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User
Posted 15 Feb 2019 at 21:13

Hi Chris, believe me, I've read your profile over and over, including tonight when I got home. I fully understand why you haven't had RT. If they can't pin point where the cancer is, what are the chances of RT getting it? 

This is exactly what Steve's specialist was talking about today. He said that its sometimes not possible to find where the cancer is and he would be very much against RT in a that scenario. RT is meant to target the cancer, not randomly take aim and hope for the best.

On your profile you mention two suspect lymph nodes in your back but then go on to say they won't zap these lymph nodes. Why is that?

BTW I think you are incredibly brave and matter of fact about what's happening. I also agree with your choices. 

User
Posted 15 Feb 2019 at 23:54
Maria B

Sounds like you have a cutting edge urologist.

Sure you have read it already but Ulsterman has has his residual cancer found by PET scan and treated with RT. Fingers crossed you have a USPSA test and it's unfetectablr. Hence you won't need further treatment.

User
Posted 16 Feb 2019 at 01:33

Hi Maria,

Professor Whocannotbenamedhere found that two out of the fourteen of my lymph nodes he removed were cancerous, but nine months later, all five of my PSA tests have been undetectable so far. Lymph node involvement is a complication, but certainly not the end of the world.

Two oncologists have advised me not to have adjuvant or salvage therapies whilst my PSA is undetectable, and so I may just have got away with it, for now!

If there are future successive rises in PSA over months or years, I will elect for a Gallium-68 PET-PSMA scan to pinpoint any recurrence. It costs £2600 in London, £400 in India and £600 in Australia. There are hardly any facilities for it in Britain, but don’t forget, we are always told our NHS is the ‘best healthcare service in the world’! Renewing my passport just in case.

I hope you get the 2/3 rebate of the cost of your private procedure back from the NHS as was suggested might be possible. I think that should be routine. My surgery cost the NHS £14-15,000 anyway, so I think it should make a contribution to Steve’s.

Good news that there are signs of life down below, unlike in my own case. However, my GP has just helpfully prescribed some Alprostadil eye drops, a.k.a. Vitaros, which may work. A bit late for Valentine’s Day though!😉

Best of luck to you both.

Cheers, John.

Edited by member 16 Feb 2019 at 11:24  | Reason: Not specified

User
Posted 16 Feb 2019 at 08:22
Hi Maria

Those are questions for the next meeting end of May. Yes in some hospitals they can remove lymph nodes or use a very focal RT beam to zap them ( cyber-knife). I’m guessing because I won’t just lay on my back with my legs in the air and be randomly zapped , then they won’t offer more expensive stuff. I did have some positive margins by my bladder so I guess they want to treat those. I’m sick of talking about it tbh. One step at a time.

User
Posted 16 Feb 2019 at 19:23

Thanks Francij, obviously I'll keep you updated.

Hi Bollinge, I didn't realize that about your lymph nodes. The surgeon wasn't (or at least didn't appear) overly worried about it and just suggested we would face this bridge if we came to it. Hopefully, like you, it was removed and hadn't gone any further. 

Interesting what you say about the Gallium-68 PET-PSMA scan. The specialist did mention a scan that was specific for PSA but not sure what he called it. Surely this sort of machine would be invaluable for people with metastatic cancer?

Its now been agreed that half of the costs will be re-inbursed but that was only made possible because the surgeon at Addenbrookes was kind enough to send a referral to his GP with the reasons for this being more appropriate surgery for a man of his age. 

Chris, you sound so much like Steve and although your journey is much further on than ours, I'm fairly certain he would be making the same choices you have (if he was in your circumstances).

Funny isn't it; we had medical insurance for years but always said, if its something really serious we go down the NHS route because the NHS have better and more advanced technology and facilities. Its now the opposite, with the private sector having the monopoly. Here in the UK we shouldn't be having to fight or pay vast amounts of money for the best treatment options, but fight we do.

I'll be watching your profile to see how you get on in May.  

User
Posted 16 Feb 2019 at 20:03
There are various scans for secondary tumours that have spread from the prostate with different ‘tracers’ (or dyes), often involving radioactive isotopes as a dye to locate distant metastases.

Thus if it comes to it, the radiologist should then know exactly what to blast with his ray-gun rather than a scatter-gun approach, irradiating the whole region.

This whole area of nuclear medicine is fast-growing, and different tracers are being tested all the time. Old Barry seems on the ball with them, and I now get almost daily urological updates intended for medics, if I can bother to read them all.

The consensus is that a Ga-68 PET-PSMA is the most accurate scan around now. Less accurate Choline scans are generally available on the NHS. Let’s hope that Steve and I never need one!

Cheers, John.

User
Posted 23 Mar 2019 at 16:38

Great news. Steve picked up his PSA results today and they are 0.03. 

He sees his specialist next Tuesday. 

Meanwhile, I'm going to Thailand for a couple of weeks to our youngest sons wedding. Steve wanted to go but his doctor has advised such a long haul flight at this stage would be risky. His words meant Steve was no longer insured :( This is something we have been planning for the last three years so we agreed that at least I should go. I feel a lot happier about that now I know his PSA results.

 

User
Posted 23 Mar 2019 at 17:32

Maria that is wonderful news!! I can imagine how happy you both are!! heres to the rest of your lives having undetectable PSA!!!

 

xxx

User
Posted 23 Mar 2019 at 18:18

Good news , so pleased for you both . shame you have to go to Thailand on your own . Hope the wedding goes well .

Phil

User
Posted 23 Mar 2019 at 23:10
Thanks Michaela and Phil.
 
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