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Radiation and ADT tips to prepare or what you wish you knew to prepare

Posted by albcan @albcan, Aug 19 12:58pm

Hi Everyone,

I’m getting ready to start salvage radiation and hormones and was hoping to get some advice on anything I should be doing to prepare.

For background had an RARP in Dec 2024 Feb 25 and May 25 PSA was undetectable but now in Aug has jumped, have another PET scan set for next week then will start new treatments.

I was diagnosed stage four initial diagnosis with metastatis in the lymph nodes and some were removed during the operation but couldn’t get them all and there were positive margins also.

Don’t know how many sessions yet will know after the scan but have been told two years “to start” on Hormones….

I’ve read a lot about the side effects of both the hormones and radiation and understand we are all different so will handle whatever the side effect are when they come but was hoping to learn tips or tricks you learned from experience going through the radiation and hormone treatments that you wish you knew before you started and or advise on what to do over the next few weeks to get ready physically or mentally.

Thanks very much for any feedback, this forum is incredibly helpful.

Al

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jeff Marchi | @jeffmarc | Aug 21 8:47pm
In reply to @rosstok "Al, Firstly, I wish you all the best with your treatment. I am now 10 months..." + (show)
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Al,
Firstly, I wish you all the best with your treatment. I am now 10 months into my treatment for advanced prostate cancer. I had IMRT and seeds 7 1/2 years ago, recurrence in February last year (2024), localized to pelvic area. I eat very well (Mediterranean and anti-inflammatory diet) and exercise a lot. Mayo (Dr. Kwon) diagnosed metastatic cancer last year and scheduled radiation and ADT (Eligard) + Zytiga. I had a bit of a stomach issue at the end of the radiation cycle (15 treatments over 3 weeks), but that was it. Fast forward to Feb this year (5 months later) I had a heart attack and had 4 stents inserted. Cardiologist discontinued the Zytiga due to its potentially negative impact on my heart (known possible side effect). Dr. Kwon concurred. - Track your heart health closely, especially if you have a family history (which I do). Due to my exercise history, I had little heart damage. Now I am also on a bunch of heart meds (Beta Blockers, Cholesterol lowering, blood pressure lowering and anti-platelet) meds. Hence, it is difficult to know the effects of ADT vs the heart meds. Hot Flashes (clearly from ADT since these started before my heart attack), fatigue (started with ADT, but got worse after the heart attack), and sleep issues. My solution is built around the four most stressed remedies: Sleep, Exercise, Diet and Social Activity/Stress management. These are very interrelated. If I have a light dinner with no alcohol and good exercise, I can sleep better. If I sleep better, I feel more like getting going during the day with exercise. Social activities help with stress but I need to manage them to keep the stress out of the equation. Exercise, for me, needs to be more than casual walking (I do that with my wife and my dog 1.5-2 miles on hilly terrain 5-7 days/week). I mix in more intense exercise 3-5 days/week with weights, rowing or paddling (hard enough to get my heart rate to 138 or so, which is all I can do with the Beta Blocker). This has had a big impact on reducing my fatigue - I now can make it through the day without that mid-day slump. It's all a huge effort, but luckily, I'm retired so I have the time for it all.

Jump to this post

You should try to get treatment from Dr. Heath, She is an incredibly well trained Genito urinary oncologist. Once you’ve had metastasis, that is who you want treating you.

Dr. Kwon Is a urologist and wants to treat people all the way through if he can, I know that he does work with Dr. Heath for some cases and you really want to make sure that that’s who’s treating you not a urologist.

Dr. Kwon sometimes doesn’t Follow through with the NCCN guidelines. His speeches are incredible, He covers everything so thoroughly, But over at ancan.org They’ve had a few people come in who have not been properly treated by him as far as the guidelines are concerned And it has left them with recurrences.

Hopefully, you’ve already been able to talk to a oncologist at Mayo Like Dr. Heath.

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