My recent biopsy results came back with one (3+3), one (3+4), and four (4+3)s.
My PSMA PET scan came back negative.
I was prescribed a treatment of low dose brachytherapy, external radiation, and ADT. Since I thought my Gleason scores put me in the intermediate risk category, I thought I could get by with just low dose brachytherapy, so I was very surprised to hear that I would need external radiation and ADT as well.
Has anyone with the same Gleason profile gone through this treatment regimen?
Thank you
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plee12
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Yes, I did ask. First I asked if a person has just one (4+3), do you automatically prescribe a combination treatment instead of a mono brachytherapy. His answer was no, but in my case there are additional contributing factors, but we didn't get into the details at the time. I was under the impression that since my PSMA came back negative for metastatic cancer, mono brachytherapy should suffice.
My urologist simply said that based on the biopsy results, I fall into the intermediate risk category. Now that I've learned that intermediate risk can be broken up into favorable and unfavorable, I can now understand the need for a more aggressive treatment for unfavorable intermediate.
I would ask why to help you understand but it sounds about right. Maybe something they saw in your scan? Everything I've read points to the necessity of hitting this crap HARD with your primary treatment. That's a fair volume of intermediate/unfavorable PC. Get another opinion from another RO.
Your prostate cancer is in a risk category called "unfavorable intermediate risk." Brachy boost therapy is a good option for curing it. 4-6 months of ADT are also usually offered with it.:
I had Gleason 9, Surgery, then 3 years later, bio chemical reoccurance. Family history that caused terrible death of two male relatives. I had radiation and 6 months ADT.Hot flashes, didnt like them, but no big deal really.
Little bit more " bitchy" , according to my wonderful wife of 43 years.
Thats it, so far, 2 years after completion of radiation and ADT, PSA less than .05.
Run 10 miles a week, very active physically (6 acre hobby farm), weight lift a little
Eat plant based with fish. Some supplements.
So everyone is different, but from my experience, I say throw everything you can at it as soon as you can!
Side effects and the IMRT radiation treatments were just something I told myself I had to do, got it done, no big deal.
As with so many things they affect different folks differently…….i adamantly refused ADT early on when it could have helped the most due to potential side effects and when the time came when it would have been life threatening not to use it the side effects were more than bearable( 1.4 yrs out). Large weight gain,fatigue,loss of strength….in all quite bearable a reasonable trade off for undetectable psa. Be aggressive with your treatment early on and perhaps you won’t be like me…..struggling to catch up a decade down the road……
Started out as a Gleason 6 and a psa of 5……a few months later psa had jumped to 10 and biopsy showed 2 positive cores of Gleason 8……this was a decade ago …..had 28 sessions of either IMRT or another type of full prostate and surrounding area radiation…….turned down ADT at the time…..a mistake……now a decade later I’ve just finished a course of salvage proton SBRT and have been on ADT for approx 1.4 years……might never have gotten to this point had I taken MD advice a decade ago and shrunk the tumor(s) with ADT………hoping that the proton tx has an appreciable effect…..if not….well we won’t go there right now…..
I would just concentrate on lowering the PSA. If MpMRI or PSMA don't show anything, then go live your life. "If you don't see it, don't treat it" my docs say.
In defense of VictoryPC's, I think he based his reply on incorrectly or unknowingly assuming that my MpMRI was negative. I only said my PSMA was negative. What I didn't say was that my MRI was positive, which was the reason for the biopsy.
But you're absolutely correct.. UIR unquestionably requires serious treatment.
I agree with pd63 and TA. I had a similar diagnosis and did radiation with 6 months of ADT. I also had my entire pelvic area radiated as a precaution to stop microscopic cancer cells.
Side effects were minimal. Totally back even stronger and in better physical shape. Cancer really had a positive impact on me in many ways. I know that is weird but true.
I suggest you start ADT two months prior to radiation and begin an aggressive exercise program NOW! Also start cutting calories and stay away from the foods that are bad for you and contribute to cancer.
Sure. First my T was back to normal range within 2 months of stoping ADT. So no lingering SE there. I really did not need a T test. I could actually feel the difference and the T rising.
I did notice some slowing of brain function and some minor changes in moods. Nothing overly serious. Wife mentioned I was a little more sensitive and irritable.
I volunteer tutor at the local community college for a couple of hours each week and found I was not as sharp.
