Prostate cancer return.

Thanks Chris. I will get dh to ask about SABR but I think the answer is that he’s had max. radiotherapy. 

Looking online, it looks like ARTA is usually given once the cancer has become castrate resistant. So I am not sure whether it’s a good idea to start it this early into treatment. Surely it is best to wait for that point to come. 

Thanks francij So if he goes on ARTA now, what happens when he does become castrate resistant, as I know that is what eventually happens? I get a feeling the HT won’t reduce his testosterone enough, I have always said he’s got far too much testosterone. 

I will see if DH will ask why he can’t have SABR. But DH is saying he can’t ask again as he asked last time and was told no because of the brachytherapy. 

Thanks Chris. No I haven’t spoken to anyone as feel we don’t have enough info. I have a list of questions for the telephone consult tomorrow morn. I will get dh to ask how many nodes are involved, where they are, whether they can be treated. I also want him to confirm we are on a management path rather than a cure. We will get the latest psa result too, not sure it will be reduced this early on. We will see what other drug is on offer. I can’t think what else to get dh to ask, knowing him he won’t ask any of my questions. I know dh wants to ask what his options are if he refuses HT. for me that is not an option, he has to continue with it. 

Wiosal, just to add,a couple of years ago my next progression would have been HT for life, to control the cancer. I didn't want HT.  My onco was going to wait until my PSA reached 2,4,8 or even 10, before putting me on lifetime HT. Advances in technology and having an oncologist who moves with the times meant a totally different direction for me. 

Following my first reported elevated PSA and referral to urology, I did not want my wife involved in the process. Her first meeting with the consultant was on the day of my surgery when she dropped me off at the hospital. Not saying it was the right action, but we all deal with things in our own way. 

Good luck for your upcoming appointment.

Thanks Chris 

I’ve written all my questions down. Just read them out to dh and he said no way am I asking all those. There are 9. That’s not that many. One of them is asking whether we are stage 4 and incurable. DH says no way is it a stage 4 and I’m not to ask that question. I think a stage 4 prostate cancer isn’t quite so alarming as other stage 4’s. Appointment phone call 8.45 tomorrow. Though it says be available an hour either side. First call was 20 mins early. The last was about 15 mins late. 

Thanks Lyn. No I’m not concerned. I have read that the brca2 mutation often means HT doesn’t work. So I’m glad all is well for the moment. Let’s hope it keeps working. 

Thanks Lyn. Yes I’ve read about that drug too. Brachytherapy worked first time and the consultant said it’s still worked as nothing in the prostate. I still don’t understand how cells got into the nodes if they aren’t in the prostate (presumably original diagnosis of N0 was wrong) anyway…as that worked with this gene, hopefully HT will work for a while. The consultant said today that hopefully the HT will keep the cancer at bay for another 10 years. Google tells me the average is 3 years. I wish he would tell it as it is. Hopefully the new consultant will be a bit more honest. 

We have a copy of the the letter from the consultant to the more local one that dh will see. It’s still has original diagnosis at the top with Gleason 3+3 N0 etc. 

On the back it then tells details of the psma scan. It looks like there are more than a couple of nodes involved. It says multiple highly avid nodes in left sidewall (SUV max 11) a few more at the aortic bifurcation and infrarenal paraaortic regions (SUV up to 7) Additional avid lymph nodes in posterior mediastinum at the level of carina (SUV up to 9) no abnormal uptake in the prostate. 

So this looks like quite a few nodes involved. Though it’s all a bit gobbledygook to me.