Finally the journey begins for me....

Posted by copyman @copyman, 2 days ago

Officially started treatment today after several months of 2nd & 3rd opinions, video consults with Dr Scholz, and endless hours of research. I just took the initial dose of 3 Orgovyx pills (4-6 month course). Will be traveling from NJ to CA (UCLA) in Sept to have Brachytherapy procedure with Dr Chang then have 5 SBRT sessions back at home. Here are my stats:

Age: 69, PSA 35, Gleason 4+3 Grade 3

MRI:

FINDINGS: PROSTATE GLAND: measures approximately 5 x 4.4 cm corresponding to a volume of 45 mL. PERIPHERAL ZONE: No evidence of prostatitis. CENTRAL GLAND: Moderate changes of BPH. Lesions 1 PI-RADS score: 5 Location: Right TZ Mid at 11 o'clock Max dimension: 3.66 cm (slice: 14) Volume: 9.492 ml Extraprostatic extension: - none
Extraprostatic Tumor Extension: Slight bulging of the prostatic capsule but no visible tumor extension beyond the capsule. Neurovascular Bundles: Normal. Seminal Vesicles: Normal. Urinary Bladder: Normal. Pelvic Lymphadenopathy: None. Pelvic Osseous structures: No suspicious osseous lesion identified.

TransperineaL Biopsy , 17 cores 14 cores benign, 3 cores from same area (transistion zone) (50-60% pattern 4)

(2nd opinion on slides reviewed by chief pathologist at Univ of Penn who concurred with original findings)

PSMA:
1. Marked PSMA-avid disease in the prostate consistent with biopsy-proven prostatic adenocarcinoma.
2. The minimally PSMA avid largely symmetric pelvic lymph nodes are favored to reflect reactive/inflammatory uptake. No suspicious PSMA avid lymph nodes identified.
3. No radiotracer avid distant metastases

Prostox text for SBRT late term toxicities: Low Risk

Thanks to everyone for the great information shared on this forum and sure I will be posting in the near future for support. Prayers for all!

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

This sounds a bit like my story. Metastases were discovered in March. I started Abi/pred/Orgovyx in April. Today I had my first of 2 sessions of HBR Brachy at UCSF. The 2nd is in 6 days. It all happened much faster than I expected it would. I checked in at 7:00, got all the monitoring in (IV, heart, oxygen, etc) then at 8:00 went into the room for the CT scan and catheter implants. I woke up well and after some recovery they wheeled me into the room with the radiation. That was only about 10 minutes or so of exposure. I had heard that the catheter removal was going to be unpleasant but it wasn't bad. My wife and I left at around 11:30.

After round 2 next week I'll be getting set up for my 5 to 6 rounds of SBRT - so, very similar. I'm fortunate not to have to fly across the country and only do a 1 hour drive. But it's good that you did your research. I did the same but only moved my care from the South Bay Area to San Francisco.

Anyway, all the best. We'll all get through this.

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Profile picture for damonk @damonk

This sounds a bit like my story. Metastases were discovered in March. I started Abi/pred/Orgovyx in April. Today I had my first of 2 sessions of HBR Brachy at UCSF. The 2nd is in 6 days. It all happened much faster than I expected it would. I checked in at 7:00, got all the monitoring in (IV, heart, oxygen, etc) then at 8:00 went into the room for the CT scan and catheter implants. I woke up well and after some recovery they wheeled me into the room with the radiation. That was only about 10 minutes or so of exposure. I had heard that the catheter removal was going to be unpleasant but it wasn't bad. My wife and I left at around 11:30.

After round 2 next week I'll be getting set up for my 5 to 6 rounds of SBRT - so, very similar. I'm fortunate not to have to fly across the country and only do a 1 hour drive. But it's good that you did your research. I did the same but only moved my care from the South Bay Area to San Francisco.

Anyway, all the best. We'll all get through this.

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@damonk Thanks and good luck with your treatment. That sounds very similar to Dr Chang's protocol. He places the catheters, rectal spacer & fiducial markers then you are awake for CT/MRI planning & radiation. The difference with how they do it on the east coast and why you are under anesthesia so long is they do everything why you are asleep, placing the 15+ catheters into prostate, planning procedure with a physicist, inserting rectal spacer & fudicial markers, then do the HDR. There are many people who would prefer not being awake at all.

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