EBRT?

[Voula4ny]

What would be the recommended treatment for a 78 year-old with Gleason score 9 and no evidence of metastatic disease? Would EBRT and ADT be standard of care?

[Magnus1964]

That would be the standard care. Lupron or abiraterone for a few months and continuing through radiation and beyond.

[Voula4ny in reply to Magnus1964]

What about brachytherapy? When is that used?

[Magnus1964 in reply to Voula4ny]

Brachytherapy would be a first line treatment for contained Pca. I am not a fan of brachytherapy. I know of too many acquaintances that had problems with it.

[Raymo69]

Please be careful about your Drs telling you that your G9 is contained. You most likely have lymph node involvement that scans today can’t see. Both my Drs. fly to Europe on a regular basis & look for cancer cells in these areas for cancer involvement in cadavers afters scans showed no involvement. 99% of the time during dissection they find cancer cells in these lymph nodes. I’m a Gleason 8, diagnosed at age 45. Turning 53 soon & doing well after targeted radiation & only 1 six month shot of Lupron. I would follow the same protocol if I were you but extend the Lupron to 18 months. I didn’t react well to it so one of my Drs. took me off, the other urged me to stay on it for 18 months as they do not have data on how men fare after only 6 months of treatment. He said there’s no statistical difference between men that have taken Lupron for 18 months and men that hsve been on it for 36 months. Hope this helps. Good luck to you. The answer to your question is yes, that is the proper standard of care, particularly for a G9. Brachytherapy will do nothing for those lymph nodes mentioned above.

Undetectable lymph nodes.

[Hidden]

What was your PSA? The Roach formula is a rough estimate of whether you have a good chance of pelvic node involvement. So really, depending on what your PSA was, the standard of care would be EBRT to the prostate, seminal vesicals, and pelvic region as a whole and 6 to 18 months of ADT. evidencio.com/models/show/1144

[cujoe in reply to Hidden]

See this recent update re: usefulness of Roach Formula in the " Era of New Molecular Imaging" (Roach is one of the authors)

ncbi.nlm.nih.gov/pmc/articl...

As the holidays are here, Remember to Be Safe to Stay Well,

Cheers, K9