18th January 2008
[QUOTE=MGgator67;3397894]... told I had cancer in later part of 2005, long and short, I got seeded in November 2006 (based on early stage and monitoring). My numbers went from 4.3 before seeds to 7.5 two months after implants, then down to 4.7 two months after that and I thought that I was on the road to victory but not the case. My PSA numbers have been going up ever since, in November of 2007 it was 11.7, tested again in December at 8.9. I have had CT and Bone scans both negative, thought I could feel good about that, then I had a Prostatcint (sp) scan done two weeks ago and it showed that there is indication in "one" lymph node.... My current thinking is to take the path that will leave me with the most option when things don't go as one hopes. My doctor talked of some options; surgery to remove node(s) and then treat the prostate with cryo, remove prostate and lymph nodes, hormone theraphy, any thoughts?? Thanks for reading.
Hi MGgator67,
I'm sorry you have had this apparent recurrence. :( If it were not for that ProstaScint result, you could still have some basis for thinking that your bouncing PSA could be the often encountered "PSA bounce" after radiation therapy, especially after seeds. Maybe what you are experiencing is partly due to a harmless but scary bounce combined with a fairly mild recurrence.
I am a big fan of hormone therapy, which has been the only therapy for my challenging case, but the main drawback of that approach used alone at your stage is that it is not often curative. :( Of course it has the advantage of setting the cancer back on its heels wherever it is located in the body, even cancer that is too small to be caught by the scans, and hormone therapy actually kills much of the cancer. :) You could probably go on hormonal blockade for about a year, following that with a low-key maintenance drug like finasteride or Avodart. That could be all you would need. If not, you could repeat the hormone therapy or try something else.
Your first and third options make sense to me as a layman who has learned a lot about this disease but without any enrolled medical education, and the first option also gives you a shot at a cure. Did you have a regular ProstaScint or a fusion ProstaScint? The latter gives an outstanding anatomical image, making it fairly easy to spot the particular lymph nodes that are the problem so they can be targeted for removal. The former is not so clear, but a doctor could take out all the nodes in the general area to make sure he got the ones that caused the scan to light up. You could back up this approach with a year of hormonal therapy, hoping to clean up any small remnants that might escape the cryo and surgery.
Removing the prostate and lymph nodes could work, but I've heard that it is not so easy to remove the prostate after radiation. I hope you get some responses from other board participants more familiar with surgery, especially surgery after radiation.
Another option that is emerging is to go after the lymph nodes that appear to be the problem with highly targeted radiation. Forms of radiation known as IMRT, TOMO therapy, or Cyber Knife are three examples of this type of approach, but you would need to talk to a radiation oncologist about that. Both IMRT and TOMO facilities are available fairly close to you in the Washington, DC area. I believe that a number of facilities have IMRT, and Inova Fairfax Hospital has a TOMO facility. I believe TOMO is also available in Baltimore. I believe there is a Cyber Knife facility in the area somewhere.
Do you know if you are on appropriate supplements, plus nutrition, diet, exercise and stress reduction? Those tactics seem to help support therapies for recurrence. Here are a few key tactics that have quite a bit of research evidence though nothing conclusive yet: eliminate all dairy products (protein casein is one of several problems with dairy food); eat no red meat including pork (due mainly to arachidonic acid, but also to fat, cholesterol and other elements); use no flaxseed or canola oils since their omega 3s are not well metabolized by men and they are high in alpha linolenic acid, which appears to fuel prostate cancer, but do use olive oil; take 200 mcg of selenium from a yeast-based supplement daily unless you are diabetic or insulin resistant; take 200 IU of vitamin E daily that includes substantial gamma tocopherol; get about 30 mg of lycopene into your daily diet, spread throughout the day; supplement with vitamin D3 unless you are spending adequate time in the sun throughout the year, which probably means in the DC area supplementing during the cold weather months; trying 8 oz daily of a high quality pomegranate juice (kept refrigerated before opening) or pomegranate extract capsules; etc. There is some evidence that both aerobic and strength exercise improves the prognosis for prostate cancer patients. There is also evidence that minimizing stress helps us. The low-key medications finasteride or Avodart also may be helpful, and statin drugs not only lower cholesterol but appear to lower the risk of very advanced and lethal prostate cancer. I have found support for all of these tactics at the Government medical research website [url]www.pubmed.gov[/url], though you have to look at the balance of the evidence as most of it is not clear cut.
