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Now on to SHT/SRT

User
Posted 01 May 2018 at 20:12

Hi all

Entering a new world here so starting a new thread.

The Road So Far...

RP Surgery July 2017 with a G7 (4+3) with 3% tumour.

PSA OK until about a month to six weeks ago when I got a 0.16 and 0.17. Result from last week 0.24. Onwards and upwards.

Saw the urology onco today.

No beating about the bush - I will be on 6 months of HT with 6 weeks of RT during the last stages of that treatment.

Very professional but to me a little brisk.

Absolutely refused to discuss PSADT, nomograms, probabilities, outcomes etc. His position was that regardless of the statistics. everyone is unique so predictions are worthless and he treats at the time according to circumstance.

Didn't care what I ate, drank or otherwise did apart from cutting back on the volume of alchohol,

So I have an initial 28 days of Bicalutamide / Dasodex, an intial jab up the bum (a hiuge needle!) with Triptorelin / Decaptyl and then another jab in three months then RT planning.

All the usual side effects explained but he really dismissed the potential of gyno.

Pretty fed up and mentally choosing my headstone right now which is daft but I feel the dice are rolling against me at every step.

Overall I felt I was in a sausage factory, unlike with the surgery.

I may of course be projecting my own fears onto the sitiuation so I will just shut up and soldier on. Not a lot of choice really.

Any advice or rays of sunshine welcome.

P*ssed off Pete

User
Posted 01 May 2018 at 20:53
Pete

I started hormone therapy two months ago and started radiotherapy yesterday. Apart from tiredness, I'm doing fine. A few mini hot flushes, but nothing too bad. I'm to be on HT for six months in total.

Ulsterman

User
Posted 01 May 2018 at 21:08

Hi Pete,

Sorry to read this, but glad that they are not fannying about and are cracking on with the treatment.

Rays of sunshine - that they are treating you and quickly. You might be dessip off now, understandably so, how much more dessip off might you be if there was no treatment offered?

Cut down on the alcohol eh? Not a bad idea for many of us. But sometimes only a few beers will do. And they can be happy beers or sad beers.

I can't comment on your treatment plan, I'm not there. Yet!

I do know and can comment on what an improvement to the life being lived a "sorted" mindset can be. If only someone knew of a way to enable others to achieve this?

Reading other people's stories may help a bit. Always people worse off and better off than you. Does not detract from what you are going through though.

And treatment options are still improving.

atb to you and your family

dave

All we can do - is do all that we can.

So, do all you can to help yourself, then make the best of your time. :-)

I am the statistic.

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User
Posted 01 May 2018 at 20:53
Pete

I started hormone therapy two months ago and started radiotherapy yesterday. Apart from tiredness, I'm doing fine. A few mini hot flushes, but nothing too bad. I'm to be on HT for six months in total.

Ulsterman

User
Posted 01 May 2018 at 21:08

Hi Pete,

Sorry to read this, but glad that they are not fannying about and are cracking on with the treatment.

Rays of sunshine - that they are treating you and quickly. You might be dessip off now, understandably so, how much more dessip off might you be if there was no treatment offered?

Cut down on the alcohol eh? Not a bad idea for many of us. But sometimes only a few beers will do. And they can be happy beers or sad beers.

I can't comment on your treatment plan, I'm not there. Yet!

I do know and can comment on what an improvement to the life being lived a "sorted" mindset can be. If only someone knew of a way to enable others to achieve this?

Reading other people's stories may help a bit. Always people worse off and better off than you. Does not detract from what you are going through though.

And treatment options are still improving.

atb to you and your family

dave

All we can do - is do all that we can.

So, do all you can to help yourself, then make the best of your time. :-)

I am the statistic.

User
Posted 01 May 2018 at 21:19

@Ulsterman - its not a big club but an elite one :) Knowing that other people are in the same boat really helps! I am on target for 6 months too. Going to be interesting trying to hold contract work down in the latter half of treatment if I still am on one. Still, like the treatment, worry about it when it comes!

@Dave - you are right - fast off the bat (paranoid me says "do they know something I don't!" but sensible me knows I hit the threshold mark so all good. More than thinking "it could be worse", I am working to help others with my thesis / counselling and trying to shift to that positive "strive unto death" mindset. I do have plans for acheiving a "sorted" mindset, but it will take some persistence and some bold steps. Carpe Prostatum :)

User
Posted 01 May 2018 at 21:21
Hi Pete, if you look at my profile I had prostatectomy July 2015, PSA undetectable until a reading of 0.3 1st September 2016 and on to 0.7 by mid November 2016. Started bicalutamide December 2016 and been on PROSTAP injections since end December 2016, salvage radiotherapy March/April 2017.

