Guest guest Posted June 3, 2008 Report Share Posted June 3, 2008 Tom, Ask him these questions if you have time. 1) Is radiation effective in a curative way for men with extensive bone mets? 2) If his answer is yes how do they target the bone mets if they are extensive on a bone scan? I would be interested to hear his answers. Kathy From: ProstateCancerSupport [mailto:ProstateCancerSupport ] On Behalf Of Tom Sent: Tuesday, June 03, 2008 12:48 AM To: ProstateCancerSupport Subject: RE: my father I meet with my radiation oncologist every Tuesday, and will meet with him later on today. During those sessions, he asks if I have any questions, if I'm experiencing any side effects I'd like to discuss and so forth. In those discussions, which have been far-reaching, he tells me he's treated some patients over and over again with radiation treatment as prostate cancer has metastasized and has migrated from one location to another throughout their bodies. I don't want to shoot from the hip and give out stats that are inaccurate, so later on today when we meet I'll ask him for a range of PSA values among those men who he's treated with radiation treatment and the timeframes (months or years) over which he's seen those patients. Since I'm not in a situation where I really have to worry about such treatment at this juncture, those discussions have fallen into the interesting but somewhat hypothetical category thus far. However, he also tells me that currently used scanning technology can't detect a tumor if it's less than a cubic centimeter in size (more or less), and that when it has that kind of mass it tends to be correlated with a PSA value of 10 or greater. " Think of it this way, " he said. " Before you had your prostatectomy last fall you had a PSA value of 26 and the prostate organ is about the size of a walnut. So the scans picked up the presence of the tumor in the prostate organ but nowhere else. After radiation treatment, we won't be able to detect a tumor elsewhere in your body until your PSA reading gets back up over a reading of about 10. If your post-op, post-radiation treatment PSA reading stays at 0.4 forever (which was my first post-op PSA reading) that would be a great outcome. " Makes sense to me. From: shedormancomcast (DOT) net <shedormancomcast (DOT) net> Subject: Re: [ProstateCancerSupp ort] my father To: ProstateCancerSuppo rtyahoogroups (DOT) com Date: Sunday, June 1, 2008, 10:11 AM Dear Sue, I am so sorry to hear about your dad. This is a great group and there is a lot to learn about Prostate Cancer. My husband has prostate cancer too. All I can suggest is follow Kathy's lead and read and learn all you can about this dreadful disease. If you ever just need to vent, here is the place to do it. There is usually always someone here to help you in with anything you need or questions you may need answered. I will keep you and your dad in my thoughts and prayers. Sincerely, Sheila ------------ -- Original message ------------ -- From: " Sue Saxey " <suesaxey@btopenworl d.com> My father is in Somerset , UK , his hospital is Yeovil. And he had been seeing his doctor but not about anything to do with prostate. He's on medication for blood pressure and he had colitis since retiring, which in recent years has been really well controlled without much medication He came to stay with me last September and mentioned that he'd noticed needing to pee in the night 4 or 5 times in place of the customary once but only for a few weeks at that stage - it felt like a very recent symptom and he asked me if I thought he should tell his GP so I said yes and he did - he had that first PSA (120) that week. What I have realised is that he finds it hard to remember all that has been said - I wish now that I'd gone with him for his September and January appointments - but at the time it felt OK not to. Thank you for the information - I'll have a good read Sue [ProstateCancerSupp ort] my father Hello My name is Sue and my 76 year old father was diagnosed with prostate cancer September 2007. At the time his GP was very reassuring but PSA was 120 and three monthly hormone treatment followed. My father was very cheerfully telling everybody that it was no problem, lots of men had prostate cancer, it's something old men live with. In Jan 2008 his PSA was down to 70 and he told me his specialist was happy. In March he started to experience hip and back pain and went to his GP who ordered an x-ray and then rang him to say it might be to do with his cancer. He wrote to the specialist who wrote back to say that with a PSA of 120 he very likely had metastatic disease at diagnosis - this was news to my father! So a series of PSAs have been done: midApril 280, May2nd 330 and May23rd 383. At the May 2nd appt I went with my father and Casodex 50mg was added and a bone scan ordered. On