I returned from MD Anderson yesterday. Recall I had PSA of 227 at diagnosis. Gleason 4+4=8. 1 met in T8 vertebra. Had radiation to my spine (tremendous pain), early chemo (Stampede study), and been on Lupron since diagnosis in May 2015 at age 53. PSA dropped to undetectable for a year and a half. Then rose slowly to 1.8 before I started Zytiga in December. Now back to undetectable.
MY NEW TREATMENT PLAN
In December I had a PET scan, prostate MRI and circulating tumor cell test. PET scan showed no active cancer outside the prostate and no sign of cancer in circulating tumor cell test. Diagnosis is oligometastatic cancer with 1 met that shows no activity.
I am going to have a robotic radical prostatectomy in July at MD Anderson. While this is ‘not the standard of care’, they are giving it a shot. The hope is that this will be curative (but of course no one knows for sure). And as numerous posts highlight earlier, we are several years away from having the facts to be more definitive if this is a good course of action or not. If my PSA stays undetectable for 6-months post surgery, I hope to stop ADT.
We had quite a debate regarding radiation vs surgery, but landed on surgery as the best option for me. It will ‘de-bulk’ (not proven to work for PCa, but a lot of examples where it does with other cancers), will help provide additional information for future staging, and preserves radiation for the future in case I need it.
I’m grateful that our doctors are adjusting their treatment plans to match their patient’s cancer. Not just using a one size fits all approach. I was told at diagnosis that ‘once the horse is out of the barn’ it does not make sense to remove the prostate. But clearly a lot has changed in 3 short years.
I hope my story helps. I’ll keep you posted on my journey. Thanks for all the valuable insight and information I get from my fellow warriors and caregivers!
Good luck James. We are in not to dissimilar circumstances but have taken different paths in getting here. I was PSA 10.5, Gleason 9(5+4) at Dx and chose RP in March 2014, followed right away with IMRT because the post surgery PSA was .5. I only started ADT after a slow rising PSA reached about 2.5 about two months ago, and a lung met was found by a Gallium scan in Dec. 2017. I am now on Lupron, Zytiga and Prednisone. I am interested in following your results and wish you all the best. I think that makes me an Oligometastatic PCa as well