Initial PSA at diagnosis was 41.3 in April 2011. Saw consultant within a week who confirmed probable Locally Advanced PCa. MRI scan to look for metastases : None found. Gleeson score 4+4, and tumour graded as T3b, with no involvement of the Lymph Nodes.
Suggested treatment 3 months of ADT followed by 74 Gy in 37 fractions of IMRT with Fiducial Markers with concurrent ADT, and then 2 years further ADT.
Currently 25 fractions through with few side effects so far.
Now 32 of 37 fractions of IMRT with Fiducial Markers.... it is a good and accurate treatment, as they X-Ray me daily to spot the gold beads, then line my prostate up to be "Zapped" accurately by the 2 Gy of radiation.
Yesterday I asked about the treatment and its aims, to be told by the senior radiotherapist that the doctor would advise... so I asked when, and she informed me I would be seen after 25 fractions for a review!
After figuring out I was already past this, they hurriedly went about setting up a review, which I hope to have in a couple of days!
Just proves it is good to ask questions, and not assume.
Completed IMRT 37 fractions on 8th December 2011. Side effects continued to worsen until Christmas, but were not too serious.
PSA test on 4th January was 2.0, and testosterone <0.4, so at castrate level.
It is now onto the 3 monthly PSA tests until late 2013. Due to see Oncologist late January for review.
Saw my Oncologist end January 2012. Agreed to 2 years of ADT, with PSA tests every 3 months and 6 monthly Oncology reviews.
In February, after a Zoladex injection, started to experience more hot flushes (8-10 a night, and 5-6 during the day). In April 2012, started to have bowel problems with mucus. PSA test result 0.9
July 2012 Oncology review. PSA 0.5 Megestrol Acetate 40mg prescribed to help hot flushes, and Laperomide 2mg (Imodium) prescribed to improve bowel incontinence. Both worked very well. Also requested change in ADT from Zoladex to Decapeptyl, due the having a lot of bleeding from the Zoladex injection.
October 2012 PSA test 0.8. Testosterone <0.4. Decided to stop Megestrol Acetate, as there is some evidence it can cause increase in PSA. Hot flushes returned after 2-3 weeks. Also had blood in Urine, given 2 courses of antibiotic.
January 2013. GP review of general health, due to increasing breathlessness. All results came back "normal" (good news!), except still blood in urine. Oncology review PSA 0.5 Agreed to continue Imodium daily, and re-start Megestrol Acetate at 40mg every other day. Hot flushes reduced within a week. Move onto 6 monthly PSA test, and annual Oncology review.
April 2013. PSA down to 0.4. Decided to cut out red meat, and then a month later cut out all meat and eggs. Hoping the change of diet may help to reduce my PSA.
July 2013. PSA down to 0.2 - the new diet seems to be helping. Still on Decapeptyl.
October 2013. Last Decapeptyl injection to take me 2 years after completion of Radiation Therapy. PSA still 0.2
January 2013. PSA 0.1 - at last! Review with Oncologist so now on 6 monthly PSA tests only. Hoping Testosterone levels will start to increase soon.
One year on from stopping Hormone therapy, I am still suffering a lack of libido, and lack of energy. The latter may be from a recent diagnosis of angina. PSA went down to less than 0.1, but just come back up to 0.1. I am now discharged from Oncology, hopefully to just have 6 monthly PSA checks for 5 years, then annual checks.
Another year on, with little change. PSA has dropped back to 0.07, so I now consider that the Radiation Therapy has been completely effective. I am thankful for the good treatment I was offered!
Another year on and PSA has risen to 0.16. Everything still fine. Still have lack of libido.
Peter's e-mail address is: peter_higgs AT me.com (replace "AT" with "@")