Friday we saw the bone scan result - widespread metastases throughout the skeleton but principally shoulders, spine, pelvis. Casodex has been stopped, stilboestrol added and we await an appointment with an oncologist. Radiotherapy was mentioned - palliative only - and then chemotherapy was mentioned but the urologist wouldn't really comment saying it was up to the oncologist and also obliquely mentioning costs and funding. He also said average life expectancy in this situation was 9-12 months, but he also expressed surprise at how fit my father looks and is, and asked would he want ureteric stents or to allow his kidneys to fail... It was all a bit shocking to be honest and it's taken me 48hours to think of looking online and here I am - I found you guys I'd appreciate your comments and insights Thank you Sue Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 3, 2008 Report Share Posted June 3, 2008 Tom, Ask him these questions if you have time. 1) Is radiation effective in a curative way for men with extensive bone mets? 2) If his answer is yes how do they target the bone mets if they are extensive on a bone scan? I would be interested to hear his answers. Kathy From: ProstateCancerSupport [mailto:ProstateCancerSupport ] On Behalf Of Tom Sent: Tuesday, June 03, 2008 12:48 AM To: ProstateCancerSupport Subject: RE: my father I meet with my radiation oncologist every Tuesday, and will meet with him later on today. During those sessions, he asks if I have any questions, if I'm experiencing any side effects I'd like to discuss and so forth. In those discussions, which have been far-reaching, he tells me he's treated some patients over and over again with radiation treatment as prostate cancer has metastasized and has migrated from one location to another throughout their bodies. I don't want to shoot from the hip and give out stats that are inaccurate, so later on today when we meet I'll ask him for a range of PSA values among those men who he's treated with radiation treatment and the timeframes (months or years) over which he's seen those patients. Since I'm not in a situation where I really have to worry about such treatment at this juncture, those discussions have fallen into the interesting but somewhat hypothetical category thus far. However, he also tells me that currently used scanning technology can't detect a tumor if it's less than a cubic centimeter in size (more or less), and that when it has that kind of mass it tends to be correlated with a PSA value of 10 or greater. " Think of it this way, " he said. " Before you had your prostatectomy last fall you had a PSA value of 26 and the prostate organ is about the size of a walnut. So the scans picked up the presence of the tumor in the prostate organ but nowhere else. After radiation treatment, we won't be able to detect a tumor elsewhere in your body until your PSA reading gets back up over a reading of about 10. If your post-op, post-radiation treatment PSA reading stays at 0.4 forever (which was my first post-op PSA reading) that would be a great outcome. " Makes sense to me. From: shedormancomcast (DOT) net <shedormancomcast (DOT) net> Subject: Re: [ProstateCancerSupp ort] my father To: ProstateCancerSuppo rtyahoogroups (DOT) com Date: Sunday, June 1, 2008, 10:11 AM Dear Sue, I am so sorry to hear about your dad. This is a great group and there is a lot to learn about Prostate Cancer. My husband has prostate cancer too. All I can suggest is follow Kathy's lead and read and learn all you can about this dreadful disease. If you ever just need to vent, here is the place to do it. There is usually always someone here to help you in with anything you need or questions you may need answered. I will keep you and your dad in my thoughts and prayers. Sincerely, Sheila ------------ -- Original message ------------ -- From: " Sue Saxey " <suesaxey@btopenworl d.com> My father is in Somerset , UK , his hospital is Yeovil. And he had been seeing his doctor but not about anything to do with prostate. He's on medication for blood pressure and he had colitis since retiring, which in recent years has been really well controlled without much medication He came to stay with me last September and mentioned that he'd noticed needing to pee in the night 4 or 5 times in place of the customary once but only for a few weeks at that stage - it felt like a very recent symptom and he asked me if I thought he should tell his GP so I said yes and he did - he had that first PSA (120) that week. What I have realised is that he finds it hard to remember all that has been said - I wish now that I'd gone with him for his September and January appointments - but at the time it felt OK not to. Thank you for the information - I'll have a good read Sue [ProstateCancerSupp ort] my father Hello My name is Sue and my 76 year