm our lives with this but that has been hard. I find myself feeling very sad and crying for no reason (I know I need to stop doing that) and he spends his time telling me not to worry and not to cry. I ordered a couple of the books you mentioned, I am looking forward to getting them and am encouraged that you and your wife are doing so well. I hope we can be as strong in the upcoming months as you two are.

Thank you again.
Hi MaryLiz,
I am sorry to see you on this board as well, but i am sure this will hel you with alot of menatl help and knowledge.

Truly there is no Right or Wrong treatment, it i a matter of individual choice, now days you have many options and the only question is what is RIGHT FOR YOU , with learning about the disease and how to fight it will give you also a clear idea of what your choice should be , so as long as you educate yourself you make your choice easier, and the bottom line is how you can deal with the side effects (some take effect immediately after treatment and last for a while but can over come and in other treatments they take a while to appear BUT MIGHT never go away) which makes your choices right for you.
Many on this forum chose the DaVinci Robotic procedure to remove the prostate (if the cancer is confined and the nerve bundle is spared they report an excellent recovery and side effect outcome...) and others had to go the radiation and hormone therapy route.

Since you had mentioned that your husband is in good health and worry about your quality of life afterwards (your sex life in particular) i have read about some members that return to potency only in couple of months after the Davinci , i had my Open RP surgery back in June 2007 and doing very well, i am 54 at present , but yet i wish i have known about this \board and others before my surgery to educate myself more.

so try to educate yourself, seek other professionals opinion (2nd and 3rd opinions always help) and i am sure you will maKE the right choice for you and your husband , and be able to deal with the after math effects.

Good Luck an keep us posted

PS it is a key element which ever way you chose , to select the best professional or surgeon that have the most experience wit prostate treatment.

Again Good Luck !!

 
Old 04-28-2008, 10:27 AM   #6
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Re: Just beginning the journey

Hi MaryLiz, I am sorry to learn of your husbands diagnosis. It is only normal to go through a whole range of emotions, I was diagnosed in March last year and we scheduled the surgery for July, 30. Inbetween my mom and dad had a 50th wedding anniversary, there was a wedding of a young nephew and my dear wife arranged a suprise birthday party for me, staying busy with all of this family stuff helped to distract us but at least once a week one or both of us would get very teary eyed.

In terms of side effects I think you have chosen the most benign of the treatments, do read and learn about the side effects of the androgen deprivation, it made me feel very different emotionally and caused me a great deal of fatique late in the process. You may want to see if there is a center convienently located which offers Proton beam. This is a type of IMRT that does not have an exit dose of radiation associated with it and should cause less side effect.

I could not have done it without the support of my wife, I am sure your husband some months from now will be making a similar statement.

Best of luck to you, please let us know as you proceed. Scott

 
Old 04-29-2008, 01:58 PM   #7
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Re: Just beginning the journey

Quote:
Originally Posted by MaryLiz50 View Post
.... My husband is 67 and other than this extremely healthy. His last PSA was 55, his Gleason score was a "high 7." The doctor said his cancer was on one side, the other is cancer free. His cancer was found because his PSA was rising and his doctor erred on the side of caution and scheduled him for a biopsy. The cells apparently are scattered. He chose radiation therapy as his treatment, hormone therapy and 45 radiation treatments. While they gave him a 90%+ chance of surviving 10 years and we are not worried about him living, it colors everything else in your life....
Hi MaryLiz,

As GBINAB emphasized, learning about the disease is helpful, and it appears you and your husband are well on the way. I've a hunch you both will feel better as you start fighting back against the cancer.

Your husband's case is clearly challenging; in several ways it reminds me of my own case and the ideas I've considered over the years and up to the present. I think your husband's choice of external beam radiation and hormonal blockade makes a lot of sense as one sound option that is tailored to his circumstances. In this game, like a football game, the quarterback (us) needs to be mindful of what the defense will let him do. Guys with low-risk cases can do almost anything and be successful, though with different kinds of "bruises", meaning side effects and complications. Older guys with challenging cases will succeed infrequently with therapies that just target the prostate - the "local" therapies, but they often enjoy success with therapies that can roam through the pelvis or throughout the body as well as the prostate.

