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rhome · 07-23-2010, 10:26 AM

I am now on my 28 EBRT treatment (70gy) which will end on number 39. My question is should I start HT treatments as soon as ERBT is done or should I wait for the next PSA test. They don;t want to do PSA until 3 months after ERBT completion. My orginal PSA was 5.4 and gleason of 5+4 at DX age 57. Went through clinical trials at City of Hope using textore consisting of 6 sessions and lupron. Psa droped to .1. Had RP done in Oct 2009. Seminal invasion positive margins but lympnodes clean. PSA 2 months after Rp was undectable. PSA after 4 months undetectable. PSA after 7 months .5. CT scan bone scan and prosticint scan all negative. Started ERBT in May 2010. Thanks for any input.

GUAMJOHN · 07-23-2010, 04:25 PM

I was put on Casodex for a short period the Lupron and stopped Casodex in the same time period as the start of radiation. However my Psa's were higher. My Rad Oncol at UCLA told me that because a Gleason 9 was highly agressive I should treat it most aggressively. Had I known about triple blockade I would have likely started it then.

All the best

John

Baptista · 08-12-2010, 04:12 AM

Hi, Rhome

Your description tells me that you are following a normal protocol for treatment of the cancer. Your doctor will use the PSA value as a marker of progress.
Unless for specific purposes, PSA tests usually are taken on intervals of three months. Don’t be anxious. Most probably you will have a smaller value in the next result but in my case the PSA reached its lowest mark 14 months after IMRT (EBRT). Only then it is considered in the plan of the next treatment, if any.
Surely, differences exist between cases, and so it is the way of confronting what to do next. Protocols are based on past experiences and usually fit a wider class of patients. I would recommend you to read some medical reports regarding PSA after EBRT. Take a list of questions with you for the next appointment with your doctor.

Wishing you the best
Baptista

Johnt1 · 08-12-2010, 12:50 PM

Rhome,
If you have seminal vesicile invasion then there is a high probability of lymphatic invasion.
A study out of Germany and Holland found that there are two lymphatic paths tha pc takes and the one path through the seminal vesicles will not be picked up through surgical sampling of the nodes. Unfortunality the only Scan that will accurrately indentify lymphnode involvement is the Combidex, which has been discontinued.
According to Dr Strum and other oncologists, HT should be started as soon a possible if Mets is suspected because it works much better when the tumor volume is low and the PC cells have not yet had a chance to mutate.
JohnT

rhome · 08-13-2010, 08:46 AM

Thanks to all for yor input. It will go a lomg way as to my making a decision. I am now done with ERBT and have a n appointment with my Onc at the end of August. I will keep you informed as to waht direction I am taking. FIGHT ON.

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