HRT & RADIOTHERAPY

My dad (86) was on AS for years, and is now on HT.  He has responded well to it in the last 2 years.  I am sure others with more experience will give you good advice.

Paul

I think it is surprising that your husband has not had a biopsy or MRI scan as I always understood that the treatment offered was dependent on the Gleason score and the stage of the cancer. Hormone treatment followed by radio-therapy was my treatment for locally advanced cancer and a Gleason score of 7.

I think you should find out the reasoning behind the treatment being offered and if that is the only treatment option. Perhaps one of the PCUK specialist nurses could offer some advice.

The CT scan will show the extent and position of the cancer. As you've discovered, the purpose of the CT scan is to plan RT. If Danny has RT this would mean that surgery would become impossible. So, the oncologist has ruled out the option of referral to a surgeon. Question 1: why hasn't surgery been discussed with Danny. Q2 Another is the type of RT. From what you say it seems that External Beam RT (EBRT) is planned. There are variants of RT - Intensity Modulated (IMRT) with image guidance is now widely available and is definitely preferable to the older conformal beam RT. Q3 Another question is whether brachytherapy is a possibility. Q4 Also ask whether hormone therapy is planned to continue after RT. This decision depends on the nature and extent of the disease.

I know someone who has recently gone on AS with a low risk cancer: Gleason 6 and early staging, T1c. He has been told that PSA will be monitored for some months, than another MRI followed by some months later another biopsy. Dependent on the results of those tests - spread over about 18 months - treatment would be discussed.

Most importantly, doctors recommend treatment, but patients decide. Remember that "Knowledge Empowers". Without knowledge Danny may take the wrong decision.

Peggy

Apologies, I've only just seen your question. My dad has not had any treatment other than HT. He is a fit 86, but as far as I am aware, he was not offered RT. I will ask next time I get the opportunity.

Paul

Hi Peggy

I had 4 weeks RT. It was 3DRT which is more focused than EBRT but less than IMRT.
Plus Hormone Therapy.

Still here 10 years plus.

Ray

Good tip on recording Dave.

So pleased to hear you are still alive and kicking, Ray. All very encouraging.

Hi Peggy,

Maybe I can help you with the acronymns.

EBRT stands for External Beam Radiotherapy and IMRT i.e Intensity Modulated Radiotherapy is one form of EBRT. 3D conformal radiotherapy is an older technique but is still a form of EBRT.

The latest type of EBRT is Image Guided Radiotherapy (IGRT) but I'm not sure how widely available this is. With IGRT doctors can target the radiotherapy treatment very accurately. This can mean that the treatment works better and can also reduce the risk of side effects.

You can read about the different forms of EBRT on this website if you follow this link.

I had 20 sessions of IMRT spread over 5 weeks - I was given every wednesday off. Since Danny is having 20 sessions I would guess that he is having IMRT which I think is now more or less the standard treatment.

Tom