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Board: Cancer: Prostate 07-24-2013, 10:44 PM
Replies: 2
Views: 897
Posted By Tall Allen
Re: Gl 9

Some high risk men get RP, but the failure rate seems too high to me, and they often need salvage radiation, which has worse side effects than if they had radiation to begin with. It makes sense to...
Board: Cancer: Prostate 07-24-2013, 05:59 PM
Replies: 1
Views: 663
Posted By Tall Allen
Re: My ongoing nightmare:

I thought of you when I read the following:

http://www.ncbi.nlm.nih.gov/pubmed/23697595

Perhaps someday men will be pre-screened for radiation hypersensitivity.

I've heard great reports on...
Board: Cancer: Prostate 07-23-2013, 11:22 AM
Replies: 8
Views: 1,231
Posted By Tall Allen
Re: Rising PSA

Your PC is considered "low risk" and NCCN (most of the top tertiary care cancer centers in the US) do recommend AS as a suitable way to deal with that. But some men have a psychological need to treat...
Board: Cancer: Prostate 07-22-2013, 09:51 AM
Replies: 8
Views: 1,231
Posted By Tall Allen
Re: Rising PSA

I assume you had no orgasms or bike rides with 48 hours of your last PSA test. Rapid rises like that may indicate prostatitis or urinary blockage. It's entirely likely you picked up some prostatitis...
Board: Cancer: Prostate 07-21-2013, 12:21 PM
Replies: 5
Views: 691
Posted By Tall Allen
Re: Multiparameter MRI Diagnosis Facility Help

That was about my age at diagnosis. Keep in mind that most prostate cancer is insignificant and indolent and does not require immediate treatment, if ever. You might want to read up about Active...
Board: Cancer: Prostate 07-21-2013, 11:15 AM
Replies: 5
Views: 691
Posted By Tall Allen
Re: Multiparameter MRI Diagnosis Facility Help

No. I would get the first biopsy locally. A normal TRUS-guided biopsy isn't a highly specialized procedure. Only about 30% of first biopsies are positive for cancer. I'd save my money for later, if...
Board: Cancer: Prostate 07-21-2013, 10:43 AM
Replies: 5
Views: 691
Posted By Tall Allen
Re: Multiparameter MRI Diagnosis Facility Help

mpMRIs are usually reserved for second biopsies when the first biopsy was negative but something still seems to be going on. A standard 12-core TRUS-guided biopsy usually is a better first step and...
Board: Cancer: Prostate 07-12-2013, 05:20 PM
Replies: 20
Views: 3,478
Posted By Tall Allen
Re: PSA down to 3.2 from 22.2 during hormone treatment

There are other kinds of scans like C11 Acetate PET scans that have much lower detection limits. Sometimes the cancer is in 5 or fewer places (called oligometastatic disease) that can still be...
Board: Cancer: Prostate 07-11-2013, 09:01 AM
Replies: 20
Views: 3,478
Posted By Tall Allen
Re: PSA down to 3.2 from 22.2 during hormone treatment

Sorry to hear that, Addn. It sounds like the cancer has escaped the prostate, and the hormone therapy is keeping it in check. I assume they did a bone scan while your PSA was high and found nothing?...
Board: Cancer: Prostate 07-10-2013, 04:08 PM
Replies: 20
Views: 3,478
Posted By Tall Allen
Re: PSA down to 3.2 from 22.2 during hormone treatment

Hormone therapy will force your PSA down.
I'm unclear - did you have the hormone therapy before, during and following the radiation? Or are you saying that you began hormone therapy after radiation...
Board: Cancer: Prostate 07-10-2013, 04:04 PM
Replies: 3
Views: 726
Posted By Tall Allen
Re: Need advice on symptoms !! WORRIED

Nothing that you're describing sounds even remotely like PCa.
If there are spots of bright red blood when you wipe yourself, it is most likely from internal hemorrhoids.
Tics and twitches happen....
Board: Cancer: Prostate 07-05-2013, 03:00 PM
Replies: 1
Views: 775
Posted By Tall Allen
Re: Prostate Cancer Back After 13 Years?

How nerve-wracking is that! Not necessarily a recurrence though. You might want to ask them to culture the biopsy cores to check for bacteria that may be causing prostatitis. Or it could be a...
Board: Cancer: Prostate 07-04-2013, 10:21 AM
Replies: 13
Views: 16,313
Posted By Tall Allen
Re: High PSA - negative biopsies - Low Testosterone - Connection ??

