YANA - YOU ARE NOT ALONE NOW

PROSTATE CANCER SUPPORT SITE

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George Pifer and Chigako live in Indiana U.S.A. . He was 65 when he was diagnosed in January, 2007. His initial PSA was 63.0 ng/ml, his Gleason Score was 8 and he was staged T2c . His is undecided as to treatment choice but is leaning towards combining Photon and Proton Beam. Here is his story.

I was a little surprised to discover that I had prostate cancer. I had lived in Tokyo for twenty five years and ate a Japanese diet of fish, vegetables, rice, soy products, little meat, fruits and watched the pH of foods. The more alkaline the better.

Jan 10 '07 PSA 63 ng/ml. Biopsy was quick and professional. Gleason 8. First, did bone scan-negative, next MRI-negative, then ProstaScint scan to check if cells were outside prostate-negative. But the oncologist I went to see at Midwest Proton Radiotherapy Institute said there was good chance of cancer cells being outside of gland.

March 29,07 1 yr. Vantas implant for hormone therapy to bring down PSA. No side effects. Vit E 400 IU + 500mg C daily.

June 26th PSA 3.5 ng/ml.

July 31st PSA 2.6 ng/ml.

August 2nd endorectal coil MRI-also negative, which is pretty good indication that the cancer cells are confined to the prostate gland.

Head medical director of MPRI (Midwest Proton Radiotherapy Institute) recommended forty four days combined treatment: 16 Proton(14 of prostate & seminal vesicles at 7560 rads + 2 of just prostate at 7920 rads) + 28 Photon (modified pelvic at 5040 rads)

Will soon make decision to either do combined at MPRI or just Photon near my home.

 

UPDATED

September 2007

 

 

I have made a final decision to do EBT(IMRT) + Brachytherapy.

My decision was made using a FACT-PROBLEM-SOLUTION methodology that a friend of mine in Japan developed for training seminars. First I listed all the facts of my situation. Next I listed the major problem. And thirdly, the possible solutions.

PROBLEM

Even though all tests indicate no cancer outside of prostate gland, must treat pelvic lymph nodes and select a therapy for seminal vesicles & prostate gland

SOLUTION

Options for therapy:

1. Proton + IMRT: 16 days proton(14D 75.6 Gy + 2D 79.2 Gy) + 28D IMRT (50.4 Gy)

2. IMRT: 44 days, pelvic lymph nodes 45-50 Gy, seminal vesicles 75.6 Gy, prostate 79 Gy

3. IMRT + LDR Brachytherapy: 22 days IMRT (4.4 Gy ) + Iodine 125 seed implants to 160 Gy

4. IMRT + HDR brachytherapy: 22 days IMRT (4.4 Gy Gy) + HDR (procedure?) (based on ASTRO ?05 paper, M. Ghilezan M.D. William Beaumont Hospital, Royal Oaks, MI)

Critical Factors for Decision Making Process - in order of priority

1. Long-term disease free survival (DFS)

2. Radiation Oncologist's experience:

a. years of actual line experience with PC procedure

b. number of high risk PC cases treated + success rate (if possible to quantify)

3. Minimal side effects: 90% chance of less than Grade 2 morbidity based on RTOG criteria

4. Continuity in total procedure(s) with follow up

5. Proximity to my residence in Angola,In (Wife still experiencing numbness in legs/arms from 12/25/06 auto accident. Can't drive to Toledo,OH for treatment.

6. Nutrition during treatment period: food preparation (My wife wants to do this so less anxiety for her if I stay home rather than go to Bloomington and Indianapolis in case of No.1)

Initially I thought that brachytherapy was only used for low-risk patients, but after talking to a radiation oncologist near my home, and doing some more detailed research, I realized that the "higher dosage" with the Iodine 125 seed implants had some advantage over the other therapies, based on research on use of higher dosages. With improvements in imaging technology, brachytherapy has produced some very good results. A recent article in Cancer, August 1, 2007 Vol. 110 No. 3, "Long-term Outcomes after Treatment with Brachytherapy and Supplemental Conformal Radiation for Prostate Cancer Patients having Intermediate and High-Risk Features", indicated that ,"freedom from biochemical progression at 14 years was...72% (for) high-risk disease."

The radiation oncologist that will treat me has had thirteen years of experience performing the procedure; and from talking to former patients, is top notch. The advice I was given by an experienced oncologist that I had been talking to was ,"if you do this therapy, make sure you have someone who knows what they are doing."

Rule No. 1 - The technology is only as good as the people who apply it.

I feel confident that my decision is best for my situation.

 

UPDATED

December 2008

 

 

I completed the seed implant operation in December '07, so the seeds have pretty much cooked themselves out by now. No side effects so far, although I did have an anal fistulectomy in June '08, which I thought may have been due to the radiation. My oncologists said the incidents of fissures are very low.

My last PSA, August '08, was 0.028. I completed 18 months of hormone treatment just this November '08 and will see what happens in the next three months when I see my oncologist in February '09.

Just tending my garden in the greenhouse and shoveling snow every other day.

George's address is: gpifer@mchsi.com