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jonbo49 posted:
hi,i'm new here looking for some answers and suggestions,my urologist did a prostate biopsy and found i had prostate cancer about 1 1/2 months ago this is 1/11/13 i'm writing this.my psa level he said was over 50,he told me removing prostate or chemo would not help me because it has spread local.so he give me a lupron injection that has to be done every 4 months,had bone scan and cat scan done 4 days ago and came back good,my doctor at oncology center said i could get radiation treatment to prostate if i agreed.i have had a catheter in for about the same time,they removed it a week ago within 10 hours was back in emergency room blocked back off and another one put in.my question is if scans show good and i'm on lupron should i do the radiation right now.going back to urologist in 2 weeks to see if catheter can come out,have read about the side effects due to this radiation some don't sound good.would appreciate any response.thank you for reading,oh i am 57 years old
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ENTERTAINER responded:
I was diagnosed in 08 my psa was 87. I went for radiation treatment then lupron every 90 days. I never needed a cath. I will tell you radiation will make your hips hurt. they sat it is not a side effect but everyone I talk to tells me the same thing. I had a burning rectum. felt like bad hemorrhoids. other than that I had very few side effects. If the lupron is not screwing your head up radiation should be no problem. my PSA is .006 at this point. the Lupron is my problem my head is really screwed up can not seem to find help
 
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Basir U Tareen, MD responded:
Depending on your age and medical condition I think it is still reasonable to have a discussion with an experienced surgeon about prostatectomy. Classically a PSA of 50 (assuming its from the cancer and not from benign causes) suggests a high likelihood of metastatic disease. There have, however, been several published reports in the literature of the benefit of prostatectomy in high risk disease in combination with a good lymph node dissection for staging. In your case the benefit of "local control" is huge -- it would allow you to remove the catheter and have an improved quality of life. Following surgery you would still have the option of adjuvant radiation if margins were positive and the radiation oncologist believed there would be a benefit.

Lupron is not a cure. Its a temporizing measure. If there is no evidence of metastatic disease I would consider speaking with both urologists and radiation oncologists about the possibility of definitive treatment.

best of luck,
Dr Tareen


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