Scott and daff both mentioned proton therapy, which itself - with its key characteristic of remarkably precise targeting, is good at getting cancer within the prostate. However, proton centers know how to combine proton radiation with other external beam radiation when the cancer is likely to have spread beyond the prostate, making proton beam reasonable for more advanced cases too. Other types of radiation facilities can also do good work with low-risk as well as challenging cases, and I get the impression from what you posted that your husband may have already chosen such a center to do the radiation.

It appears hormonal blockade therapy prior to the radiation and during it too, as I understand it - still learning, has a number of favorable effects in working with the radiation. For one thing, it shrinks the prostate itself, perhaps allowing a more targeted very-high-dose region than would otherwise be possible, which probably decreases the chance of damage to the rectum and other healthy tissue. (That's a point where proton beam excells.) Hormonal blockade also stuns and kills prostate cancer cells, clearing the way for the radiation to do its work. Hormonal blockade also increases oxygen circulation in tumors crammed with cancer cells by opening up internal areas (where blood circulation has been choked off) as a result of its cell-killing activity. This is important as radiation needs oxygen present in order to generate the free radicals by which it kills cancer cells, including the prostate cancer stem cells that are not affected by hormonal blockade. (It used to be thought that hormonal blockade did not actually kill any prostate cancer cells; now we know that is not so.) Hormonal blockade is also able to stun, starve and otherwise kill some wayward prostate cancer cells throughout the body, far from the radiation's impact, as I understand it as a layman survivor.

Scott mentioned not caring for the side effects of blockade, something that the vast majority of men who have had blockade would agree with, including me. However, for most of us blockade is quite tolerable, especially if we use tactics known to help counter the side effects. (Many doctors using blockade are not familiar with them. Your husband should probe to see if his doctor seems to be aware of them. Many docs just focus on the therapy and don't concern themselves much with how the patient fares.) Also, generally, younger guys like Scott seem to have a rougher time, while older guys like your husband seem to have an easier time. But that's not a guarantee - there are exceptions.

 
Old 04-29-2008, 02:57 PM   #8
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Re: Just beginning the journey

Thank you all for enlightening us. It has been extremely interesting and helpful to hear other "war stories." My obvious concern is that he is still around for us to be old together. I think for him the hormone/radiation route is what he is most comfortable with. He talked to a few doctors and they all said removing the prostate or the hormone/radiation treatment option where the two he should look at. Since it does not appear his cancer has spread anywhere else and is localized in one side of his prostate, he feels this is his best option at this point. I think the hardest thing we have been having to deal with now is the emotional aspect of it all. I think shock and disbelief has gone away and now we are just mad and ready to get treatment over and get our life back.

 
Old 04-29-2008, 03:28 PM   #9
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Re: Just beginning the journey

Quote:
Originally Posted by MaryLiz50 View Post
Thank you all for enlightening us. It has been extremely interesting and helpful to hear other "war stories." My obvious concern is that he is still around for us to be old together. I think for him the hormone/radiation route is what he is most comfortable with. He talked to a few doctors and they all said removing the prostate or the hormone/radiation treatment option where the two he should look at. Since it does not appear his cancer has spread anywhere else and is localized in one side of his prostate, he feels this is his best option at this point. I think the hardest thing we have been having to deal with now is the emotional aspect of it all. I think shock and disbelief has gone away and now we are just mad and ready to get treatment over and get our life back.
Thanks for the updates. If you haven't made a final choice yet on the radiation part, I'd again encourage you to read about proton beam therapy- while it's a very small percentage of those choosing radiation that go this way, it's often because of lack of knowledge, since this generally provides the same benefits but with lower incidence of side effects. It's getting more popular, and many centers are in the works, but there are only 5 centers right now. The one doing this the longest, since 1990, is Loma Linda University in California, but I understand they have had such a strong response lately that they aren't taking new patients until late this year. The center in Jacksonville where I went is still taking patients. There are websites and an excellent book (You Can Beat Prostate Cancer- Robert Marckini).

 
Old 04-29-2008, 04:54 PM   #10
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Re: Just beginning the journey

Quote:
Originally Posted by IADT3since2000 View Post
Scott mentioned not caring for the side effects of blockade, something that the vast majority of men who have had blockade would agree with, including me. However, for most of us blockade is quite tolerable, especially if we use tactics known to help counter the side effects.
Hi again MaryLiz,

I know Jim is not suggesting otherwise, but I want to make this statement concerning the 'blockade'.

