Treatment input? 60yrs old; localized; 6,6,3-4,3-4,4-3 Gleasns; PSA 8.58, lrge prostate (37), BMI:37.8, existing heredtry lymphadema(legs)

[StLouisGuy]

From all I can tell, radiological and surgical options have equal, and generally positive, prognosis for my bundle of symptoms, but am seeking info from anyone with similar bundle who is choosing a treatment or has had one -- especially if you've had combo HDR Brachy/external radiotherapy with Lopron. Thanks

[Tall_Allen]

No, surgery does not have equal outcomes with brachy boost therapy or SBRT monotherapy for your unfavorable intermediate risk PC. I'm not sure you need Lupron with HDR brachy boost therapy or SBRT. Here's an article explaining the data:

pcnrv.blogspot.com/2018/10/...

[StLouisGuy in reply to Tall_Allen]

My understanding is the Lupron is suggested due to the size of the prostate, as well as the cancer data... The thought is that it shrinks the prostate as well as "putting to rest" the cancer pending the radiation therapy....

[Tall_Allen in reply to StLouisGuy]

HDR brachy does not require a smaller prostate the way LDR brachy does.

[StLouisGuy in reply to Tall_Allen]

Any source you can point me to regarding no lupron for hdr brachy?

[Tall_Allen in reply to StLouisGuy]

If you're asking about prostate size limitations with HDR brachy:

brachyjournal.com/article/S...

You have to find a specialist in it - it's not available everywhere.

[AlanMeyer Moderator]

Tall_Allen's blog post summarizes an important trial in a way that goes well beyond anecdotal, personal experience. But since you asked, here is my anecdotal, personal experience.

I was treated in 2003-4 in a clinical trial at the National Cancer Institute with HDR brachytherapy + 3DCRT + Lupron. Here's a link to a history of my treatment: yananow.org/display_story.p... . As stated there, my Gleason score was 4+3 according to the NCI pathologist. The PSA reading when my cancer was first discovered was 6.3 (as stated in the web page I referred to) but NCI had it as over 10 when I was treated.

Here I am, 15 years and counting, no further treatment and no signs of cancer.

Best of luck.

Alan

[TinCanSailor-Texas]

2001, I went through 7 weeks of external radiation treatments, followed by 126 Bachytherapy seeds. It is now 2019 and my PSA HAS been non-detectable since late 2002. Yes, over a period of 6years I I gradually experienced ED. But, I am alive and well at 81. I work out at gym 3 evenings a week, etc. .

[Jimraz]

I agree, surgery is not equal, too many life crippling side effects. I had similar numbers to yours 9 years ago, I'm 82 no side effects, no cancer, PSA negligible. I chose Proton Beam Therapy Ask the hard questions! Remember it's YOUR LIFE that's on the line, not your Doctors!! Good luck and God Bless.