old father was diagnosed with prostate cancer September 2007. At the time his GP was very reassuring but PSA was 120 and three monthly hormone treatment followed. My father was very cheerfully telling everybody that it was no problem, lots of men had prostate cancer, it's something old men live with. In Jan 2008 his PSA was down to 70 and he told me his specialist was happy. In March he started to experience hip and back pain and went to his GP who ordered an x-ray and then rang him to say it might be to do with his cancer. He wrote to the specialist who wrote back to say that with a PSA of 120 he very likely had metastatic disease at diagnosis - this was news to my father! So a series of PSAs have been done: midApril 280, May2nd 330 and May23rd 383. At the May 2nd appt I went with my father and Casodex 50mg was added and a bone scan ordered. On Friday we saw the bone scan result - widespread metastases throughout the skeleton but principally shoulders, spine, pelvis. Casodex has been stopped, stilboestrol added and we await an appointment with an oncologist. Radiotherapy was mentioned - palliative only - and then chemotherapy was mentioned but the urologist wouldn't really comment saying it was up to the oncologist and also obliquely mentioning costs and funding. He also said average life expectancy in this situation was 9-12 months, but he also expressed surprise at how fit my father looks and is, and asked would he want ureteric stents or to allow his kidneys to fail... It was all a bit shocking to be honest and it's taken me 48hours to think of looking online and here I am - I found you guys I'd appreciate your comments and insights Thank you Sue Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 3, 2008 Report Share Posted June 3, 2008 Kathy, I left to visit my docs today before reading your message. As it turns out, I had two doctor's appointments today -- one with my urologist at Duke, the other with my radiation oncologist at UNC Chapel Hill. In talking with my radiation oncologist, I asked him to refresh my memory as to the previous discussion we'd had about treating men with highly elevated PSA values. I had thought -- as it turns out correctly -- that I'd heard him say that he has patients who have PSA values in the "thousands" who he's treated for "years". I didn't want to cite that in here until running it by him once again since, as I mentioned previously, this was just a peripheral discussion to some other stuff we were talking about several weeks ago. However, and having said that, he tells me that he has one patient currently whose PSA value is 5,600 (not a mis-print) and he has lots of patients who have PSA values in the hundreds and thousands who he's treated over multi-year periods. He also said that 25% of men with significantly elevated PSA values live 10 years or longer, so the risk of a man dying of prostate cancer is actually fairly remote though men like myself -- guys who are fairly young and who have particularly aggressive tumors -- are at highest risk over the long term. I asked him about the treatment regimen for newly diagnosed men who have significantly elevated PSA values and he said the typical protocol is to put the men on hormonal therapy for several months until the PSA value appears to reach its base. When I pressed him as to what was realistic to expect insofar as a basing number, he said it's not unusual for a man who has a significantly elevated PSA value to be able to bring the number down to something below 10 -- say 5 or thereabouts. When it appears the PSA value has based, then they initiate radiation treatment, usually to the prostate bed and then to other areas where the tumor has metastasized, though he says they have to pick and choose the mets they treat since there's a lifetime limit in terms of the aggregate amount of radiation that can be administered to any one patient. So, he says, if the mets is one that is particularly painful, or one on a load-bearing joint (such as a hip-bone) that assumes greater priority in terms of treatment than some other sites might. Hope this helps. Tom From: shedormancomcast (DOT) net <shedormancomcast (DOT) net>Subject: Re: [ProstateCancerSupp ort] my fatherTo: ProstateCancerSuppo rtyahoogroups (DOT) comDate: Sunday, June 1, 2008, 10:11 AM Dear Sue, I am so sorry to hear about your dad. This is a great group and there is a lot to learn about Prostate Cancer. My husband has prostate cancer too. All I can suggest is follow Kathy's lead and read and learn all you can about this dreadful disease. If you ever just need to vent, here is the place to do it. There is usually always someone here to help you in with anything you need or questions you may need answered. I will keep you and your dad in my thoughts and prayers. Sincerely, Sheila ------------ -- Original