I just want to be sure that everyone understands that the androgen deprivation is accepted as good therapy and is recommended in almost all cases of external beam radiation usually commencing a month or more prior to beginning radiaton treatment. I am not suggesting that the effects are so bad that you should not consider it, just that it is good to be aware that the effects for some can be quite profound and unexpected, but very worth going through to facilitate a good treatment.


Good luck, please continue to let us know. Scott

 
Old 04-29-2008, 10:52 PM   #11
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Re: Just beginning the journey

Quote:
Originally Posted by MaryLiz50 View Post
Thank you all for enlightening us. It has been extremely interesting and helpful to hear other "war stories." My obvious concern is that he is still around for us to be old together. I think for him the hormone/radiation route is what he is most comfortable with. He talked to a few doctors and they all said removing the prostate or the hormone/radiation treatment option where the two he should look at. Since it does not appear his cancer has spread anywhere else and is localized in one side of his prostate, he feels this is his best option at this point. I think the hardest thing we have been having to deal with now is the emotional aspect of it all. I think shock and disbelief has gone away and now we are just mad and ready to get treatment over and get our life back.
Hi again Liz,
i have read some of the comment s and advise by others here since i responded to your post .
As i have mentioned before educating your self about your options will be your best allied, no matter what others have chosen , and regardless of our "WAR STORIES" you should make the decision which you know is comfortable for you to live with (side effect included ..)
One more known fact i must bring to your attention since you mostly worry about beating the cancer and growing old together is that once you go the radiation route you ruling out any Surgery option in the future if further treatment is needed , But if you chose to remove the prostate by surgery , you always can do Radiation if further treatment is needed, which also helped me make my choice (besides the fact i wanted it all out of my body without any chances of "left Overs").

It is known that any treatment choice you chose will have similar side effects, the only question left is for how long, and how severe they can be.

I am only a survivor , not an expert or experienced with any of the other treatments but my surgery , my knowledge is based on research and learning about the options i had ..
Hope your journey will be easier with the help of this board
and wish your husband good luck !!! i am sure you 2 will make the right decision regardless of which way you chose.

Good Luck !!!

GB

 
Old 04-30-2008, 07:42 AM   #12
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Re: Just beginning the journey

Quote:
Originally Posted by MaryLiz50 View Post
... He talked to a few doctors and they all said removing the prostate or the hormone/radiation treatment option where the two he should look at....
GBINAB raised a common issue that new patients often hear from surgeons in discussing treatments: many surgeons will say that you can always do radiation if surgery fails, but it is very difficult and chancy to do salvage surgery after radiation. Fortunately, there is a way around this problem for those chosing radiation instead of surgery. It is rapidly becoming a problem of the past, though we are unlikely to hear that from our surgeons. And we have a role to play!

The key is for the patient to verify that the radiation doctor plans to give an adequate dose of radiation to the prostate. Research has clearly demonstrated that adequate high doses will eliminate cancer in the prostate as effectively as surgery will handle the cancer. Years ago, it was not possible to safely give the high doses of radiation to the prostate that are now routinely given at many centers. In fact, the radiation doctors were not even sure if the higher doses would do any good. The unfortunate consequence of a dose with Gray ratings in the 60s (as in 6000s cGy) was that some cancer in the prostate survived for some patients.

How things have changed! How quickly things have changed! When I was first diagnosed in December 1999, conventional external beam radiation given from four ports was the norm, and there were still questions whether radiation from seeds would do the job. Shaped radiation, known as 3D conformal, was just coming into its own. Proton beam radiation looked attractive, but there was little information on long term outcomes. About the time 3D conformal hit its stride, Intensity Modulated Radiation Therapy (IMRT) hit the scene, allowing radiation aimed from an arc of 180 degrees around the body and shaped.

Advanced techniques of positioning the body, tracking the subtle movements of the prostate (breathing, gas, etc.), and adjusting the aim on a daily and even real time basis to compensate became possible.

Then, as Dr. Myers related to us last week, TOMO therapy allowed a 360 degree arc for aiming, and the Cyber Knife carried this further to a sphere of aiming instead of a circle. Encouraging long term results data for proton beam radiation also became available, and it turned out that some severe radiation burns from that technique were associated with some mistakes made during one period at Mass General's facility - not at Loma Linda, and that that was no longer a problem. (My impression - I'd like to hear from expert MDs on that one.)