If it’s any consolation I have felt blindsided, scared, unsure if the doctor had fully read my notes, looked at my scans.

They are unbelievably busy and I think sometimes lose sight of us as individuals.

I asked questions, also didn’t always get answers but when my oncologist told me he wasn’t prepared to risk major side effects of SRT in my instance I asked for a second opinion.

After recurrence the urological surgical professor referred me for a pelvic MRI.

My oncologist also sent me for an F18 choline PET scan, both scans showed problem areas which were targeted during radiotherapy. He told me my recurrence was high grade and that SRT had a 40% chance of cure. He told me my PSADT was 1,2 months.

A year post radiotherapy I am still on PROSTAP as my oncologist initially decided to treat me like I was a new patient going through the EBRT route.

I had 20 treatment fractions rather than the 30 you seem to be getting.

It is incredibly difficult dealing with recurrence and all it means. I am so sorry you are another person facing this.

But here I am a year post SRT, I don’t know how it will all go but right now I am enjoying life, thankful to be here and enjoying the company of my family and friends. I even went to Calgary in Canada for a holiday 6 weeks after RT with full insurance and my wif3 and I had a great time.

Do I have dark moments, yes but mostly I am happy and fulfilled.

Stay positive my friend, you will get through this with the support of family, friends and communities like this.

Ian.

Ido4

User
Posted 01 May 2018 at 22:42

Pete, John was in the almost identical situation - even down to the PSA of 0.17 and the onco's refusal to provide RT or tablets for the man boobs. Here we are, 6 years this month after salvage RT, and John is tootling along with a PSA of 0.1 and feeling like that was a different part of his life now firmly in the past. There is hope!

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 01 May 2018 at 23:17
Pete - I forgot to say my GP prescribed tamoxifen to prevent man boobs.

And I'm having 33 VMAT treatments. I don't totally understand the differences in delivery methods, but I was told VMAT is more accurate and less likely to hit healthy organs.

And today they wouldn't treat me - my bladder wasn't full enough and my rectum was too full. They sent me away for an hour to get it all sorted. They also warned me about my weight saying I had put a little on and that my calculations would need to be redone if this continued.

Ulsterman

User
Posted 01 May 2018 at 23:39

Survey completed.

dave

All we can do - is do all that we can.

So, do all you can to help yourself, then make the best of your time. :-)

I am the statistic.

User
Posted 02 May 2018 at 07:48
I completed your survey too Pete.

Ido4

User
Posted 02 May 2018 at 09:35
Hi Pete

I started from a slightly different place as following my RP in 2015 I didn't achieve an undetectable PSA. The PSA went on rising so we decided on 37 sessions of salvage RT in 2016. Still didn't get an undetectable so in 2017 started on 3 monthly Prostap. Guess what - first PSA test following first injection PSA undetectable and has remained that way since.

Life is good.I won't pretend that things haven't changed a bit due to side effects but although retired there just aren't enough hours in the day to fit everything in.

I have to admit that having the cancer has never been a cause for concern to me. I have every faith in my onco and the team have always been very honest with me about side effects of treatments so I have been able to deal with them.

I am still working part time, walking a lot, gardening, riding the motorbike in all weathers and enjoying holidays.

I know that this me and you are you but I hope this will encourage you.

All the very best to you.

Kevan

User
Posted 02 May 2018 at 21:42

Hi everyone

Just a quick note as I am having a last blast on the red as this is my first day on the HT tablets so anything more than this will be a ramble.

I just wanted to thank everyone for the kind words and support.

Knowing that there are other people in the same boat to talk to is better than any anti-depressant tablet!

Carpe Prostatem!

Pete

User
Posted 02 May 2018 at 21:53

Good heavens - you aren't thinking of giving up alcohol are you????

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 02 May 2018 at 22:12

Pete,

If you give up alcohol, you probable wont live any longer?

But it just may seem that way?

atb

dave

and for me, tonight is happy beers night!

All we can do - is do all that we can.

So, do all you can to help yourself, then make the best of your time. :-)

I am the statistic.

User
Posted 03 May 2018 at 07:42

Survey completed.

User
Posted 06 May 2018 at 21:56

Well I am on holiday so the alcohol embargo is off the books for a week 😂

I am on day 5 of the pills and so far the main change is that my sweat smells different - less teenagery.