message ------------ -- From: "Sue Saxey" <suesaxey@btopenworl d.com> My father is in Somerset , UK , his hospital is Yeovil. And he had been seeing his doctor but not about anything to do with prostate. He's on medication for blood pressure and he had colitis since retiring, which in recent years has been really well controlled without much medication He came to stay with me last September and mentioned that he'd noticed needing to pee in the night 4 or 5 times in place of the customary once but only for a few weeks at that stage - it felt like a very recent symptom and he asked me if I thought he should tell his GP so I said yes and he did - he had that first PSA (120) that week. What I have realised is that he finds it hard to remember all that has been said - I wish now that I'd gone with him for his September and January appointments - but at the time it felt OK not to. Thank you for the information - I'll have a good read Sue [ProstateCancerSupp ort] my father Hello My name is Sue and my 76 year old father was diagnosed with prostate cancer September 2007. At the time his GP was very reassuring but PSA was 120 and three monthly hormone treatment followed. My father was very cheerfully telling everybody that it was no problem, lots of men had prostate cancer, it's something old men live with. In Jan 2008 his PSA was down to 70 and he told me his specialist was happy. In March he started to experience hip and back pain and went to his GP who ordered an x-ray and then rang him to say it might be to do with his cancer. He wrote to the specialist who wrote back to say that with a PSA of 120 he very likely had metastatic disease at diagnosis - this was news to my father! So a series of PSAs have been done: midApril 280, May2nd 330 and May23rd 383. At the May 2nd appt I went with my father and Casodex 50mg was added and a bone scan ordered. On Friday we saw the bone scan result - widespread metastases throughout the skeleton but principally shoulders, spine, pelvis. Casodex has been stopped, stilboestrol added and we await an appointment with an oncologist. Radiotherapy was mentioned - palliative only - and then chemotherapy was mentioned but the urologist wouldn't really comment saying it was up to the oncologist and also obliquely mentioning costs and funding. He also said average life expectancy in this situation was 9-12 months, but he also expressed surprise at how fit my father looks and is, and asked would he want ureteric stents or to allow his kidneys to fail... It was all a bit shocking to be honest and it's taken me 48hours to think of looking online and here I am - I found you guys I'd appreciate your comments and insights Thank you Sue Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 3, 2008 Report Share Posted June 3, 2008 Kathy, I left to visit my docs today before reading your message. As it turns out, I had two doctor's appointments today -- one with my urologist at Duke, the other with my radiation oncologist at UNC Chapel Hill. In talking with my radiation oncologist, I asked him to refresh my memory as to the previous discussion we'd had about treating men with highly elevated PSA values. I had thought -- as it turns out correctly -- that I'd heard him say that he has patients who have PSA values in the "thousands" who he's treated for "years". I didn't want to cite that in here until running it by him once again since, as I mentioned previously, this was just a peripheral discussion to some other stuff we were talking about several weeks ago. However, and having said that, he tells me that he has one patient currently whose PSA value is 5,600 (not a mis-print) and he has lots of patients who have PSA values in the hundreds and thousands who he's treated over multi-year periods. He also said that 25% of men with significantly elevated PSA values live 10 years or longer, so the risk of a man dying of prostate cancer is actually fairly remote though men like myself -- guys who are fairly young and who have particularly aggressive tumors -- are at highest risk over the long term. I asked him about the treatment regimen for newly diagnosed men who have significantly elevated PSA values and he said the typical protocol is to put the men on hormonal therapy for several months until the PSA value appears to reach its base. When I pressed him as to what was realistic to expect insofar as a basing number, he said it's not unusual for a man who has a significantly elevated PSA value to be able to bring the number down to something below 10 -- say 5 or thereabouts. When it appears the PSA value has based, then they initiate radiation treatment, usually to the prostate bed and then to other areas where the tumor has metastasized, though he says they have to pick and choose the mets they treat since there's a lifetime limit in terms of the