What are the cutting edge/unique treatment options such as cryogenically freezing/microwave/proton beam/injections to kill it without having it be surgically removed?
62yrs old athlete, great health otherwise…
Gleason 5+4, stage 4, 12 cores 100%, no spreading, T3 tumor, PSA level 16.
Willing to travel ANYWHERE in the USA for this!
Thank you so much for your help!!!
First thing to do is to have a bone scan/CT to rule out that it has already metastasized. If negative, you may want to look a little harder using a PSMA PET scan, now available at UCLA or UCSF. If it has not metastasized, there is only one kind of therapy that has an excellent long-term record of cure for "high risk" cases like yours -Brachy Boost therapy.
Brachy Boost Therapy for you would involve external beam radiation to the whole pelvic area (in 20-25 treatments) plus brachytherapy to the prostate itself plus 18 months of hormone therapy.
This has an excellent record of success for cases, with over 80% cure rates. There are several expert practitioners, and two kinds of brachytherapy - where are you located?
prostatecancer.news/2018/03...
As for more experimental treatments, Amar Kishan at UCLA is running a clinical trial of SBRT monotherapy. This involves only 5 treatments that covers both the pelvic LN area and the prostate itself and a shorter course of ADT. So far, results have been comparable to brachy boost and urinary toxicity has been very low:
prostatecancer.news/2021/01...
Whole gland ablation has had awful results. The problem is that thermal ablation doesn't fully destroy the cancer. Plus, in a case like yours, where there is a high probability of micrometastatic cancer (too small to see with any kind of scan), ablation of the prostate alone is useless.
prostatecancer.news/2021/03...
A televisit with Amar Kishan at UCLA may be a good starting point for you. He can tell you about his experimental SBRT-only clinical trial for high-risk. He will also refer you to Albert Chang at UCLA for a discussion about HDR brachy boost therapy, and also for a PSMA PET scan.
GGEX300 wrote >>> " ...62yrs old athlete, great health otherwise…Gleason 5+4, stage 4, 12 cores 100%, no spreading, T3 tumor, PSA level 16. Willing to travel ANYWHERE in the USA for this! ... "
some info on me >>>
YESTERDAY was the 6th anniversary of MY CASTRATION that began treatment at almost 65 year's old for Gleason10, PSA 14+, confined to right half, BONE and CT clear. My heart rate when ECG connecting for the orchiectomy Pre-Op was 32bpm. Nurse TOLD ME to get up and move around to elevate for reading, I did and at 39bpm I was good to go.
Due to physical condition and lower HR and BP I was classified as an endurance athlete and treated as such with notations when shoulder was replaced and other surgeries, when in ER's after bicycle crashes resulting in broken neck, punctured lung, cracked ribs, cracked scapula, broken clavicle, antibiotic administration blah-blah-blah...
Choice for treatment was a FIRST OFF for an individual of my diagnosis/conditioning/age being CRYOABLATION plus the 3 drug cocktail of Opdivo-Yervoy-Keytruda injected in situ the ablated tumor 7 months following cryo and then began bi-weekly TESTOSTERONE injections after one month following immuno injection.
Present conditioning at almost 71 permitted my attempt at the 167 mile ONE DAY Cross Florida Bike Ride last Saturday that I had to abandon at 154 miles due to SEVERE WEATHER >> began HEAVY RAINS, 40mph winds and a temperature drop that caused hypothermia with cramping. BTW, made the first 101 miles stopping only to replace flatted rear tube and then to re-attach rear bag in 5:21:15 moving at 18.9mph average.
PLEASE NOTE >> I am a NON FDA APPROVED - EXPERIMENT IN PROGRESS determined to live my remaining life to the max even if treatment hastens death. I am PREPARED (and wife of 48 years in June agrees) to take measures NOT TO EXTEND LIFE when QUALITY HAS DIMMINISHED to unacceptable levels.
p.s.-- My X-FL attempt was a decision made 2 weeks ago having NOT TRAINED. It will be 1 year on April 27th that a wild hog ran into me at 1:25AM at mile 32 of a planned 100 mile overnight bicycle ride. After getting back on bike I rode the 4.7 miles home then wife took me to the ER where tests resulted in showing the cracked scapula + cracked ribs + punctured lung + some other minor issues. Have my 71st Birthday Ride on 7/10 that will be 143 miles, it is my usual "double my age plus 1 for good measure." :0)
You are a beast! Great admiration from me. Inspiring too.
