New to this community. Just received prostate cancer diagnosis with 4+3 Gleason score.

Trying to decide course of action. Leaning toward proton therapy. Cancer is currently contained. So much info to process. It is overwhelming.

[Tall_Allen]

Perhaps the only nice thing is that you don't have to decide right now. (I'm assuming your PSA was < 20 ng/ml) In fact, I think it's a good idea to decide not to decide. Just leave yourself open, gather information, and meet with various specialists.

pcnrv.blogspot.com/2016/08/...

A good first step is to get a second opinion on your biopsy results from Epstein's lab at Johns Hopkins. Just tell your urologist to mail him the slides. The cost is $275.

pathology.jhu.edu/departmen...

If you say where you are located, we may be able to suggest specialists to visit.

If you are overwhelmed, as I was, you might want to seek psychotherapy to sort out all the emotions running through your head. I also learned to practice Mindfulness, which helped a lot.

[Schwah]

As usual tall Allen is spot on. As part of my journey I saw a number of specialists including visiting a doctor at Loma Linda to consider proton beam therapy. My opinion for what it’s worth, is that it seemed almost like a cult. Like their treatment was the one and only treatment that made sense. Interestingly, Near the end of our appointment my wife asked the doctor if it were him, what would he do? We were kind of shocked when he said “ I would do seeds. But not too many doctors are trained in that since insurance reimburses so low for that treatment” lol. Anyway my point is that you have a lot of options and it’s time to educate yourself. Good luck on your journey. You found a great place to start in this site.

Schwah.

[mike2344]

I have the same Gleason score of 4+3. With the education I got from my support group in Honolulu. I decided to go to see a Prostate Cancer Specialist in California. He recommended SBRT radiation at UCLA. After checking out the Protron Beam and Seed options I decided to do SBRT at UCLA because I think it gives the least side effects. The treatment was for 5 sessions over 1 1/2 weeks. I am very happy with my decision.

Mike Tave

[407ca]

Just,

Take some time to learn of options and do not decide on anything until you have gathered and processed second opinions. A second opinion on the biopsy slides is very important and worth every penny. Learn first, decide later.

[MikeUSNA64]

I had Gleason 7 (4-3) contained to prostate, PSA 9-11, one small tumor among 25 samples. Diagnosed last November. After considerable research decided on seeds/brachytherapy. Went to doctor who helped write Brachytherapy guidelines. He prescribed ADT (bad consequences for me), then radiation, then seeds. When back got second ADT shot and had examination prior to starting radiation. Examine showed medial prostate lobe extended and they want to operate before radiation. Decided to get second opinion. Went to Cleveland Clinic (Dr. Ciezki). No operation. No further ADT. No radiation. Had brachytherapy. Will have first PSA follow up in November. Recommend Cleveland Clinic, very patient centered, great institutional knowledge, and excellent physicians (see reviews on line). Also have gone vegan with very healthy diet, plus lot of exercise (cardiovascular and strength), plus mediation. Read Dr. Ornish's book. Also recommend Dr. Mark Sholz's book about treatment options. amzn.to/2Bd3nge Good luck.

[Hidden in reply to MikeUSNA64]

I like the healthy eating ... keep on rolling brother ..😎

[Hidden]

Very sound advice. Appreciate.

[Hidden]

PSA? In April 2003, with a PSA of 6.4, I had Brachytherapy and chased it with 25 sessions of IMRT. PSA never really came down. Ten months later, PSA rose, then exploded to 32.4 with metastatic lesions to T3 and L2. Medical Oncologist told me that it mattered not which primary treatment I had, it was too late use to micro-metastatis.

You will have to decide which primary treatment you want. In 2003, my choice had a 92% chance of cure - the same as a prostatectomy. At the time, all other primary treatments were less. I do not know the numbers today. On my initial Gleason score, I spent 6 to 8 hours a night reading various studies and papers. I also talked to numerous people with my circumstances. Finally I discussed my findings with seven physicians.

My decision upon metastasis is why I am still kicking 15 years later with undetectables. My last medication was in February 2010. Good luck. Find the best advanced prostate cancer available and follow their lead. I found my guy in academia and research.

Gourd Dancer

[HopingForTheBest1]

To help you decide you should consider genetic testing. This will determine if you have any genetic mutations, and if so your doctor's will be able to recommend specific courses of effective treatment options. That's what precision medicine is all about.

[dirtfisher]

I had Proton Therapy in Aug 15, 4 yrs later PSA is still 0.16, had no side effects. PSA was 5.95 to start with and Gleason was 6 (3+3).

[patroman]

My dad had same gleason score 10 yrs ago, cancer confined to prostate. He went with external beam radiation therapy which failed within 5 yrs. He has been on hormone therapy ever since. To this day he regrets his choice and wish he went ahead with the surgery instead. His younger brother had a prostatectomy and has been cancer free for 8 yrs now.

There are so many variables to consider and everyone is different so what treatment may work for one may not necessarily work for another. Good luck and don't rush into any treatments without completely considering all options.

