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Old 09-07-2012, 02:08 AM   #1
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new member to the pc team ,JAC DE BKK

french , 75 yold, avk heart treatment , psa 5.7 , gleason 8 , irm and scintigraphy look fine but i may have occult metastase, french doctors = hormonotherapy [zoladex already started] and radiotherapy [prostatic and pelvian] I WAS HOPING FOR HIGHT DENSITY RT < but cannot due to anti vitamin k treatment> , CYBERKNIFE for gleason 8 may be too hight and what about pelvian irradiations any have experienced hight gleason +RT+HT as a TMT any advise welcome......

 
Old 09-09-2012, 03:18 AM   #2
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Re: new member to the pc team ,JAC DE BKK

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Originally Posted by jac de bkk View Post
french , 75 yold, avk heart treatment , psa 5.7 , gleason 8 , irm and scintigraphy look fine but i may have occult metastase, french doctors = hormonotherapy [zoladex already started] and radiotherapy [prostatic and pelvian] I WAS HOPING FOR HIGHT DENSITY RT < but cannot due to anti vitamin k treatment> , CYBERKNIFE for gleason 8 may be too hight and what about pelvian irradiations any have experienced hight gleason +RT+HT as a TMT any advise welcome......
Jac

Welcome to the board.

Your diagnosis with a Gleason 8 is for high risk of recurrence. The combi of hormonal (HT) plus radiation (RT) is typical in similar cases. Zoladex will turn the cancerous cells more receptive to the radiation leading to better outcomes.
The protocol differs among physicians and some subject the patient to long periods of neoadjuvant HT before administering RT but it seems that two to three months in HT is the preferred timing for the start of RT.
Ht will continue as adjuvant and in patients with grades 4 this usually lasts to 18 months. In the combi, radiation is in fact the treatment that may provide you cure however the results (for the good or the bad) will be seen after terminating the hormonal protocol.

All treatments have risks and side effects that you should be aware of.
I would recommend you to search in the net. You may also read books on the treatments.
Diet and a physical fitness program are important aspects to consider in countering the side effects (it helped me). Zoladex will lower your testosterone levels considerably and that will leave you with menopause like symptoms such as fatigue, hot flashes, low libido, etc. This drug is also linked to coronary risks so that you should discuss the matter with your doctor.

I would recommend you to get tested periodically for Testosterone, Heart health and Bone loss (osteoporosis). Check for vitamin D and B12 and any other supplement that you may think it good to take.

The National Cancer Institute got an article titled “An Overview of Nutrition in Cancer Care”, which may be of interest to you. Here is the site;
http://www.cancer.gov/cancertopics/pdq/supportivecare/nutrition/Patient/page1#Keypoint5

Wishing you luck in your journey.

Baptista

Last edited by Baptista; 09-09-2012 at 03:25 AM.

 
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Old 09-09-2012, 06:16 AM   #3
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Re: new member to the pc team ,JAC DE BKK

first thank you for your comments , i should go back to south of france to undergo some radioyherapy , i was looking for the new tmt byvarian true beam ,unfortunately not available before end 2013 in france, england ,switzerland , sweden maybe belgium or netheirland,,,in asia where i stay many months/year i think bangkok may have one site. if someone have done the rapidarc [vmat]...i would like to know...any advise welcome, anyone with gleason 8 having done IMRT and HT what type of experiences again thanks BAPTISTA my mood is on low level

 
Old 09-09-2012, 07:22 AM   #4
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Re: new member to the pc team ,JAC DE BKK

Hi Jac,
My treatment was with RapidArc on the Novalis Tx system -- TrueBeam is a bit faster, but each treatment was only about 5 minutes. CyberKnife is slower -- about 45 minutes each. I had a hypofractionated SBRT protocol of only 5 treatments. I had low-risk cancer, but several treatment centers in the US are now using it for high risk cases like yours, leaving much wider margins. I think hypofractionation gives better results than normal fractionation, but with lower toxicity. There are several linac machines that can deliver radiation this way. However, the machine does not matter so much as the tracking system, because with that kind of beam intensity it is vital that the prostate is tracked very accurately within the treatment (intra-fractional motion). They implant gold fiducials or Calypso radio transponders to track the motion.

May I also suggest you have a C11Choline or C11Acetate PET/CT scan prior to treatment. It is much better than technetium bone scans or even F18 PET scans in locating any metastases. It may be more available in Europe (e.g., Groningen, Rostock, Bologna, Turku, Aachen) than in the US.

- Allen

 
Old 09-09-2012, 05:26 PM   #5
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Re: new member to the pc team ,JAC DE BKK

here also ,thank you TALL ALLEN, from my researh it is not easy to find in europe the up to date varian true beam equipment into some hospitals ,may be LONDON and ZURICH, i sent them e.mail to known possibility , timing schedule and cost.....
i ll see my doctor for additional scan for metastases as you suggested....my psa is low and without my avk treatment i could have had an internal curie therapie hight flow plus a pelvian RT
flying to USA is quetionnable as i am not a very rich man , no insurance outside FRANCE, and i presume the cost of treatment should be hight......anyhow thank you i shall try to fight for life

 
Old 09-10-2012, 02:17 PM   #6
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Re: new member to the pc team ,JAC DE BKK

Jac

Regarding the Truebeam system you may find the location where the equipment is in operation by contacting the variant company. In Germany and England you can avail of CyberKnife.

Remember that by being a French national you can use your national health program card in other European (EU) country. You can get information at your SS center.

You can also check for possibilities of a treatment in Singapore, if that is convenient with your life style and place where you live

In any case, you need to consider that the treatment will require you to visit/stay the hospital during one week for CK and five weeks for IMRT, continuously.

Hope for the best.

Last edited by moderator2; 09-10-2012 at 03:46 PM. Reason: posted disallowed website

 
Old 09-10-2012, 05:51 PM   #7
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Re: new member to the pc team ,JAC DE BKK

THANKS , I AM IN TOUCH WITH THE EUROPEAN REPRESENTATIVE Of VARIAN TRUEMOVE...HE WILL LET ME KNOW THE CLOSEST PLACES I COULD GO < THEN I HAVE TO TAKE APPOINTMENTS AND <OF COURSE < BRING MY MEDICAL FILE FOR ADVISE ......I GOT AN APPOINTMENT ON NOV 8 FOR THE SECOND SHOOT OF ZOLADEX 10.8 thanks BAPTISTA

 
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