Just got the news I have Prostate Cancer

[Leatherback]

I have had a 15 point biopsy which showed 1 pin had cancer, now have had 48 point biopsy to check for any other signs.

How long after these results will my medical professional be looking to start treatment.

My PSA is 5.25 and I am 60 next month

They have given me a score of 6 a low cat 2 score

Does anyone know about the Proton Bullet treatment which is used a lot in Germany and North America

[Hidden]

Hi, sorry to hear you have the cancer. It sounds like you found it early. One needle positive out of 15 suggests it's quite small. I'm not sure if a 48 needle biopsy was necessary. Your PSA is under 10 which is good. I presume the "6" score is a Gleason score which also isn't too bad.

How soon your treatment starts depends on a few things. Usually here in the UK we have a bone scan and MRI before any treatment to see if the cancer has spread beyond the gland itself. This will determine what treatment is appropriate.

Proton beam therapy is a relatively new form of radiation therapy which has the advantage of being able to be more focussed than other forms of radiation. Whether it's appropriate for you is the first thing, whether it's available is another. There is ONE proton beam machine in the UK. That's it.

I'm also not sure it's any more effective than other forms of radiation. It's tighter focus means it causes less collateral damage, e.g. to the bowel.

In some respects, for some men, surgery might be a valid alternative. These days with endoscopic surgery and robotic assistance it can be less damaging than it was in the past. I chose that and six years on, I'm glad I did.

It does depend though on what treatment is appropriate for you.

[Leatherback in reply to Hidden]

Good Morning

Thanks for your reply

It is nice to know that your treatment went well

[docdiamond]

I don't know why an additional 48 needle biopsy is needed. These days a lot of people start off with a 3T multi-parametric MRI instead of a biopsy, but that's not an option so soon after your biopsy. If you are Gleason 6, just watchful waiting may be an option, but I am no expert. Please just beware that a lot of urologists make their money by doing procedures, which could explain the second biopsy. Gleason 6 prostate cancer usually moves very slowly, so don't be pressured into an expensive and life changing procedure before you have had a chance to evaluate your options.

[rogervsmith561]

Hi, I had fusion directed biopsy and from this a Gleeson score of 3+4 = 7. My prostate was 72 cc’s and I am electing to have brachytherapy (radioactive seeds). For this I need to have 60cc prostate, so am on hormone therapy to reduce mine. Due on 30th Oct to have an examination to see whether is has shrunk sufficiently. Not sure snout your ‘bullet’ treatment?

[Drwine]

I would suggest genomic testing such as Prolaris or Oncotype DX to see if you could be a candidate for active surveillance or whether you are in the early stage of a more aggressive cancer that needs more treatment such as surgery or radiation.