Radiation treatment

david,

That is Great!!! Thanks for sharing your experience. This gives me some confidence and eases my mind somewhat. Hopefully I will get some direction for my treatment after June,2.

If you don't care to say, what was your Gleason score and PSA before treatment? Why did you have the hormone treatment along with the IMRT? just curious.....Again, glad you are on the road to recovery and beat this disease!

Roger

Wow 37. Seems like a lifting. Good to hear you suffered little in the way of side effects.

lifetime, I meant 

My PSA had risen from 4.8 to 8.7 over the past two years (my reading just prior to treatment was 9.91). My Gleason was 4+4 (one core only )although it was tested by another hospital and they interpreted it as 4+3. MRI - PIRADS 4, no palpable DRE. I considered all the options but didn't fancy surgery and because my tumour was close to the surface I chose IMRT with hormone therapy. My hormone therapy was 6 months Bicalutamide (3 months prior IMRT then during IMRT). Maybe I have been lucky but I am now 6 weeks post-treatment and have no real side effects (libido is still not 100% but is getting there). I am back to working full time in a demanding job and take regular exercise. I have cut down on dairy although I know this is a contentious issue. I wish you all the best.

Thanks for sharing.

Are you saying you have completed your radioation? And your hormone therapy? Have you had a PET scan recently? I ask because this type of scan can identify if any cancer has spread beyond the prostate capsule, something that a MRI may miss.

Barney: yes, I completed my radiotherapy and hormone therapy about 6 weeks ago. I have not had a PET scan - I think I will trust the PSA reading. As I said to Roger, I had few side effects and everything seems to be returning to normal. Obviously, fingers crossed from here on in but I intend to live life as before with 6-monthly PSA tests.

It's my understanding that radiation therapy combined with hormone therapy offers a very good cure to locally advanced PCa. Was your locally advanced? May I ask what country/ city are you in?

Your post reminds me of my case

negative DRE

PIRADS 4 on mri 

doubling of PSA in 18 months 

I have booked a biopsy in late June.

UK (Kent). The MRI suggested it was locally advanced. If you are doing this under the NHS I would recommend two things:

​1) INSIST on a targetted biopsy. I made every effort to do this but despite my insistence the Urologist still went ahead an did a saturation. There was only one positive core which was, surprise surprise, exactly where the MRI suggested it would be. I was not at all happy as the side effects of the biopsy were much worse than the treatement.

​2) Difficult, but try to get a second opinion on the Gleason score. Again I tried to do this but was repeatedly told that the result had already been peer reviewed. For reasons that I won't go into, my results were reviewed by UCL and they came back with 4+3 and not 4+4! Not a huge difference but it took me from the 'high risk' category into the 'intermediate risk' category which was good for my peace of mind.

​As I have said to Roger, I genuinely have very few side effects and a combination of IMRT and hormone offers good outcome results.

​All the best

Thanks for the feedback. I am in Australia and saw three urologists. One wants to perform a targeted biopsy and the other two don't.

I told the one that wants the targeted biopsy that he has my business.

you suggest obtaining a second opinion on the Gleason score and I assume the staging. Can this be done with the pathology report obtained post biopsy?

I am scheduled for a MRI May 18. I see in the discussions a PIRADS score. I researched PIRADS. But, I am not sure what it means after a MRI is performed.

Because MRI shows shading which is only suggestive of PCan the PI-RADS score ranks the probability and position of possible PCa. It stands for Prostate Imaging Reporting and Data System. The higher the score (1-5) the greater the probabilty and the more serious. My PI-RADS was 4 which is High risk (clinically significant cancer is likely to be present). 3 means the presence is equivocal and 2 and 1 are low or very low risk respectively.

​Hope this helps 

It does help. Thanks for the informant explanation. More knowledge is a plus when you get information from the professionals that treat you.

Thank you David.