I am also more up and down emotionally but that may be just my head playing games

One minute I am thinking the fact that I was t2c n0 m0 is a good thing and the next (based on a comment on another forum about the fact that I had a very small tumour volume means it has escaped and may be aggressive) I am updating my will.

I have tried to park the obsessive research as on one hand I find research that says that even with srt the chances are poor and on the other the standard gp update letter I got from the hospital suggest that even with bcr the chance of avoiding clinical reoccurrence is quite good.

Going to have to grit my teeth and press on.

Pete

User
Posted 06 May 2018 at 23:28

survey submitted

Barry
User
Posted 10 May 2018 at 09:48

Thanks to everyone responding to my survey. I am getting enough data to make some interesting interpretations!

Regarding my situation, I have been pondering what could have led me here with a t2c n0 m0 and I wonder if the fact that I had two biopsies and after the second one I bled like a stick pig might have had a bearing, by allowing cells to escape. Either that or just random chance that one snuck out. My daydream is that this is just a result of a tiny amount of benign prostate tissue being left behind.

Whatever, it is sort of sinking in now that what is done is done, and I need to look forward.

I do have a lot to be thankful for. Caught early, both sets of treatment (first RP and now SRT) happening quickly, a loving and supportive family, a job (for the time being as I am a contractor) and something of a rainy day pot. Focusing on these thinks is going to be critical for my state of mind going forward, whatever happens. I also have the opportunity to put something back, in terms of my thesis.

Carpe prostatem

User
Posted 10 May 2018 at 19:59

Not trying to say “how lucky am I” but rather express my need to concentrate on the positive aspects or end up by default thinking “oh ship, I am ducking ducked! Gonna be gone by Xmas,”

User
Posted 10 May 2018 at 20:03

Good to see such a positive post PP :-)

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 14 May 2018 at 21:24
Hi all

Quick update. Saw one of the nurse specialists today and had my horse jab.

Had to do my usual “explain where I am in the journey” as the handover is usually a bit patchy but we ended up on the same page. Not her fault, I just think they don’t join up departments as well as they could.

My bum is now very sore but I feel fine otherwise.

No sign of man boobs yet!

P

User
Posted 18 May 2018 at 23:31

Four days after my first Trip jab and I have a stinking head virus and am REALLY angry out of the blue after a blue funk. I think it was some celeb saying he had been told he was ‘cured’ four months after RP that set me off. Bollocks can you say that after that time. Also had a call from GP scheduling second jab..

I have to put on a game face with everyone apart from my oldest friend and my own counsellor because you can’t show the cracks. I want my family to live their lives without propping me up.

I feel angry at myself for feeling like this when many are far worse but I hate unknowns.

Any advice on not being a wuss at this early stage?

P

User
Posted 19 May 2018 at 00:30

Nah, you are not being a wuss. It is okay to be angry - your counsellor has no doubt explained to you that you may go through grief phases - for the loss of the bits of you that you never fully appreciated before like your sexual identity / prowess, for the realisation that you are not indestructible, for the fact that you may not outlive all your friends, or just for having to deal with something that seems indiscriminate and unfair. I think most people diagnosed with cancer feels these things at some point (or their loved ones do). I was very angry and sad in the early days that J & I probably won't live to be 100 together, that at 44 my sex life was more or less over, that I was dealing with PCa 3 times over. But a new normal sets in eventually and I just made a decision that we were going to cram all our adventures in now while we can, just in case. Nine years on I am wondering if we can actually afford to keep on having all these adventures since he is still here, still well, still with a PSA of 0.1, etc, etc!!!!

Be angry about the celeb and then feel a bit sorry for him. He may have paid a fortune for private treatment from a urologist with an ego the size of a small planet who has told him he is cured. We had a member on here recently who was told before he was even discharged "I got it all, consider yourself cured" which is preposterous but a patient will believe it if he has no reason not to. Alternatively, the celeb may have agreed to go public at the request of one or other of the campaign groups who do I think sometimes want to play down the negatives so as not to discourage men from going to the doctor. On the other hand, John tells me that Jeremy Vine did yet another phone in on PCa this week and it was handled really well including the 'survivor' who talked openly about ED when Vine was waffling with euphemisms.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 19 May 2018 at 06:04
I think for some people it helps to have surgeons with big egos who tell them they are cured provided they are still monitored. This bravado allows them to get on with lives and transfer all their worries onto the surgeon.

