The Big "C"

So we spent nearly two hours with the radiation doctor today.  No, not about me; about DeRay.  We’ve having a banner year.  The Big C has captured us.  DeRay has already started treatment--two simultaneous shots called Firmagon, one on each side of his stomach.  Firmagon is a unique hormonal therapy that treats advanced prostate cancer.  It reduces the body’s level of testosterone, which affects the growth of the prostate gland, including cancer cells.  He’ll have two more shots next week, then in a month or so he’ll start radiation treatment. 

Its common practice now to ignore prostate cancer in older men because it is assumed they will die of something else before the slow-growing cancer takes them.  In the 12 biopsies they took of DeRay’s prostate, four of them were cancerous.  Of the four, three of them were the slow-growing cancer and would pose no immediate danger.  Only one put him in an area that needs to be treated.

Prostate cancer spreads:  1)  By breaking through the capsule, which is so common that they always extend the treatment to cover this; 2) to the glands (lymph nodes); and 3) to the bones.  DeRay’s uncle knew he had prostate problems but delayed going to the doctor until the cancer had spread to his bones.  Very painful.  He then had radiation treatment for bone cancer – too late.  I think that’s why DeRay is being extra cautious.  Cancer is more easily treated when it is under 10 on the Gleason scale. DeRay’s is 7.

So DeRay is under the care of a Radiation Oncologist as well as the urologist in the Tanner Clinic.  They will both be there for the next treatments.  Two choices are offered for radiation treatment:  1) External Beam Radiation; or 2) Brachytherapy (or a radioactive implant).  The external beams are totally painless.  The radiation is aimed from different directions directly at the prostate but as radiation beams pass through the cancer area, normal tissues in front of and behind the cancer area are also “treated”.    

With the advice of the Radiation Oncologist, we have chosen the Brachytherapy (pronounced Breaky Therapy).  “Brachy” comes from the Greek root meaning “from within” or “close by” and refers to placing a radioactive source directly into or around the cancer area.  By treating from the inside out, brachytherapy delivers the high radiation dose needed to kill the cancer without the high risk of normal tissue injury.  During the short procedure in the operating room, approximately one-hundred seeds are placed throughout the prostate gland.  Radiation emits slowly from the seeds and travels just a few millimeters before it stops.  Seeds give a large dose of radiation to the prostate with very little radiation reaching the rectum or bladder.  DeRay will have six treatments--two each day for three days, two weeks apart.  Ohmygosh, you should see those long needles they poke in – at least 14” long.  Of course, only about the length of your finger goes in but still – intimidating.  Five hours between the two treatments of radioactive stuff in all these needles controlled by a computer.  Once it is over, you are safe.  No radioactive material escapes to contaminate anyone else.  No isolation.

There are very few diseases with as many different treatment options as prostate cancer. 

And that’s the gory story

of DeRay

and GammaWest Brachytherapy –

Did it take you two hours to read this?  What else did he talk about?  He talked a little about surgery but he’s not a surgeon and it’s never recommended for older men.  He’s a Radiation Oncologist who has brand new expensive equipment to pay off!  Go figure.