The gene tests that got a lot of press lately were Prolaris and OncotypeDx.

DNA methylation is part of normal cell differentiation and also of carcinogenesis. I read that DNA methylation is...
Board: Cancer: Prostate 07-02-2013, 04:55 PM
Replies: 3
Views: 623
Posted By Tall Allen
Re: Prognosis indeterminate: Always?

I've gotten pretty good at reading and translating Medicalese to English. Please feel free to ask if I can translate anything for you.

Doctors are very busy actually treating people and don't...
Board: Cancer: Prostate 07-02-2013, 03:12 PM
Replies: 3
Views: 623
Posted By Tall Allen
Re: Prognosis indeterminate: Always?

He's having ADT+HDR+IMRT -- right? The following retrospective study of almost a thousand men showed that the 8-year biochemical failure rate for that combo therapy was only 14% and the 8-yr cancer...
Board: Cancer: Prostate 06-27-2013, 11:35 AM
Replies: 5
Views: 805
Posted By Tall Allen
Re: Differences among proton beam centers?

SBRT=Stereotactic Body Radiation Therapy
EBRT=External Beam Radiation Therapy
SBRT is one kind of EBRT. It usually involves 5 high-intensity treatments. CybeKnife is one popular kind of SBRT. It...
Board: Cancer: Prostate 06-26-2013, 09:44 AM
Replies: 5
Views: 805
Posted By Tall Allen
Re: Differences among proton beam centers?

I am talking about both cure rates and side effects. The studies so far do not support any additional benefit to proton beam therapy for PC. For more info that I accumulated on protons, please see my...
Board: Cancer: Prostate 06-25-2013, 11:20 PM
Replies: 5
Views: 805
Posted By Tall Allen
Re: Differences among proton beam centers?

There are two kinds of proton devices - the old kind, like at Loma Linda and Mass General, and the newer pencil-beam proton, like at MD Anderson & UF Jacksonville. There are no published oncological...
Board: Cancer: Prostate 06-18-2013, 01:09 AM
Replies: 1
Views: 480
Posted By Tall Allen
Re: prostate

An increase of .3 in your PSA is not significant -- recurrence isn't even suggested unless your PSA goes up by at least 2.0. What does your RO say?
Board: Cancer: Prostate 06-16-2013, 10:56 AM
Replies: 11
Views: 1,184
Posted By Tall Allen
Re: Feeling so deflated

The hormones are before ("neoadjuvant") and during ("concurrent"), because they may help the IMRT be more effective at killing the cancer. Many of the worse effects of hormone therapy like bone loss...
Board: Cancer: Prostate 06-08-2013, 09:40 AM
Replies: 3
Views: 719
Posted By Tall Allen
Re: Lupron and male breast swelling

I know 2 guys who had the radiation pre-treatment for this common occurrence. However, tamoxifen may work even better than radiation. In fact, some researchers found it worked much better:...
Board: Cancer: Prostate 06-06-2013, 12:38 PM
Replies: 3
Views: 2,243
Posted By Tall Allen
Re: Headaches from Flomax?

Speedster356,

I switched from Flomax to Rapaflo and all my urinary issues disappeared immediately. There are probably a dozen different alpha-blockers on the market. You can ask your Uro if he has...
Board: Cancer: Prostate 06-01-2013, 12:30 PM
Replies: 11
Views: 1,184
Posted By Tall Allen
Re: Feeling so deflated

I think most ROs do the brachy boost a week or two before the IMRT. My layman's guess is that the placement is more accurate if they insert the radioactive needles in a prostate that is not already...
Board: Cancer: Prostate 06-01-2013, 10:19 AM
Replies: 11
Views: 1,184
Posted By Tall Allen
Re: Feeling so deflated

I'm so sorry to hear about the disappointing biopsy upgrade. I know that feeling when bad news like that arrives, like a cold wind freezing your heart. Thank God that you have taken the steps and...
Board: Cancer: Prostate 05-31-2013, 08:37 AM
Replies: 2
Views: 707
Posted By Tall Allen
Re: Crazy PSA Numbers - Help!

