Just a quick update…
I shared my last PSA results with my radiation oncologist via email yesterday to see if the results would influence his treatment recommendation.
He stated that a stable PSA is “great news” and that “continuing to monitor at this point is a very reasonable approach.” I also asked if a four-month PSA test frequency was appropriate or if we should look at increasing the frequency. With my numbers, he said that a three to six month frequency was most common, so sticking to four months was fine.
I also asked for clarification about sexual function after salvage radiation therapy. For some reason, I had it in my mind that from our conversation during the initial consult, he said that zapping me would likely damage my one remaining nerve bundle to the point that sexual function would be a thing of the past. He corrected me.
He said that post-radiation function is highly dependent on pre-radiation function. There will likely be some degradation, but not necessarily a complete loss of function as I had somehow lodged in my brain.
He closed the conversation by saying, “Hopefully your PSA will continue to behave itself and we can worry about that [sexual function] down the road.”
Needless to say, I was quite pleased with those responses.
We’ll see what the urologist says on the 21st (I put the wrong date in my last post) but, for now, I’m fine with doing nothing until my next PSA test in December.
12 thoughts on “Day 2,827 – Q&A with the Radiation Oncologist”
Good news then!
Yes, I think so. I hope you’re not being impacted by the NoCal fires too much beyond hazy/smokey skies.
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I’m 100 miles or so from the fires so it’s not been affecting us too much here in the south bay, but I was up in Tahoe a couple of weeks ago and the smoke is bad up there. I had a friend up in Reading who was evacuated for a week, but he’s back home now.
That’s good to hear. It’s so heartbreaking to watch the news. I drove through Whiskeytown National Recreation Area in April 2015 and looking at the Cal Fire maps, it looks like it was consumed by fire. Sad. Glad that your friend is okay.
What fantastic news! Congrats all around.
As a cautionary tale. I had brachytherapy and then conformal beam radiation. My sexual function was considerably degraded.
Thanks, Jim. Yeah, I suspect that, should I choose to go down this path, it will hit me hard (pun not intended), too.
Something worth asking imho is what kind of radiation technique will be used. Straight thru the body (least precise, highest collateral damage), conformal beam (more precise, less collateral damage), stereotactic (most precise, least collateral damage). Then there’s proton treatment s, which aren’t radiation in the traditional sense. They’re the most precise by far, maybe too precise.
The above represents my understanding as a layman and should not be considered definitive medical opinion.
Good points, Jim. I’ll have to check my notes from the consult to see what he said.
Nice to read some good news, sounds like time is on your side Dan.
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Congrats Dan.. I am new to your site, I am 55 and coming up on 2 years since my RP with 12 lymph nodes each site and left nerve spared. I just had my last PSA about a month ago, 0.014 and freaked out. I have now come full circle and sticking to the 3 month testing schedule. However, my Urologist said if I wanted, I could meet with the radiation oncologist who would also probably say…. chill out and wait to see if it even rises. But, I have got several comments that 0.03 is when you would start to think about things. I had negative margins, no lymph nodes affected, no seminal either. Granted 3 of 12 were Gleanson 4+5=9, everything appeared to be contained w/i the prostate. Thanks BrianTinsley.com
Thanks for the comment. Yes, I get the “freaked out” part of seeing a detectable PSA. It’s important to see what your next PSA does—it should give you a much better idea of what your next steps might be. (I’ve learned that it’s more about the trend and doubling time, in conjunction with your pathology, than the actual numbers themselves.)
Good luck with your next PSA test. I know the waiting will be unnerving, but it should be worth it.
All the best,