I restore and maintain old roadsters and while on Lupron I noticed it took me longer to complete a task because I would forget something. That was very unusual for me. So I started to reference my manuals more then I would have.
I am the primary caregiver for my wife and 3 dogs. As mentioned I am very active walking, gym, cooking and cleaning, gardening, etc. I did find I needed to get off my feet and take a short 30-45 minute nap each day. Normally that would not happen.
During radiation and ADT I lost 12 pounds but since then I put back 4 of them. I attribute that to diet change and activity level.
Using resistance training I was able to not have any significant muscle loss. This was the most difficult part since it took more effort and I learned I needed lighter weights while on ADT. Lighter weight and more reps made a difference.
I had a minor “knot” at the Lupron injection sight for a day or two. Nothing that really impacted me. Suggest you put all your weight on the opposite side of the shot and remind the PA or medical assistant to inject it slow. That mad a huge difference the second time.
I guess when I consider side effects I really had a “walk in the park.” To sum it up exercise and diet are the critical factors to overcoming SEs. A positive mental attitude helps a great deal too.
As I end I probably need to caution you that the radiation was more of a issue with SEs and that took a good year to return to normal.
Thanks very much for sharing so much of your experiences in dealing with all the side effects. It looks like you handled them like a true champ. I'm sure your success story will be an inspiration for many others. By the way, may I ask what kind of radiation you were treated with?
I guess I should note that the total amount of radiation over that 25 sessions varied greatly between the whole prostrate and the pelvic area. Much less to the pelvic area. Probably has to do with the ROs preferred cook book times.
For what it's worth, I was diagnosed with intermediate UNfavorable risk earlier 2024. Was prescribed 28 rounds of radiation. Doc felt I should also add ADT but when met with some resistance from me acknowledged that I was borderline for that measure. . . (My profile should be on one of these sites, lol.) Finished radiation on July 1, so far, my PSA is on the decline.
Hello again j-o-h-n, good to meet up with you again. Thanks for remembering me from three years ago. I'm in the process of exploring all my options. Unfortunately, there are just too many options available for someone like me who falls into the gray area (unfavorable intermediate risk). Or perhaps that's a good problem to have?
One of the options I'm looking into is focal therapy. However, based on everything I've read and watched, they say focal therapy is applicable only if you have unitary disease, that is the cancer is located in only one side of the prostate, but they don't really explain the reason for that restriction. For example, if there is one cancerous spot in one side of the prostate and one cancerous spot on the other side of the prostate, why can't focal therapy be applied to each spot individually?
If you don't know the answer off the top of your head, don't worry about it.
I definitely do not know the answer, but I do know you'll be around for many many years. Keep posting and keep enjoying yourself in "Formosa". I'm old enough to remember when it was changed. Stay well.
Ok no problem. Thanks for the well wishes. By the way, did you know the singer, Lobo, who wrote, "Me and You and a Dog Named Boo" and "I'd Love You to Want Me", wrote "Love to You Taiwan" after a visit to Taiwan?
plee12 wrote -- " ... I was prescribed a treatment of low dose brachytherapy, external radiation, and ADT... "
I've had 3 friends receive above protocol within the last 3 years and all are doing fine. BTW, they are strong bicyclists and put up with the side effects of ADT/Radiation and continued on during treatment. The older guy, 70's+ continued World traveling including hiking and biking.
IMO, go with it, current ADT is easier to deal with, AND LIVE LIFE.
Thanks very much for the valuable Dara points. Glad to know they're all doing well. Do you happen to know if they were all Gleason (4 + 3)s or (4 + 4)s?
This month I'm 9.5 years clear of the 5+5 tumor in my right half of prostate that I had a Hemi-cryoablation performed on and also agreeing to be my doctor's 1st patient offered for his experimental 3 drug immunotherapy injection.
FYI My in-laws (Philippinos) are enamored with Taiwan and have visited it several times. I have never heard of the songs you mentioned, but I just watched the video about Taiwan that I found on the Internet. See Attached.
JUST back from today's late start 35.54 mile bike ride. Yesterday's ride was only 24.42 miles I started at 2:31AM and Sunday's 24.42 miler I started at 2:04AM that I completed only minutes after the MOON WAS FULL @ 4:01AM. BEAUTIFUL sight!!
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