aggregate amount of radiation that can be administered to any one patient. So, he says, if the mets is one that is particularly painful, or one on a load-bearing joint (such as a hip-bone) that assumes greater priority in terms of treatment than some other sites might. Hope this helps. Tom From: shedormancomcast (DOT) net <shedormancomcast (DOT) net>Subject: Re: [ProstateCancerSupp ort] my fatherTo: ProstateCancerSuppo rtyahoogroups (DOT) comDate: Sunday, June 1, 2008, 10:11 AM Dear Sue, I am so sorry to hear about your dad. This is a great group and there is a lot to learn about Prostate Cancer. My husband has prostate cancer too. All I can suggest is follow Kathy's lead and read and learn all you can about this dreadful disease. If you ever just need to vent, here is the place to do it. There is usually always someone here to help you in with anything you need or questions you may need answered. I will keep you and your dad in my thoughts and prayers. Sincerely, Sheila ------------ -- Original message ------------ -- From: "Sue Saxey" <suesaxey@btopenworl d.com> My father is in Somerset , UK , his hospital is Yeovil. And he had been seeing his doctor but not about anything to do with prostate. He's on medication for blood pressure and he had colitis since retiring, which in recent years has been really well controlled without much medication He came to stay with me last September and mentioned that he'd noticed needing to pee in the night 4 or 5 times in place of the customary once but only for a few weeks at that stage - it felt like a very recent symptom and he asked me if I thought he should tell his GP so I said yes and he did - he had that first PSA (120) that week. What I have realised is that he finds it hard to remember all that has been said - I wish now that I'd gone with him for his September and January appointments - but at the time it felt OK not to. Thank you for the information - I'll have a good read Sue [ProstateCancerSupp ort] my father Hello My name is Sue and my 76 year old father was diagnosed with prostate cancer September 2007. At the time his GP was very reassuring but PSA was 120 and three monthly hormone treatment followed. My father was very cheerfully telling everybody that it was no problem, lots of men had prostate cancer, it's something old men live with. In Jan 2008 his PSA was down to 70 and he told me his specialist was happy. In March he started to experience hip and back pain and went to his GP who ordered an x-ray and then rang him to say it might be to do with his cancer. He wrote to the specialist who wrote back to say that with a PSA of 120 he very likely had metastatic disease at diagnosis - this was news to my father! So a series of PSAs have been done: midApril 280, May2nd 330 and May23rd 383. At the May 2nd appt I went with my father and Casodex 50mg was added and a bone scan ordered. On Friday we saw the bone scan result - widespread metastases throughout the skeleton but principally shoulders, spine, pelvis. Casodex has been stopped, stilboestrol added and we await an appointment with an oncologist. Radiotherapy was mentioned - palliative only - and then chemotherapy was mentioned but the urologist wouldn't really comment saying it was up to the oncologist and also obliquely mentioning costs and funding. He also said average life expectancy in this situation was 9-12 months, but he also expressed surprise at how fit my father looks and is, and asked would he want ureteric stents or to allow his kidneys to fail... It was all a bit shocking to be honest and it's taken me 48hours to think of looking online and here I am - I found you guys I'd appreciate your comments and insights Thank you Sue Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 3, 2008 Report Share Posted June 3, 2008 Kathy, I left to visit my docs today before reading your message. As it turns out, I had two doctor's appointments today -- one with my urologist at Duke, the other with my radiation oncologist at UNC Chapel Hill. In talking with my radiation oncologist, I asked him to refresh my memory as to the previous discussion we'd had about treating men with highly elevated PSA values. I had thought -- as it turns out correctly -- that I'd heard him say that he has patients who have PSA values in the "thousands" who he's treated for "years". I didn't want to cite that in here until running it by him once again since, as I mentioned previously, this was just a peripheral discussion to some other stuff we were talking about several weeks ago. However, and having said that, he tells me that he has one patient currently whose PSA value is 5,600 (not a mis-print) and he has lots of patients who have PSA values in the hundreds and thousands who he's treated over multi-year periods. He also said that 25% of men with significantly elevated