[Hidden]

Some great advice above. You have the luxury of time. This is a slow moving disease, and it takes years to deal with it. The biggest mistake newly diagnosed men make is to be "rushed" into all sorts of stupid (not for the "Get it all!" guy making the money!) actions which may damage you for life. 99% of the time, using a knife and/or radiation will only damage you and do NOTHING to prolong your life. Always chose the "more gentle" path.

Lesson 1: This cancer business is FULL of lies, BS, ignorance, money-grabbers, quacks and 20-year old treatment manuals that are still in general use. Read about alternatives in places like "Thetruthaboutcancer", Dr Mark Stengler, Dr James Forsyth (in Reno), "Chrisbeatcancer" (I like him a lot).

Lesson 2: Vitamin C via IV actually does work. For a few lucky ones, this and an anti-cancer diet and life style can keep them out of the Great Big Cancer Money Machine and they beat cancer naturally.

Good luck on your journey! You have made a good start asking questions!

[Hidden in reply to Hidden]

I did the c twice weekly my first year under treatments . I do believe in it still . ...

[Hidden in reply to Hidden]

Perhaps you can go back to it now that you know it works best in combinations, and thus less if it (and the other parts of the "brew") are needed. Gently catchy tiger ... and don't kill the hunter.

[EdinBmore]

Ditto Tall_Allen's advice. Learn as much as you can before you make your treatment decision. There are numerous reputable sites on the internet worth looking at, get second and third opinions, and take your time. I say this because your life is about to change in ways that you cannot imagine and it will take time to adjust to your new reality. Hope your process is as uneventful as it can be. Good luck to you.

EdinBaltimore

[j-o-h-n]

Greeting J-S-N-T-C, First DO NOT PANIC... Most men die with Pca and not from it.... As mentioned above see a good Oncologist that specializes in Pca (prostate cancer). Take time to study this fxxking disease and your options. Keep posting here for good info. Speaking of info would you give us more info about yourself. i.e. age? location? treatment center(s)? Doctor's name(s)? All info is voluntary but it helps us help you and helps us too. Thanks.

Good Luck, Good Health and Good Humor.

j-o-h-n Monday 10/14/2019 5:41 PM DST

[Hidden in reply to j-o-h-n]

I am 69 and live in Lakeland, FL. In June 2018 my PSA was 10. After 3 months of surveillance and PEMF treatments my PSA dropped to 6.5. The Watson Clinic urologist at the time set up an appointment for a year recheck. At that time my PSA had risen to 7.5. An MRI with contrast was ordered, and I was informed that I had an 80% chance of cancer, but it would be necessary to have a biopsy to confirm. In September 2019 I had a biopsy at the Moffitt Cancer Center, Tampa, FL, with results indicating a cancerous tumor in the left side of the prostate. I was given the choices of either radiation or a radical prostatectomy. Two months ago I decided to go on the Plant Paradox diet, as well as continuing pulse electromagnetic field therapy (we purchased a DCX PEMF/Rife machine, which I use 2 hours daily). After reading the various posts I'm leaning toward continuing trying holistic therapy methods and taking my chances, with periodic blood test monitoring. My father fought a 10-year battle with prostate cancer. Thanks for all the great insight.

[Hidden]

You might want to check into HIFU. With gleason 8 I wasn't a candidate for RP because of prior TURP (roto-rooter) surgery for enlarged prostate. I was steered toward external beam radiation but chose HIFU instead. Whoever you see is going to recommend what they are practiced in. Very few offer HIFU. I had to go out of state.

[j-o-h-n]

Thanks for the info. You may want to copy and paste your bio info below your name on your home page. Keep up the good fight and keep posting here if necessary.... and don't forget to laugh...If your father has passed then please accept my condolences.... May he rest in Peace.

Good Luck, Good Health and Good Humor.

j-o-h-n Monday 10/14/2019 6:58 PM DST

[Hidden in reply to j-o-h-n]

🙏

[Sxrxrnr1]

How old are you, do you have other serious morbidities that could lead to your demise?

10 year survival of PCa victims with your Gleason is close to 99 percent, treated or not.

Often a good thought to consider your overall life expectancy into the equation if to treat aggressively or not.

What is not quite a certainty, but very likely, any local intrusive therapy will cause a lifetime of side effects that can severely compromise your QOL.

Furthermore there will be no assurance that the cancer will not return,,,there are no guarantees that a local therapy will be a cure.

A very substantial recurrences occur no matter the choice of therapy.

[Cmdrdata]

I had G4+3 and PSA=7. Had 5-session SBRT, but PSA never got to undetectable PSA level. I personally believe that SBRT was successful, but the cancer has already metastasize BUT the metastatic were still small that they were undetectable, thus my PSA result. Some of the comments mentioned failed radiation,, but is it really that or maybe due to micro metastasis that were undetectable and thus PC recurrence? My opinion, “hit it hard with every treatment available”. Time is off the essence.

[AlanLawrenson]

I had PBT in South Korea in 2013. Altogether a success. However, today I would have elected to have focal laser ablation under mpMRI control, as my tumors were well defined. See my book on Amazon.