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What to ask the radiation oncologist about prostate cancer?

Posted by surftohealth88 @surftohealth88, May 7 3:13pm

Tomorrow we have zoom call with radiation oncologist that was recommended to us by prostate surgeon. Our meeting with surgeon was somewhat confusing since we did not expect to be told that my husband's case is not "urgent" and that we should talk to radiologist and as well to a doctor that does focal treatments. We were convinced that RP was the best approach, as we still think that RP is a way to go with cruciform and IDC but since we were told that we should have consultations with radiology, we agreed. I can say with whole honesty that we were like two deer caught in headlight after we were told that there is no rush, and we both failed to react with NEW questions and stared at "old ones" on our paper in confusion. So, in preparation for tomorrow's appointment I am asking for help with possible questions - any suggestion and advise is welcome. Thanks so much in advance < 3

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surftohealth88 | @surftohealth88 | May 12 2:51pm
In reply to @groundhogy "Here is a good website to compare odds of cure for the major treatment paths. You..." + (show)
@groundhogy

Here is a good website to compare odds of cure for the major treatment paths. You have to determine your stage, low risk, intermediate, or high risk (risk of recurrence). So if you are intermediate, pull up the intermediate chart and you can see the odds of 10-20 yr survival, etc. based on the treatment you pick.
https://www.prostatecancerfree.org/compare-prostate-cancer-treatments/
It is best viewed on computer or just print it on paper. Not so viewable on phone.

To make the graphs easier to read, i drew a dot on the endpoints of the elipses, and then drew a line through the dots. This turns the elipses into lines.

Also be aware the the graphs don’t show any salvage radiation benefit. This would boost the surgery odds up a bit.

And, this is a very dysfunctional industry from my view. Loads of bad info mixed in with the good info. Same with the docs. Many of them are more dangerous than the cancer.

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Yes, but one has to look at individual presentation to make valid decision.

My husband is basically none of the "standard" groups used for that diagram. For example, his PSA was 7.6 (now 5.2), he has low tumor burden BUT he is actually "unfavorable intermediate" because he has IDC and cribriform present. IDC and cribriform are the one that put him in high risk so he has to have aggressive approach, regardless of the fact that it is one singe core in the whole prostate with gleason 7.

On the other hand, because he has one single core with that presentation and because his cancer is one singe spot contained inside the gland RP is by both experts deemed as curative in his case. Yes, they both said "curative" for RP. I even asked about "salvage" radiation and RO told me "nah, I do not think he will need that". I was surprised, but hey, was nice to hear it. IDC and cribriform sometimes show resilience to radiation so to choose radiation as the first step would not warrant complete eradication no matter what any diagram shows.

Only time will tell if RP was "curative". One has to choose the step that is "the best at the moment" and at the moment for his particular case RP is the recommended path.

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1 reply
groundhogy | @groundhogy | May 12 3:54pm
In reply to @surftohealth88 "Yes, but one has to look at individual presentation to make valid decision. My husband is..." + (show)
@surftohealth88

Yes, but one has to look at individual presentation to make valid decision.

My husband is basically none of the "standard" groups used for that diagram. For example, his PSA was 7.6 (now 5.2), he has low tumor burden BUT he is actually "unfavorable intermediate" because he has IDC and cribriform present. IDC and cribriform are the one that put him in high risk so he has to have aggressive approach, regardless of the fact that it is one singe core in the whole prostate with gleason 7.

On the other hand, because he has one single core with that presentation and because his cancer is one singe spot contained inside the gland RP is by both experts deemed as curative in his case. Yes, they both said "curative" for RP. I even asked about "salvage" radiation and RO told me "nah, I do not think he will need that". I was surprised, but hey, was nice to hear it. IDC and cribriform sometimes show resilience to radiation so to choose radiation as the first step would not warrant complete eradication no matter what any diagram shows.

Only time will tell if RP was "curative". One has to choose the step that is "the best at the moment" and at the moment for his particular case RP is the recommended path.

Jump to this post

Yeah, nothing is perfect for every case. Sounds like you did your homework which is the important thing and cane to a reasonable pathway.
Good luck!

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