PSA values live 10 years or longer, so the risk of a man dying of prostate cancer is actually fairly remote though men like myself -- guys who are fairly young and who have particularly aggressive tumors -- are at highest risk over the long term. I asked him about the treatment regimen for newly diagnosed men who have significantly elevated PSA values and he said the typical protocol is to put the men on hormonal therapy for several months until the PSA value appears to reach its base. When I pressed him as to what was realistic to expect insofar as a basing number, he said it's not unusual for a man who has a significantly elevated PSA value to be able to bring the number down to something below 10 -- say 5 or thereabouts. When it appears the PSA value has based, then they initiate radiation treatment, usually to the prostate bed and then to other areas where the tumor has metastasized, though he says they have to pick and choose the mets they treat since there's a lifetime limit in terms of the aggregate amount of radiation that can be administered to any one patient. So, he says, if the mets is one that is particularly painful, or one on a load-bearing joint (such as a hip-bone) that assumes greater priority in terms of treatment than some other sites might. Hope this helps. Tom From: shedormancomcast (DOT) net <shedormancomcast (DOT) net>Subject: Re: [ProstateCancerSupp ort] my fatherTo: ProstateCancerSuppo rtyahoogroups (DOT) comDate: Sunday, June 1, 2008, 10:11 AM Dear Sue, I am so sorry to hear about your dad. This is a great group and there is a lot to learn about Prostate Cancer. My husband has prostate cancer too. All I can suggest is follow Kathy's lead and read and learn all you can about this dreadful disease. If you ever just need to vent, here is the place to do it. There is usually always someone here to help you in with anything you need or questions you may need answered. I will keep you and your dad in my thoughts and prayers. Sincerely, Sheila ------------ -- Original message ------------ -- From: "Sue Saxey" <suesaxey@btopenworl d.com> My father is in Somerset , UK , his hospital is Yeovil. And he had been seeing his doctor but not about anything to do with prostate. He's on medication for blood pressure and he had colitis since retiring, which in recent years has been really well controlled without much medication He came to stay with me last September and mentioned that he'd noticed needing to pee in the night 4 or 5 times in place of the customary once but only for a few weeks at that stage - it felt like a very recent symptom and he asked me if I thought he should tell his GP so I said yes and he did - he had that first PSA (120) that week. What I have realised is that he finds it hard to remember all that has been said - I wish now that I'd gone with him for his September and January appointments - but at the time it felt OK not to. Thank you for the information - I'll have a good read Sue [ProstateCancerSupp ort] my father Hello My name is Sue and my 76 year old father was diagnosed with prostate cancer September 2007. At the time his GP was very reassuring but PSA was 120 and three monthly hormone treatment followed. My father was very cheerfully telling everybody that it was no problem, lots of men had prostate cancer, it's something old men live with. In Jan 2008 his PSA was down to 70 and he told me his specialist was happy. In March he started to experience hip and back pain and went to his GP who ordered an x-ray and then rang him to say it might be to do with his cancer. He wrote to the specialist who wrote back to say that with a PSA of 120 he very likely had metastatic disease at diagnosis - this was news to my father! So a series of PSAs have been done: midApril 280, May2nd 330 and May23rd 383. At the May 2nd appt I went with my father and Casodex 50mg was added and a bone scan ordered. On Friday we saw the bone scan result - widespread metastases throughout the skeleton but principally shoulders, spine, pelvis. Casodex has been stopped, stilboestrol added and we await an appointment with an oncologist. Radiotherapy was mentioned - palliative only - and then chemotherapy was mentioned but the urologist wouldn't really comment saying it was up to the oncologist and also obliquely mentioning costs and funding. He also said average life expectancy in this situation was 9-12 months, but he also expressed surprise at how fit my father looks and is, and asked would he want ureteric stents or to allow his kidneys to fail... It was all a bit shocking to be honest and it's taken me 48hours to think of looking online and here I am - I found you guys I'd appreciate your comments and insights Thank you Sue Quote Link to comment Share on other sites More sharing options...
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