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Medical Forum / Diseases and Disorders / Prostate Cancer / October 2004Seeds May Rival Prostate Cancer Surgery
http://my.webmd.com/content/article/95/103115.htm >http://my.webmd.com/content/article/95/103115.htm TEMPORARY BRACHYTHERAPY - THE NEXT STEP With everything crossed, I will be entering into this Program as of next Friday. HDR Brachytherapy at Sir Charles Gairdner Hospital, Perth, Western Australia: e.g. http://www.brachytherapy.com/prostate-technique.html At SCGH they use Iridium Wire in lieu of Pellets, but the balance of the procedure is identical. The total program is a 3 pronged attack involving: 1. ADT Hormonal Treatment for 6 months, primarily to shrink the prostate and the tumour by starving it of Testtosterone. 2. HDR Brachytherapy - 2 day procedure 3. 3D-Conformal RT - reduced from 7 wks to 5 wks Following that, some further Hormonal Treatment involving Bone Strenghening is given over a longer Period in most cases. Info on this program is here: http://www.genepi.waimr.uwa.edu.au/radar/ (technical) and excerpt from the Clinical Trials at SCGH: /begin 03.04 A Randomised Trial Investigating the Effect on Biochemical (PSA) Control and Survival of Different Durations of Adjuvant Androgen Deprivation in Association with Definitive Radiation Treatment for Localised Carcinoma of the Prostate. Description: Randomised to one of four arms: Arm A: (STAD) LH-RH analogue for 5 months prior to and during first month of RT Treatment (total of 6 months). No bisphosphonate therapy. Arm B: (STAD) LH-RH analogue for 5 months prior to and during first month of radiation treatment (total of 6 months). Bisphosphonate therapy Zometa 4mg IV 3-monthly x 18 months. Arm C: (ITAD) LH-RH analogue (as STAD) but continued for further 12 months (total 18 months). No bisphosphonate therapy. Arm D: (ITAD) LH-RH analogue as for STAD arm, but continued for further 12 months (total 18 months). Bisphosphonate therapy Zometa 4mg IV 3-monthly x 18 months. /end -- "if you can see it coming, head it off at the pass, else put the wagons in a circle" lol -- Please reply to this ng as: -- my email adress is 100% faked to prevent proliferation of SPAM!! -- Regards -- Clarence Crow > ... > The total program is a 3 pronged attack involving: [quoted text clipped - 3 lines] > 3. 3D-Conformal RT - reduced from 7 wks to 5 wks > ... I had a similar treatment in a clinical trial at the National Cancer Institute in the USA. I was first given Lupron (that was my choice, my doctor advised against it), then had HDR, then 5 weeks of 3DCRT (50 grays), then another HDR. The HDR was 10.5 grays each. There were some side effects, but I seem to have recovered from all of them. My PSA was undetectable after the radiation and while the Lupron was still active, but went up to .8 at the last reading, after the Lupron was well worn off. I get another reading Thursday and may find out whether this procedure is working or not. If it's down I'll be very happy. If it's up I'll be very concerned. Good luck to both of us. Alan > http://my.webmd.com/content/article/95/103115.htm I may be telling you something that you already know but, the end result is the same... you remove ALL the prostate tissue and tumor with surgery, you hopefully kill ALL the prostate tissue and tumor with seeds. Seeds are a relatively easy proecedure, surgery is a bloody mess. With seeds you may develop lots of side effects with many of your lower organs for the next year. With surgery you have the worst of it from the start, and hopefully slowly get it all back within a couple of years. With both no ejaculate for the rest of your life. Rarely long incontinence. Possible erectile dysfunction with both. It's a personal choice.  SignatureJK Sinrod Sinrod Stained Glass Studios www.sinrodstudios.com Coney Island Memories www.sinrodstudios.com/coneymemories >> http://my.webmd.com/content/article/95/103115.htm > [quoted text clipped - 7 lines] >the rest of your life. Rarely long incontinence. Possible erectile >dysfunction with both. It's a personal choice. A personal choice?? Not quite so! In the program I've volunteered to enter "RADAR", the ultimate choice is made by the TROG computer, from the Data Input by a Panel of Specialists who analyse Questionnaires completed by the Candidate that cover ALL aspects of his Quality of Life now AND in the future, plus a series of exhaustive tests covering ALL possible Medical aspects and outcomes, specific to the Candidate's