Elevated PSA

Thank you for your information on the MRI Guided biopsy. Apparently medicare does not pay for this procedure. I shall explore the procedure and will discuss this with my Urologists. I can pay for this out of pocket.

Stewart,

You mentioned Proton Beam Therapy, Photon Beam Therapy . I have researched Brachythearpy. You indicated you researched these treatments. In a thread earlier. I would like to know more about them. I just want to know about treatments if a doctor mentions them to me as possible treatments

Roger

Roger,

Check out this website. It has lots of good information about treatment options and success rates. I found this very helpful and my urologist recommended it for information.

http://www.pctrf.org/video-library/

Roger: Proton Beam Therapy (or Proton Therapy) is a fairly new form of radiotherapy that is not yet available in the UK or Australia (2018 maybe).  I hope the moderator allows this link because it is a UK-based science blog that explains the current state of play: scienceblog.cancerresearchuk.org/2015/07/16/proton-beam-therapy-where-are-we-now

It is used where children have brain tumours, as well as PCa, because there is little or no irradiation of tissue/organs surrounding the target area. The South Korean Government funded a Proton Beam Therapy Centre in their Natioan Cancer Centre for example.  It is well-established as a therapy in the USA and in European centres like Swizerland and Prague.

I found that the closest centre to Australia was in South Korea, but the cost is some AUD53,000 excluding 8 weeks accommodation and airfares. However, I had a very aggressive PCa (Gleason 8 from biopsy, which was 9 from subsequent pathology tests.

Roger, when  you have your consultation with your doctor about treatment options, ask about the low dose Brachytherapy. I have seen and read about a high dose Brachytherapy which I believe requires two treatments where the seeds are implanted with a higher dose of radiation. Then the seeds are removed. A second treatment is required about one week after the first. If you are a condidate for the low dose seed implants - that would be good as it is a one time treatment. The seeds are implanted and they remain there. After about 4 months, the radiation is gone and it has done it's job. I am not sure what necessitates the high dose Brachytherapy versus the low dose version. From what I have read, he low dose option works for low to intermediate risk prostate cancer. Good luck with your consultation. Keep a positive attitude. Your can be cured of this.

Charles

Yes, I will ask. When you had the seeds implanted, could YOU tell if they were there. And did you experience any issues...pain discomfort. ? I am trying to keep a positive attitude. I am getting family support that means a lot to me.

Roger

Roger,

The good thing about this procedure is that you are completely anesthetised and not aware of anything. The entire procedure was roughly one hour. When I came out of the anesthesia, I felt sort of the same sensation as when I had the biopsy. Not really terrible pain, but not comfortable. And they want you to pee a couple of times before you are released. And those first couple I felt a burning feeling. I guess that is expected after that procedure. After the first few times of urinating, that intense burning feeling subsided. I went home shortly after coming out of the anesthesia. I took ibuprofen when I got home at the advice of my urologist. Unless your doctor gives you something stronger - but the ibuprofen seemed to work adequately. I kept taking it for the first few days after the procedure. And I take it on the days that I think I need to. In answer to your question, I didn't feel like there were any seeds there... which was a concern before I committed to having the procedure done. Depending on each individual condition, I read there are usually between 50 and 130 seeds implanted. They implanted 96 into me. For the first few days, I had to urinate frequently. The radiation (from any radiation treatment) causes some fatigue, but not constantly. I had to limit physical activity for a while. But like my urologist and radiation doctor told me, listen to your body and when it tells you to rest - do so. They told me that the side effects would get less and less as time goes on. I am going into week 7 and the down days are getting fewer and fewer. It is just hard for me to do little because I am used to doing more activity. I am in the middle of some house renovations and for the past week I've been going full speed. Today, however I feel that I have over done it. So I am taking a day off... and catching up on emails and some paperwork. I do a newsletter for a car club that I belong to, so today is a good day for working on that.

Let me know how your meeting with the doctor goes... and what he recommends for you.

Charles

I certainly will Charles. My appointment is at 4 P M tomorrow. I cannot take aspirin or iberphopen or any aspirin related product . I am allergic to them, so I I will have to use tylenol. Your description of the procure and side effects does sound tolerable.

My good friend I appreciate your support and advice. I will keep you informed.

Roger

Charles,

One question I forgot to ask. Did you have nausea during your treatment. Nausea and vomiting is a high concern with me. I had extreme experience with this taking antibiotics for diverticulitis. Very difficult for me to take antibiotics. Having nausea for a long period of time is something I cannot deal with.

Roger

No nausea. The anesthesiologist gave me something prior to the procedure that he said would prevent that. And it worked fine because I felt fine after - other than sore between my legs. Also, my urolgist started me on Flomax (Tamulosin - generic version) one week prior to the procedure. Even though I was not having any problems with urinating, he said it was a preventative. And it is probably a good thing to be on it for a while. The urine stream is sometimes slow to begin. The radiologist said this is because of the radiation. It causes inflamation to the prostate and to the urinary tract. This will subside in time.

Good luck - and let me know what happens with your doctor visit.

Charles

Thanks!!...I will keep you informed.

Roger

Charles

Just got back from urologist visit. He is going to Perform a Prolarist test from the pathology report to find out how aggressive the cancer is. Also sending me for a MRI to see if the cancer is contained in the prostate. If I get good results, he wants me to go on the wait and see. Actually active survillanc, taking my age in consideration. When u get time Google that test and let me mnow what you think?

BTW- Both core samples 3+3 =6 and 4+3= 7. Only had 10% in the core samples.

Roger

I'm glad your visit went well. I googled the prolarist test. Sounds like it will give you and your urologist a better idea of what you're up against. If it is a non aggressive slow growing type, active survailance might be a good option for you. You core samples are not bad. Mine numbers were 3+3=6 in both samples that contained the cancer sells. The prolarist test will hopefully indicate what type of cells. Mine were Adenocarcinoma (I think that was the name), which my urologist told me was a non aggressive type and very slow growthing. Also, from what I read about the prolarist test, it will project for a 10 year prognosis. With that information, you can make a more educated decision. If a treatment is decided upon, look at many choices and one with the fewest side effects and one with very good success rate. And if the active survailance is a choice, just keep up with check ups etc. Let me know what the prolarist test shows. And good luck! Charles

Charles,

I just signed a consent form for Prolaris testing. Each individual is different, they genectic test your pathology results. It is entirely different from the gleason score. My urologist wants to make sure I can go on active survailance before sending me to a cancer doctor. i cannot get the MRI until May 18, because of the biopsy. The MRI will determine if the cancer is still within the prostate. I think all of this is good, it will give me a second opinion and it does give me some sense of hope that my cancer is not as agressive as indicated in the gleason score. I will let you know the results of the prolaris test as soon as I get it back.

Roger