Simple fact is more tgsn 2/3 of people who catch it early are effectively cured, ie they die of something else that isn't related to PC. Why should those people continue to be victims of PC when ultimately they won't be??

Of course the downside is if it does come back you have to go through it all again but at least you will have had 6 months of blissful ignorance!

User
Posted 19 May 2018 at 06:09
survey completed BTW
User
Posted 19 May 2018 at 17:12

@Lyn - thanks. I know the Kubler-Ross model well from my counselling work but it is one thing to study and another to experience! I do need to let go and break out of the cycle because you can see from the comment below I'm stuck on the numbers game.

@francij4 - thanks for doing the survey. I think it is definitely transferrance with a little bit of denial. I know the 2/3 number but in my case I am in a horrible grey area. G7(4+3) T2cN0M0 with low volume (3%) and no margins but PSA rising in less than a year. The discussions and research around PSADT is very ambigious. They do seem to suggest that a high PSADT in < 6 months means no chance of 15 years and > 1 year you stand a better chance but again I am in a grey area with a probably high PSADT somewhere between the two. BUT it was spotted quickly. I feel like it is Russian Roulette, especially having to wait four months for SRT and an onco who would not even touch prognosis. Really it all boils down to whether I have (agressive) mets or not, localised or otherwise. I guess one advantage is that (painfully slow as they are) trials are bringing new treatments on line every year. Just have to grit my teeth and plod on.

User
Posted 19 May 2018 at 17:34

You see and read what you want to believe.

‘Having to wait 4 months for RT’ is a bit of an odd comment. You are aware, presumably, that this is deliberate? The science shows that the longer you are on HT before RT starts, the better the outcome. Some oncos are going for 6 or even 9 months between starting HT and starting RT.

It is hard to keep track of your story with no profile completed :-(

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 19 May 2018 at 18:36

Hi Lyn

Yes - you are right. I'm flapping at the moment, mainly because I have been ill all week and am very tired.

I understand the wait for the RT. I just meant that it is a long wait to reflect and grow man-boobs and and even longer wait to see if it works :)

I wasn't aware of the profile thing but now you have mentioned it, it is a good idea, so I have added my potted history for all to see.

Cheers

P

User
Posted 19 May 2018 at 18:55

Tomorrow will be a better day

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 19 May 2018 at 19:09

Hi Pete,

good too read your positive upbeat posts, sorry to read the other ones.

Kubler-Ross eh?

I dont know your sense of humour, mine is dark, even if I am in the mire.

For a quick demonstration of the KR Model, you could You Tube - Homer Simpson -the 5 stages of grief.

Cracked me up when I saw it many years ago. Cracked me up again when I watched it having had my diagnosis.

It's not for everyone, but it may help someone deal with their demons?

Hope you can have a good weekend.

dave

User
Posted 20 May 2018 at 10:50

@Dave

I will see you Homer Simpon's 5 stages of grief and raise you American Dad's 5 stages of grief https://www.youtube.com/watch?v=8JOpLm1UiLQ

Yes, I survive on black humour too!

@Lyn

Now I know that profiles are a thing, I had a read of some of the others here. Notwithstanding what may or may not be going on with me there are a lot of men here with far bigger challenges who are being very brave. I feel kind of sheepish now...

P

User
Posted 21 May 2018 at 21:52

Quick question based on something someone said in another forum - would a scan have helped in my current situation?

User
Posted 21 May 2018 at 22:11

What sort of scan Pete?

dave

User
Posted 21 May 2018 at 23:08

Some oncos would have scanned in your situation but based on your description of your onco, I suspect it would have been pointless in your case as he is hell bent on treating you in a certain way. If you ask him, i think he will say that at 0.17 your PSA was too low for a normal MRI scan to be able to pick anything up, and that he doesn't have access to any of the fancy, modern tracers that give more detailed images at small PSA levels.

Fact is, your PSA is fairly typical of stray cells left in the prostate bed so HT followed by RT is a sensible treatment option. If you had an atypical PSA trend (2.0 straight after op or something like that) we would probably all have been screaming at you to get a second opinion and a choline PET scan.

Gotta trust your doctor more than unofficial experts on forums :-/

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 22 May 2018 at 17:26

Thanks Lynn

Can you tell I am a worrier? :)

It is a bit stressful at the moment as my contract is coming to an end and I doubt I will get another one for the two months before RT and I let it all nibble away at me. I do have a fair lot of savings but still...

Luckily today is a good day (I got through my personal training session in one piece) and the sun is shining.

P

 
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