When it goes up and down like that it's usually not PC. PSA from PC goes up steadily. Did your Uro tell you that he thought you have prostatitis? They often give Cipro to see if that will clear that...
Board: Cancer: Prostate 05-29-2013, 09:35 AM
Replies: 5
Views: 1,315
Posted By Tall Allen
Re: TomoTherapy radiation and studies on side effects?

There is no doubt that HDR provides greater flexibility in dosimetry than LDR. I think it's fascinating how they use dwell times to regulate the dose, and that it's all calculated and run by...
Board: Cancer: Prostate 05-28-2013, 07:56 PM
Replies: 5
Views: 1,315
Posted By Tall Allen
Re: TomoTherapy radiation and studies on side effects?

I guess I use all the medical jargon without thinking.

IGRT=Image guided radiation therapy. It's a general term that can be used in conjunction with any kind of external beam radiation - they use...
Board: Cancer: Prostate 05-28-2013, 06:42 PM
Replies: 5
Views: 1,315
Posted By Tall Allen
Re: TomoTherapy radiation and studies on side effects?

I can't help you there because I haven't seen any comparative studies. But I can't imagine that it would be much different from any other IGRT technique in which intrafractional motion, and not just...
Board: Cancer: Prostate 05-25-2013, 11:06 AM
Replies: 15
Views: 2,491
Posted By Tall Allen
Re: PCa progressing at a 3.5 month Double Time

It sounds like you got 2 very good strategies. As I think about it, the adjuvant ADT makes sense in your case because of the higher probability that there are stray cancer cells out there beyond the...
Board: Cancer: Prostate 05-25-2013, 10:35 AM
Replies: 20
Views: 1,429
Posted By Tall Allen
Re: Husband recently diagnosed

I'm happy to have helped in any way. After all this information-gathering and doctor-consultations, you both will have some difficult decisions to make. I hope you will keep posting and share your...
Board: Cancer: Prostate 05-24-2013, 09:34 AM
Replies: 20
Views: 1,429
Posted By Tall Allen
Re: Husband recently diagnosed

Dealing with hospitals and insurance companies can be a nightmare.

IMHO, one way of making sure of "getting it all" is to have better imaging. In your husbands case, he has a small prostate which...
Board: Cancer: Prostate 05-23-2013, 08:19 PM
Replies: 20
Views: 1,429
Posted By Tall Allen
Re: Husband recently diagnosed

As I said, that's the standard of care. Personally, I was looking for something that had a better sexual SE profile, which is why I narrowed it down to SBRT or HDR brachy monotherapy for myself. But...
Board: Cancer: Prostate 05-23-2013, 08:24 AM
Replies: 20
Views: 1,429
Posted By Tall Allen
Re: Husband recently diagnosed

I forgot to mention a comment about his prostate size. 20 ml is small, which is an additional adverse feature. Sometimes doctors calculate the PSA density (PSA/prostate volume), which is .585 in his...
Board: Cancer: Prostate 05-22-2013, 10:24 PM
Replies: 20
Views: 1,429
Posted By Tall Allen
Re: Husband recently diagnosed

He's right that not many do those as monotherapies -- you would have to go to one of the specialists I mentioned for that and travel outside of Montana.. Sorry -- I should have made it clear that...
Board: Cancer: Prostate 05-21-2013, 11:40 AM
Replies: 20
Views: 1,429
Posted By Tall Allen
Re: Husband recently diagnosed

If they gave the dimensions of the prostate, I can calculate the volume for you, or if you call the uro's office and ask, they can probably tell you. T2a or b is good and won't preclude any...
Board: Cancer: Prostate 05-21-2013, 10:19 AM
Replies: 20
Views: 1,429
Posted By Tall Allen
Re: Husband recently diagnosed

For my comments on proton, please see post #16 on the following thread:

http://www.healthboards.com/boards/cancer-prostate/909558-active-surviellance-viable-option-now.html

You'd be talking...
Board: Cancer: Prostate 05-20-2013, 10:54 PM
Replies: 20
Views: 1,429
Posted By Tall Allen
Re: Husband recently diagnosed

Thanks for the plug, Robert ;-)

Deb,
I know what a shock that must've been for both of you. But you should know that many men with a similar diagnosis, which is called "intermediate risk" do get...
Board: Cancer: Prostate 05-16-2013, 08:41 PM
Replies: 21
Views: 7,456
Posted By Tall Allen
Re: Prostate Cancer

Warfarin may not be necessary if the estrogen is taken as a transdermal cream or patch. It seems to cause blood clots only when taken as a pill or injection. The slow, steady infusion through the...
Board: Cancer: Prostate 05-08-2013, 08:45 AM
Replies: 13
Views: 16,313
Posted By Tall Allen
Re: High PSA - negative biopsies - Low Testosterone - Connection ??