Good luck, take care, and keep in touch,
Jim
Hi MGgator67,
I'm sorry you have had this apparent recurrence. :( If it were not for that ProstaScint result, you could still have some basis for thinking that your bouncing PSA could be the often encountered "PSA bounce" after radiation therapy, especially after seeds. Maybe what you are experiencing is partly due to a harmless but scary bounce combined with a fairly mild recurrence.
I am a big fan of hormone therapy, which has been the only therapy for my challenging case, but the main drawback of that approach used alone at your stage is that it is not often curative. :( Of course it has the advantage of setting the cancer back on its heels wherever it is located in the body, even cancer that is too small to be caught by the scans, and hormone therapy actually kills much of the cancer. :) You could probably go on hormonal blockade for about a year, following that with a low-key maintenance drug like finasteride or Avodart. That could be all you would need. If not, you could repeat the hormone therapy or try something else.
Your first and third options make sense to me as a layman who has learned a lot about this disease but without any enrolled medical education, and the first option also gives you a shot at a cure. Did you have a regular ProstaScint or a fusion ProstaScint? The latter gives an outstanding anatomical image, making it fairly easy to spot the particular lymph nodes that are the problem so they can be targeted for removal. The former is not so clear, but a doctor could take out all the nodes in the general area to make sure he got the ones that caused the scan to light up. You could back up this approach with a year of hormonal therapy, hoping to clean up any small remnants that might escape the cryo and surgery.
Removing the prostate and lymph nodes could work, but I've heard that it is not so easy to remove the prostate after radiation. I hope you get some responses from other board participants more familiar with surgery, especially surgery after radiation.
Another option that is emerging is to go after the lymph nodes that appear to be the problem with highly targeted radiation. Forms of radiation known as IMRT, TOMO therapy, or Cyber Knife are three examples of this type of approach, but you would need to talk to a radiation oncologist about that. Both IMRT and TOMO facilities are available fairly close to you in the Washington, DC area. I believe that a number of facilities have IMRT, and Inova Fairfax Hospital has a TOMO facility. I believe TOMO is also available in Baltimore. I believe there is a Cyber Knife facility in the area somewhere.
Do you know if you are on appropriate supplements, plus nutrition, diet, exercise and stress reduction? Those tactics seem to help support therapies for recurrence. Here are a few key tactics that have quite a bit of research evidence though nothing conclusive yet: eliminate all dairy products (protein casein is one of several problems with dairy food); eat no red meat including pork (due mainly to arachidonic acid, but also to fat, cholesterol and other elements); use no flaxseed or canola oils since their omega 3s are not well metabolized by men and they are high in alpha linolenic acid, which appears to fuel prostate cancer, but do use olive oil; take 200 mcg of selenium from a yeast-based supplement daily unless you are diabetic or insulin resistant; take 200 IU of vitamin E daily that includes substantial gamma tocopherol; get about 30 mg of lycopene into your daily diet, spread throughout the day; supplement with vitamin D3 unless you are spending adequate time in the sun throughout the year, which probably means in the DC area supplementing during the cold weather months; trying 8 oz daily of a high quality pomegranate juice (kept refrigerated before opening) or pomegranate extract capsules; etc. There is some evidence that both aerobic and strength exercise improves the prognosis for prostate cancer patients. There is also evidence that minimizing stress helps us. The low-key medications finasteride or Avodart also may be helpful, and statin drugs not only lower cholesterol but appear to lower the risk of very advanced and lethal prostate cancer. I have found support for all of these tactics at the Government medical research website [url]www.pubmed.gov[/url], though you have to look at the balance of the evidence as most of it is not clear cut.
Good luck, take care, and keep in touch,
Jim