My impression as a layman is that advanced IMRT through Cyber Knife all can do the job very well in skilled hands (and minds). (That probably goes for older 3D CMRT in skilled hands, though the challenges would probably be greater.) That means the modern methods will deliver a very high dose, in the neighborhood of the upper 70s or higher Gray to the prostate with a lower but adequately lethal dose to surrounding tissue that might be cancerous, while avoiding a dangerous dose to nearby healthy tissue. We now also know that radiation from seeds is an effective choice in many circumstances, as is a combination of seeds and external beam radiation. The book "A Primer on Prostate Cancer" discusses dosing; a table on page 113 shows superior relapse-free survival when the dose ranged from 75.6 to 86.4 Gray instead of from 64.8 to 70.2 Gray - for intermediate risk cases, 70% vs. 50% at the five year point.

I too like the idea of having something in reserve, such as radiation in reserve if needed after surgery, rather than using up all our defenses. But the numbers are showing that relapse free survival with initial radiation is about the same as with surgery. Also, I've heard several radiation doctors remind their surgical colleagues that the statistics for success with surgery include the cases where radiation was used after surgery to handle problems. That means that radiation is doing as well as surgery that includes surgery aided by radiation. The radiation patient still has a lot in reserve if needed: cryo surgery is an established option, and so is hormonal blockade therapy. Some leading radiation doctors are even skilled at carefully using follow-up radiation, as described, for instance, by Dr. Michael Dattoli. There are other options beyond those if needed.

To me, the key is to ask the doctor what dose is planned for the prostate. I'm a layman and do not have any medical authority, but from what I read I would want the doctor to tell me the plan would call for a dose to the prostate in the upper 70 Gray range, or higher. If the plan were for a lower dose, I would at least want to get a second opinion from another radiation center.

Comments from our radiation guys?

I hope this is reassuring to you and your husband.

Jim

 
Old 04-30-2008, 12:24 PM   #13
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Re: Just beginning the journey

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Originally Posted by MaryLiz50 View Post
..... I think for him the hormone/radiation route is what he is most comfortable with.....
Just to add another variable, and I don't know the answer-- but I know there were several patients that were to go on hormonal blockade following their
proton radiation treatments at Univ of Florida Proton Therapy Institute. But I had heard that the proton facility at Loma Linda, CA asked higher-risk patients to have the hormonal blockade prior to their receiving the radiation treatments. Obviously a difference of opinion, and maybe there is no proven answer as to which way is preferable.
.

 
Old 04-30-2008, 01:20 PM   #14
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Re: Just beginning the journey

I was treated last year for Gleason 8 prostate cancer at the Dattoli Clinic in Sarasota with a combination of androgen deprivation, two sets of IG-IMRT and brachytherapy in between. The Dattoli clinic does nothing but prostate cancer all day every day and has done something like 30,000 cases for experience. Dr. Dattoli talked with me and my wife on the phone for more than an hour before I decided to go with them. They have peer-reviewed journal articles in Cancer and Urology that show better than 80% success rate with high risk cases and the latest in imaging technology. I am a natural skeptic with a Ph.D. in geophysics so am not easily impressed, but I have to tell you I am a convert. (No, I don't get a referral fee!). I urge you to check them out; someone else recommended their latest book. It was inconvenient to re-lo to Sarasota for six weeks but well worth it; they are also in the PPO my company insurance uses and take Medicare. My current PSA is undetectable. I would also recommend the book "Intimacy with impotence," written by a prostate cancer survivor and his wife which covers a myriad of issues frankly and clearly. Good luck whatever you decide to do.

 
Old 05-01-2008, 11:28 AM   #15
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MaryLiz50 HB User
Re: Just beginning the journey

Many many thanks to all of you for your input and advice. It helped us ask alot of questons we might not have otherwise thought to ask. We saw a total of 5 doctors, 1 GP, 1 Urologist, 2 Surgeons and 1 Radiologist. They too gave us alot to think about. The short of the story is Chris got his first hormone shot this morning. He goes for a CAT scan in June and starts radiation in either July or August. The most important piece of advice that we were given (and figured out for ourselves in the end) is that you need to feel comfortable with your doctors and your decision. I don't know what is to come during the next few months, but if everything in life was a sure thing no one on this board would be dealing with this in the first place. We are just looking forward to treatment being over. We will take what life throws at us during and after treatment a day at a time.

 
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