The treatment sounds very unusual and rather creative.

I've never heard of "light" radiation before.  The standard
view is that pretty heavy radiation is required for a sure
kill on cancer cells.  However on the other hand, I have
no idea how the radiation interacts with cryoablated tissue,
or how well the patient can tolerate radiation after the
cryoablation + the failed prostatectomy.  Maybe what
the docs are doing is very smart and very advanced.

It's also unusual to use chemotherapy at this early
stage before HT failure.  But it's not the first time that's
been done and another poster on this group strongly
argued that it makes more sense to use chemo early
rather than late.  He claimed that chemo doesn't work
very well with PCa, but it has a better chance if the
cancer isn't yet too advanced.

One thing I'll say for what the doctors are doing, at
least they're making a strong effort to treat the guy.
Most doctors at this stage just give the patient a shot
of Lupron and tell him that's all that can be done.  If
he dies of PCa, it won't be because his doctors didn't
try to save him.

   Alan

hi alan - as i read the post about the person's father, i had some mixed
emotions.  i'll share them here.

first -  tom's comment -Diagnosis: Diagnosed with Prostate Cancer at age
70, on February 5, 2003
(happened to fall on my birthday). 

my comments - feb 5, 2003 is when i got the bad news i had prostate
cancer myself.  i got the phone call that i had an elevated psa on my
birthday.  BTW - my birthday is on halloween.  i'm still trying to
figure out if i was 'tricked or treated'.

second - tom's comments -  The initial PSA leading to the test was 6.6
and the biopsy showed cancer in the left lobe with a Gleason grade of 7

my comments - my psa was 6.35, which is close to his dad, but my gleason
was 6, which again is very close to his dad.

third - tom's comment - The initial treatment he chose after
consideration and consultation with two close friends with PSA's of 0.0
after the procedure was Cryoabiation.  His Cryosurgery was done in
April 2003 and the first post-surgery PSA reading in August was 0.2. 

my comments - i, too, had my treatment done in april 2003.   but my
decision was based off of logic, not emotion.  i had plenty of time to
think about the "what if" situation because my dad had pca and all the
time i was walking the path with him, i was giving this a lot of
thought.

here is where my feelings get split.  on one hand, my dad and myself
both got told that our psa's were 6 at the time they discovered the
prostate cancer.  in my dad's case, they told him to do watchful waiting
and i walked the path along with him as i came first hand just how
ruthless this prostate cancer is.  how the cancer will bring down a man
who has been healthy all his life and put him in a wheel chair and give
him much pain before it kills him with death.  

in my case, i was given the option of more than watchful waiting.  and
although my first choice was seeds, through logic, i knew that i had to
go the RP route, but i won't discuss that part here.

tom's father case was that he mention that the father's friends are the
one who said the cryosurgery was the way to go.
so far, i explained my feelings, but can't fault anyone or any logic for
arriving where they did in their decision process.

fourth - tom's comments - For the next three readings the PSA doubled
going to 0.4 and 0.8 so a second biopsy was performed which showed
remaining cancer in the remains of the same lobe. 

my comments - whoa!!!!!   right here, i see a problem.  one of the main
benefits and advantages of cyrosurgery is that it can be done over and
over again, as needed.  so, it's obvious that they didn't kill the
cancer and it's not that serious, why not give him some lupron to weaken
the pca and then freeze it again.

fifth -  tom's comment - Salvage Treatment: Bone Scans, CT Scans and
Ultra Sounds showed no sign of metastasis so local urologist attempted a
Salvage Radical Prostatectomy this past April 2004.  The procedure
failed as the urologist was able to see the previously ablated prostate
and removed nearby lymph nodes, but in his opinion the necrotic tissue
was so dense that removal would have been too dangerous for loss of
blood and the sake of the all too close rectal wall and other nearby
tissues and organs.  He described it as similar to getting a tennis
ball out of dried cement.  The Urologist's visual inspection of the
removed lymph nodes was  that they appeared cancer free, but the lab
showed abnormal tissue with an estimated Gleason of 6 which means the
Cancer had left the organ and metastasized if only slightly.

my comments - i very seldom ever hear of anyone getting an RP after a
failed first attempt of a pca treatment.  the reason is simple.  all
other treatments change the cell structure, whether it is cooked by
radiation or frozen by cryosurgery.  so, in my opinion, i don't
understand why they are going this direction.

sixth - tom's comments - Two weeks after surgery my father received
his first 4-month shot of Lupron to suppress his testosterone.  This
group decided to continue the Lupron, but take an aggressive
approach.  Starting in mid June, dad had 5 weeks of "light radiation"
split between the pelvic area in general (first 3 weeks) and the
prostate area specifically (last two weeks).  During this combined
Lupron & radiation, the PSA fell from 0.8 to 0.4 then 0.2 then 0.15 and
the most recent 0.12.  Starting today he will begin receiving a
moderate dosage (lighter than usual, unknown as to the exact amount yet)
of a combination of Taxotere (Doceltaxel) and Estramustine (Emcyt). 
He received his port yesterday and the procedure went fine although they
had a little trouble finding a vein for his IV.

my comments - i feel like that they are treating the father's cancer
sort like shuting the door after the horse has left the barn.  the
medical people had a chance to kill the pca when it was young and just
getting started, but after a failed treatment are trying to do something
to stay ahead of the situation.
 

seven - tom's comments - Dad tends to want to follow MD's blindly and I
think it's common for his generation.

my comments - the same was true with my dad too.
 
alan -  you brought up a very good point when you said, "I have no idea
how the radiation interacts with cryoablated tissue, or how well the
patient can tolerate radiation after the cryoablation + the failed
prostatectomy".

on your comment - But it's not the first time that's been done and
another poster on this group strongly argued that it makes more sense to
use chemo early rather than late. He claimed that chemo doesn't work
very well with PCa, but it has a better chance if the cancer isn't yet
too advanced.

i would agree with you.  i see nothing wrong with throwing the chemo at
the pca to weaken it and try to get ahead of this situation.

and you comment about - Most doctors at this stage just give the patient
a shot of Lupron and tell him that's all that can be done.    now, that
sure hit home because that is EXACTLY what they told my father.

i did not express my feelings on this case when i posted it because i
thought i might have been looking at it wrong for the reasons which i
have already stated.

alan, i want you to know i agree with what you said about them treating
tom's father, but i think they dropped the ball after the first type of
treatment had failed.

~ curtis

knowledge is power - growing old is mandatory - growing wise is optional    
"Many more men die with prostate cancer than of it. Growing old is
invariably fatal. Prostate cancer is only sometimes so."