personal circumstances. Personally, I feel much safer with this approach than having to make a personal choice, which could be WRONG and then would put all the onus of Failure back on yourself. As I'm already 69 and have grandchildren, I'm keener to stay alive a little longer, than to be a superstud. -- "if you can see it coming, head it off at the pass, else put the wagons in a circle" lol -- Please reply to this ng as: -- my email adress is 100% faked to prevent proliferation of SPAM!! -- Regards -- Clarence Crow > >> http://my.webmd.com/content/article/95/103115.htm > > [quoted text clipped - 21 lines] > As I'm already 69 and have grandchildren, I'm keener to stay alive a > little longer, than to be a superstud. Clarence isn't it still your choice to go with what the computer recommends or not? SignatureJK Sinrod Sinrod Stained Glass Studios www.sinrodstudios.com Coney Island Memories www.sinrodstudios.com/coneymemories >><snip> >> A personal choice?? [quoted text clipped - 13 lines] > Clarence isn't it still your choice to go with what the computer >recommends or not? Sure, there is a cooling off period, which gives me a chance to opt out of the computer's decision, but seeing I'm already in the Radiotherapy court, (recommended by none other than my Urologist, due to my age and existing health conditions), the only Options I have are limited to the lesser invasive Radiotherapy ones, and how could I be better equipped to make a decision than the computer, which really is only performing an analysis of the Data fed in by the Panel of Specialists? The computer will also decide on my resilience to be able to sustain a minor Surgical procedure to have HDR temporary Brachytherapy. I realise, I responded to you without putting a case for RRP Surgery and apologise for that. I'm already convinced to go with the RADAR program, provisional on the results of my final Tests, viz: Blood (many), CT & Bone Scans plus X-Rays of Chest and Spine. If the cancer has spread beyond Local, the Radiation Oncologist will then inform me what remaining options are still open and treat me accordingly. -- "if you can see it coming, head it off at the pass, else put the wagons in a circle" -- Please reply to this ng as: -- my email adress is 100% faked to prevent proliferation of SPAM!! -- Regards -- Clarence Crow Clarence I wasn't criticizing your choice at all. I was just saying that the final decision is always yours. Computer may say X, but you would rather take a 3% higher risk for quality of life reasons and choose Y. I for one don't that that the goal is living the most amount of years, but the quality of the years. I don't plan to live forever. Unless your numbers are way out of the middle range, final prognosis is almost identical whatever we do. SignatureJK Sinrod Sinrod Stained Glass Studios www.sinrodstudios.com Coney Island Memories www.sinrodstudios.com/coneymemories All of us devotees of Doctors Patrick Walsh and Steven Strum would argue that low PSA, low stage, and low Gleason scores within men of middle age treatment options are comparable and therefore a decision of the victim. Most of us would prefer to have the onus on us (no word play intended). Your PSA, Gleason and age are all bordering on the "no other reasonable decision" area. The older you get, the less you can handle major surgery. PSAs over 10 and Gleasons over 7 are less curable with RRP. So, you had a choice, but you were very close to having none. Conversely, my age was the determining factor to have RRP. My PSA was slightly elevated and my Gleason was 7, but all indications where that my PCa was organ defined. At my age, the only chance of a cure was RRP. Even so, my doc let me make the final decision. SignatureProstate Cancer Survivor (so far), not a doctor PSA 16 10/17/2000 @ 46 Biopsy 11/01/2000 G7 (3+4), T2c RRP 12/15/2000 G7 (3+4), T3bN0M0 PSA .1 .1 .1 .27 .37 .75 EBRT 05-07/2002 @ 47 PSA .34 .22 .15 .21 .32 Lupron (1 mo) 07/21/2003 @ 48 PSA .07 .05 .06 Lupron (3 mo) 8/03 (48), 12/03, 4/04 (49), 09/04 (50) non illegitimi carborundum > >> http://my.webmd.com/content/article/95/103115.htm > > [quoted text clipped - 28 lines] > > -- Clarence Crow Rival indeed, not a bad post of a web MD article.CONDESCENDING tone toward surgery.Why do people need an ax to grind?Is it the money.Long term stats not impressing with seeds as I understand it but think posititive,why not surgery no fun just more conclusive if sucessful. Take Care. |
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