This past monday Kevin had his first appointment with Dr Gary Hudes, his
medical oncologist. at Fox Chase Philly.  First we saw the Nurse
Practitioner who went over Kevin's history very carefully. Since Kevin
had written down chemo as one of his concerns, she told us right off
that there was no way he needs chemo now, we were very relieved. She
went out to review Kevin's records and films with Dr Hudes before he
came in to see us.  Dr Hudes also went over all the records, asked
questions and asked for whatever questions/concerns Kevin had. When
Kevin was telling him his(our) concerns, the doctor listened very
carefully and said all the questions were good ones.  He proceed to tell
us what Sue, the nurse practitioner,  had said, that chemo is not needed
now.  He also mentioned  Abiraterone which isn't approved yet, but he
thinks very highly of it when it is available, he also mentioned
Ketoconazole. We were very glad to see that if Kevin's psa starts going
up, these are things to be tried before he would think of chemo. When
clinical trials were talked about, he said Kevin was not eligible for
them right now.

He said he believes Kevin should have one doctor in charge and told he
would gladly act as the consultant if we wanted to stay with the Uro
etc. We looked at each other and said we want you to be Kevin's doctor.
So now he is Kevin's doctor, but Kevin will still use the Uro for the
lupron shots because it is more convenient for his from work.

Dr Hudes wants to continue watching Kevin's psa and see if it continues
going down, he also wants to see with the next psa what effects the
radiation on the spine has.  Kevin will be seeing the urologist in
August since he alredy has that appointment set up and will have a psa
for that visit and in the meantime Dr Hudes will be talking with the
Uro.  Before Kevin sees Dr Hudes in Oct. he will have another psa, a
pelvic/abdomen CT scan and another CT bone scan.

I think previously I mentioned that Kevin was having some dental surgery
done and needed to get it done before he can start getting Zometa. The
Uro had him scheduled for the first Zomet treatment the middle of august
which is about a month after kevin's last dental surgery.  Both the
nurse practitoner and Dr Hudes said that is way too early, Kevin needs 3
to 6 months for him mouth to heal before he can start the Zometa. He
asked Kevin to talk with the periodontist and see what he thinks in
terms of healing time. Just this alone is good enough reason to be
dealing with a medical oncologist and not just with a Urologist.

Fox Chase Cancer Center in Philly is a very impressive place and every
person we had to deal with was very nice, helpful  and friendly. Of
course the most important thing is the doctor and we feel we made a very
good choice with Dr Hudes. Monday was a very good day for us!!

sue

biopsy - 2/20/08 - Gleason 9, 5+4 all 12 cores
dx 3/4/08 - started one month of Casodex
3/17/08 - started Trelstar shots, later changed to Lupron shots to this
day and to continue.
44 IMRT sessions - 4/28 to 7/1/08
5/19/09 - started Casodex again and to continue
10 radiation treatments on the spine - June 9 through June 22, 2009

psa:
2.2    10/-5
4.1    8/07
7.9    12/07
0.1    8/08
4.1    2/2/09 - thought to be from bladder stone and cysto
14.5   5/5/09
19.0   5/11/09
10.3   6/15/09

Testosterone - 20 - 6/15/09