I am going to start with a little information to everyone-medical terms and doctor names and treatment descriptions. That way when I refer to something everyone will know what I am talking about.
Dr Steven Sukin is the Urologist/Surgeon that did David's surgery in October, he is head of Robotic Surgery for St. Lukes Hospital. David had what is called DaVinci Robotic sugery instead of open surgery. 5 small holes instead of one big incision. Overnight stay in the hospital-healing time cut in half.
Dr. Brian Buler is the head of Radiation/Oncology at Methodist Hospital. He will be doing the radiation treatments. We were able to get in to see him because Rene pulled some strings with Methodist-they are one of his customers-he called the PR person for the hospital and got it set up. This guy is responsible for cutting edge technology with radiation. Was the first doctor in the world (yes THE WORLD) to do IMRT at Methodist in 1994. We have seen him twice, and I expected to be passed off to another doctor, just because he is so busy.....but hasn't happened yet! Would like to know what Rene's PR person said to him! VERY thankful to Rene for doing this for his dad. I know we are in the best possible hands for this next step.
IMRT is Intensity Modulated Radiation Therapy, and is done for all types of cancer treatment not just prostate. 40 beams of radiation will target the area, the machine will circle around and deposit the radiation avoiding the good cells. Different than external beam radiation.
PSA prostate specific antigen. A blood test that indicates adnormal cell activity. Normal number is 4, David's increased from 2.5 to 10.4 in 5 years. Not a cancer indicator, one of the most "false positive" medical test around. For that reason if numbers are high, it is normal to retest. And do a DRE.
DRE digital rectal examination (the "bend over" test men hate) Dr. Sukin found a knot when he did David's. That's why he scheduled a biopsy the next day. When the biopsy was done, 12 samples were taken and all 12 showed cancer.
Gleason score is a rating of the number of cancer cells found within the core samples from the biopsy. 10 is as high as they go. David's score was 8 in ten of his samples and 7 on the remaining two. This indicated what Dr. Sukin called aggressive prostate cancer. (many men have prostate cancer, not all is aggressive, making the different treatments so varied)
Now for the update!
David will have his first post op PSA test on Monday. We meet with Dr. Sukin on Wednesday for the results. They wait 3 months after the surgery for all the cancer cells to settle back down. We are expecting the number to be 1 or below, because the cancer had escaped the prostate we know it won't be zero. The following week on the 15th we go back to Houston and Dr. Butler to start the mapping for the radiation. MRI's and CT scans will be done with the information plugged into a digital program to map out the areas to deposit the radiation. (Dr. Butler worked with gaming technology software to come up with this approach) David will be "marked" with little tattoo marks so they line him up the same way every time. It will take about a week to 10 days to get the plan put in place. Once that is done David will start the program. The plan will also determine how many treatments he gets (37 to 42). Looking at Monday thru Friday for 6 to 8 weeks. More on that as it happens.
Roena
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