Radiation Information

Today was Geoff's visit with Dr. Trenkner (I think that is how it is spelled).  He is the radiation doctor.  This was mostly an information gathering visit.

First he met with a nurse who got all his history and physical information...you know the questions...any family history, do you smoke, what medications do you take, etc. 

Next Dr. T came in and talked for quite a while.  He said with Geoff's Gleason scores being 8's and 9's, radiation would be a good option...but so would surgery.  Basically, both options are open to him right now and Dr. T didn't really commit to which one would be better.  He said, of course, he believes in the radiation so he would have no reservations about recommending the radiation.  The regimen would be...

Hormones would be administered first for about two months to "kill" all the testosterone.  (Testoterone is the culprit that promotes prostate cancer growth)  Then radiation treatments would begin daily, Monday through  Friday, for 39 treatments, or about 8 weeks.  Then, because the Gleason scores are 8's and 9's, the hormone therapy would continue for 18-24 months.  PSA tests would be administered on a regular basis.  There are some side effects but most likely not lasting.  On occasion, the side effects become chronic, but not very often.

If he chooses radiation first, then the option of surgery is off the table.  Apparently there is not much room "in there" to work for the surgeon and once radiation is completed, the prostate sort of attaches to the bladder (it all kind of gets cooked) and the prostate could then not be removed.  I'm not sure what the recommendation is, then, if there is a recurrence.

While remembering that Geoff's CT scan and bone scan were clear, Dr. T's concern was that with the high Gleason scores, there is a higher chance of metasteses and/or recurrence.  For that reason he seemed to lean more toward the radiation, but stressed that BOTH treatments were acceptable (almost equally acceptable, it seemed).

Geoff asked about surgery with follow-up radiation.  Dr. T said that would be indicated if there were any afftected lymph nodes or any cancer noticed outside the prostate.  

After talking with Dr. T, a patient advocate came in and gave Geoff all kinds of information about cancer support groups and organizations.

So...the first visit is done.  Tuesday, Jan 14 will be the first visit with the surgeon.