Thanks and if you bicycle steer clear of wild hogs. 😀
And cars! My brother and his bicycling buddy were riding along the should of a winding 2 lane road a few years back when a car coming in the OPPOSITE direction crossed ALL the way over into their lane and their shoulder wiping them out. My brother got away with a shattered pelvis. He has recovered pretty well and still bikes, but not on roads- only in parks. His friend was not as fortunate and ended up being paralyzed from the waist down. It was a beautiful Sunday afternoon and the belief is that the driver, a woman real estate broker in her 50s, was LIKELY texting..Be careful out there. Wild Boar- that's really crazy.
Plenty of my riding is 10pm to 8am, way less traffic.
Prostate Cancer can also be treated by PSMA Therapy Dr. Ishita Sen has explained how does PSMA therapy works and what are the circumstances
nuclearmedicinetherapy.in/t...
Please read the article
Welcome. You need to act promptly on this. Do as Tall_Allen suggests. Keep us informed. 🙏
If you download the Partin table app and enter your info you’ll see that the chance of your cancer being contained in the prostate is low. The app data is dated, I would put your chances higher than the app but still discouraging. I tried the new Ultrasound, unsuccessfully, dropped $30k on it. You’re looking at removing it or the technique Allen suggested. The good thing about removing it is they can inspect it afterwards and see if there is cancer right up to the cut line. If not, there’s still some hope it is contained. But the PSMA scan, right now, before they put you on ADT, which they will, is really the best bet so you know up front what you are looking at.
If money is not an issue, you could look into the cryo/immuno treatment that is offered by Dr. Gary Onik in Florida. A similar treatment is done by Dr. Jason Williams in Mexico.
Hello GGEX300,
Welcome to the club no one wants to belong to. My situation was similar to yours at diagnosis. See my profile for the details and for where things stand now, 5+ yrs later.
First, I'm sorry to say that it's extremely unlikely that you will discover some new, cutting edge treatment that will cure your cancer. Gleason 9 PCa is extremely serious and whatever treatment path you choose will almost certainly have effects you don't want. More than anything else, your attitude will determine the quality of your remaining life. Here are some suggestions:
1. Be honest with yourself about being afraid. Figure out how to deal with the fear of death and disability. Family, friends, a spiritual practice, therapy, support group are all potentially helpful. Do what works for you. Do not skip this step or you risk all your subsequent decisions being driven by fear.
2. Quality vs quantity of life. Figure out where you are on this continuum. Be able to articulate it with your family and medical team. Understand the likely outcomes of your treatment alternatives with respect to quality and quantity of life.
3. Figure out how to be your own advocate.
a) How willing and competent are you about becoming knowledgeable about your treatment choices? Try to avoid the extremes of "I can't understand this" and "I'm smarter than my doc." In any case, find a medical team you trust and be open & honest with them.
b) Know your tolerance for risk and uncertainty. For example, if evidence and outcomes from peer reviewed journals are your standard, look no further than Tall_Allen's advice. Especially when trying to find your own way forward, try to put some reasonable boundaries on the level of risk you will accept so you don't go off the deep end into crazytown.
c) It's good to increase your understanding and familiarity with probability but remember there is no certainty (except death of the body).
I'll tell you why I made the choices I did -- not because I think you or anyone else should make the same ones but in the hope that it helps you make your own choices. I figured that my PCa voyage was going to be a campaign not an engagement. I did not choose the "hit it hard and early" approach because I wanted to maximize quality of life and was willing to accept the risks of a shorter life. I chose focal treatments that had no unwanted side-effects and bought me a few years of high-quality time but turned out not to be curative. Against standard medical advice, I declined ADT but when the time came, I did accept salvage radiation and it's unwanted side-effects (worth it--so far). I was and am extremely fortunate to have a very understanding spouse and a spiritual practice and faith that sustains me.
Send me a private message, GGEX300, if I can be helpful. Best of luck to you.
--Mr. Safety
hi GGEX300 ... consider taking a look at this website ... envita.com ... best wishes ... Nous 
You just answered your own question "CUTTING" edge............
Good Luck, Good Health and Good Humor.
j-o-h-n Wednesday 04/14/2021 5:08 PM DST
Get a PSMA pet scan to see if there are any mets. Don’t mess around with this. If it’s contained- remove it. Do genetic testing and see if immunotherapy could be an option. Stay strong
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