Gina,
I don't think we are not allowed to give doctor recommendations on this board. You might be interested to read about his work on 5-alpha-reductase inhibitors, which can prevent the metabolism...
Board: Cancer: Prostate 05-05-2013, 03:57 PM
Replies: 6
Views: 801
Posted By Tall Allen
Re: Disease free survival for prostate cancer

I'm sorry to hear about your biochemical (PSA) progression. You may be aware of Dr. King's recent analysis that showed the importance of having salvage radiation (SRT), and enough of it -- 70 Gy,...
Board: Cancer: Prostate 05-05-2013, 09:53 AM
Replies: 6
Views: 801
Posted By Tall Allen
Re: Disease free survival for prostate cancer

The longest tracking I know of is from Johns Hopkins. They report that 68% had progression-free probability after 25 years post RP.
http://www.ncbi.nlm.nih.gov/pubmed/23083655


At Memorial Sloan...
Board: Cancer: Prostate 05-05-2013, 12:16 AM
Replies: 6
Views: 801
Posted By Tall Allen
Board: Cancer: Prostate 04-26-2013, 10:24 AM
Replies: 21
Views: 7,456
Posted By Tall Allen
Re: Prostate Cancer

I'm sorry to hear it has metastasized, and that it has become castration-resistant. There's been some research recently that showed that lower, more frequent doses of Taxotere may work just as well...
Board: Cancer: Prostate 04-25-2013, 11:42 AM
Replies: 14
Views: 2,542
Posted By Tall Allen
Re: IADT, 8 months on vacations

Hi Rhonda,

From everything I've read, the biggest prognostic indicator is how complete the early response is to ADT, and how quickly that happens. I'm not minimizing the adverse impact of PSADT,...
Board: Cancer: Prostate 04-21-2013, 07:53 PM
Replies: 6
Views: 952
Posted By Tall Allen
Re: PCa4 PSA 100 Gleason 1+1????????

In the US, primary Gleason grades below 3 are not reported. And it is unknown for Gleason grades below 4 to be metastatic.
Board: Cancer: Prostate 04-21-2013, 02:27 PM
Replies: 6
Views: 952
Posted By Tall Allen
Re: PCa4 PSA 100 Gleason 1+1????????

There's no such cancer diagnosis reported as Gleason 1+1. Pathology only reports the dominant Gleason grade of 3 or more. If the pathology report is correct (I doubt it), it would mean that your...
Board: Cancer: Prostate 04-21-2013, 10:28 AM
Replies: 14
Views: 2,542
Posted By Tall Allen
Re: IADT, 8 months on vacations

Hi Baptista,

If your previous SRT already irradiated the pelvic nodes with sufficient dosage, I agree that there is no point to looking there for the cancer. In my friend's case, his SRT was...
Board: Cancer: Prostate 04-19-2013, 12:13 PM
Replies: 2
Views: 724
Posted By Tall Allen
Re: wife and I concerned about biopsy...

Low natural levels of testosterone (hypogonadism) are, unfortunately, associated with prostate cancer. There is no evidence that testosterone supplementation contributes to or aggravates PC. In fact,...
Board: Cancer: Prostate 04-17-2013, 04:20 PM
Replies: 15
Views: 2,491
Posted By Tall Allen
Re: PCa progressing at a 3.5 month Double Time

You are right that hypofractionated radiation (SBRT or HDR) is easier on surrounding tissues than IMRT. They have consistently found no benefit to ADT with hypofractionated radiation. I'm sure they...
Board: Cancer: Prostate 04-17-2013, 04:11 PM
Replies: 14
Views: 2,542
Posted By Tall Allen
Re: IADT, 8 months on vacations

I should have added that I know of two places in Italy that have experience treating mets with SBRT. Dr. N. Di Muzio, Radiation Therapy, at San Raffaele Scientific Institute in Milan, Italy, and Dr....
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