Radiation Therapy

had prostate surgery  with cancer in the tissue outside the prostate and gleason of 9, doctor has suggested radiation even though he said and the oncologist say it doesn't show any greater survival rate. should i put myself though this radiation ordeal even though no one thinks it will help?

On 5/31/2007 Westerville wrote:

had prostate surgery  with cancer in the tissue outside the prostate and gleason of 9, doctor has suggested radiation even though he said and the oncologist say it doesn't show any greater survival rate. should i put myself though this radiation ordeal even though no one thinks it will help?

I'm in the same position. Am doing a special diet and lots of suppliments to extend my survival. Have you done Hormone Therapy? Dr. Leibowitz of CAlifornia believes that local treatment for metastatic disease is not a good idea but other Dr.s have opposite opinions.

Your doctor is wrong, with known positive margins adding Radiation and ADT will increase survival.  Particularly with a high grade (gleason 9) tumor.  With a gleason of 9 you should not have had surgery as definitive treatment but external radiation and androgen deprivation therapy.

 

On 6/1/2007 Witchdoctor wrote:

Your doctor is wrong, with known positive margins adding Radiation and ADT will increase survival.  Particularly with a high grade (gleason 9) tumor.  With a gleason of 9 you should not have had surgery as definitive treatment but external radiation and androgen deprivation therapy.

I am not sure what the "Witchdoctor" agenda is, but something is wrong with him.

 

Why do you think that, try12? I mean, Witchdoctor is probably a radiation oncologist and his opinions and advice come from that side, but other than that he/she is saying very reasonable things, that are both logical and according to what is generally known about prostate cancer from many websites. There are many people on this forum, myself included, that value his opinions and have a good starting point for further looking into the matter.

Who are you TRY12 and what agenda are you talking about?  I offer "standard of care" advice that can be proven anywhere without much difficulty.  I do not solicit people to come to me or my clinic, my only concern is getting the word out on appropriate treatment, which sadly, sometimes is lacking.  Operating on a gleason 9 prostate cancer, while it can be done, is PROVEN not to be the best course of treatment and potentially costs lives and especially in younger prostate cancer patients where there is a higher percentage of high grade cancers.  Treatment with XRT and ADT result in a 60 to 70 percent cure.  Prostatectomy is 28 percent.

Surgery of Prostate cancer should go the way of the doe-doe bird since equal or better results can be obtained with less morbidity.  Why do you think Urologists are building their own centers for radiation.  I don't begrudge them this, in my opinion , it is a victory for better care.

There are people here who monitor the board who actively recruit patients. I am not one of them.  What is your agenda TRY???

ok, witchdoctor give me some advice since i am going for radiation treatment on the 6th of june. i realize now i should have had radiation before the surgery but that is not an option now. what questions should i ask this radiation oncologist , what is ADT? what do i take for two years ADT and radiation? i believe i am scheduled for 5 days a week 8 weeks of treatment. i really only know that it's external don't know which external is the best , Tomo? i have already made the first mistake, believing my urologist don't need to make more mistakes. have considered going to cancer treatment of america in phillie but at 59 and still working they are not going to hold my job forever after being off 6 weeks for the surgery. it's hard enough dealing with the cancer and not knowing who to trust. thanks for your advice.

State of the Art is Intensity Modulated Radiation Therapy.   Don't worry about Tomo, Cyberknife or Protons.  They are investigational and there is NO evidence they are better and I doubt they will ever be proven "better" or with fewer side effects but some people will mislead you by saying so.  All of them are putting the cart before the horse with regards to results and in some cases even ethics.

They should treat your LN's and the prostate bed and then treat the area of the prostate with a boost. 

If you had received the Radiation upfront the current protocol is to add Androgen deprivation therapy for at least two years.(this does not change just because you had surgery)  It used to be Lupron but now they have implants that can be used as well that last 6 months to a year.

This should give you close the the cure as doing it upfront would have but with some increase in potential of chronic irritation (not alot but more than before surgery)

The problem with the ADT is you have to be patient because the final answer will not be until you stop the drug after two years.

The ADT will cause Andropausal (like Menopausal) symptoms and you should take Vit, calcium and mineral supplements and watch your blood counts.  Occasionally you can get significant anemia.  Most people tolerate it fine with few if any problems so don't get too concerned.

If no one thinks it can help, don't do it.  It has a lot of side effects and can possibly make things worse.  My husband took it for 5weeks, one treatment daily and swears he will never do it again.  He was also told he needed Lupron Depot (1 shot a month for a year) without being told it was chemical castration.  After one shot and a lot of research we stopped that too.  We never were told about how importand diet is to any type of cancer.  We only drink purified water, got rid of all aluminum in the house, eat low fat no sugar, very little red meat and supplements and exercise.  He has only been out of the woods for one year however we check his psa every month and is remaing <0.2.  There are a lot of other issues he had during his diagnosis and treatment to make him so bitter about the medical profession and their way to diagnose and treat.