Treatment advice prostate cancer

[Terry-777]

Looking for treatment alternatives and good doctors for newly diagnosed prostate cancer 3+4 7, stage 2. There’s a lot of information out there. Difficult to sort through all of it.

Thanks

[Tall_Allen]

No rush. You have plenty of time to learn about it and meet with doctors in various specialties. If pattern 4 is low enough, you can even go on active surveillance.

It's a good idea to pay $275 for a second opinion fromEpstein on your biopsy slides.

pathology.jhu.edu/departmen...

Your best treatment options are surgery, SBRT, low dose rate brachytherapy or high dose rate brachytherapy - all as monotherapies. If you are able to, you should meet with experts in each of those therapies. An expert in one therapy will probably know little about the others.

[Terry-777 in reply to Tall_Allen]

Thanks for your help and input. It seems like there is no direct path to resolving this. I have to talk and network with people to find some of the better alternatives and doctors. Thanks again. Cheers

[Tall_Allen in reply to Terry-777]

Where do you live? I might be able to recommend some top doctors. Also, do you have any restrictions as to where you can go for treatment?

[Terry-777 in reply to Tall_Allen]

I live in southern Wisconsin and would try to find a Dr. in the Midwest. However, if there is a Dr. that is outstanding and worth the traveling, I might consider that. I turn 65 in May and will then will have Medicare along with my regular health insurance.

Thanks

[Tall_Allen in reply to Terry-777]

You can certainly wait till May to decide.

If Chicago is close, I suggest you talk to Arica Hirsch at Advocate Lutheran about SBRT. I've talked to several of her patients who spoke very highly of her.

illinoisck.com/conditions-t...

For Low Dose Rate brachytherapy, one of the foremost practitioners, Brian Moran, is also in Chicago:

chicagoprostatecancer.com/p...

If Detroit isn't too far for a 2-day visit, I suggest you talk to Alvaro Martinez about high dose rate brachytherapy:

mhpradiation.21co.com/local...

[Terry-777 in reply to Tall_Allen]

Thank all of you for your help.

[Hidden in reply to Terry-777]

This man T_A is a expert on all prostate cancer treatments . He knows more about this than many doctors do. Start living a super healthy lifestyle right now . You can do much 🙏

[JWS13 in reply to Tall_Allen]

TA...do you know ANY LEGITIMATE FDA APPROVED TREATMENT that does not have ANY ED SIDE EFFECTS OR MINIMAL ED SIDE EFFECTS? Thanks very much in advance...

(61, dx 6 months ago with PC (msw) -Gleason 4-3 - PSMA PET (UCLA)-All cancer still in capsule -no lymph node involvement-willing to travel

[Tall_Allen in reply to JWS13]

i had SBRT and had no ED. Low risk, but no guarantees. It depends on your age. I took daily Viagra during treatments and for 6 months after to improve my chances.

[JWS13 in reply to Tall_Allen]

TA..where did you have your SBRT and with what Doc...thanks

[Tall_Allen in reply to JWS13]

UCLA -Chris King. Amar Kishan is there now.

[CHPA]

How old are you?

[ExPat193]

I too was, was recently diagnosed, in December 2019

As my brother, also PCa, taught me. You are either the hammer or the nail

Take charge of your treatment

Within a month I had all necessary testing done and treatment plan in place.start radiation sometime in May, 42 sessions. Gleason 10

Sought second opinion in Europe, I have dual residency and dual health insurance.

Within a month, using Stateside scans, I have completed four of the seven radiation sessions

Know your condition and do what you feel is right for you.

EVERYONES CASE IS DIFFERENT

[Hidden in reply to ExPat193]

The bug or the windshield!We can not be complacent with advanced PC. Be the hammer! Exactly ! 😂

[tsim]

Hey Terry, a little shout out, I'm a Southern Sconi guy B&R although I haven't lived there for 30+ years. TA is correct as usual, since you're fully encapsulated in the prostate you have plenty of time to make a decision, so don't rush into anything. Prostatectomy seems a bit radical to me, can be left with some permanent side effects. Sorry I can't recommend any docs in Wi., Mayo could be an option for you. When you get to Medicare I would recommend going with a supplemental plan, that way you can go anywhere you want.

[Terry-777 in reply to tsim]

Thanks for the information, I am thinking U of Chicago or Mayo as possibilities. Not sure which doctors. Go Badgers!!!

[Hidden]

Time to start a complete health kick . Diet exercise and good thoughts could increase health options in the future . Start now !

[Magnus1964]

Your weight and general health would be factors to consider when looking at treatments, i.e. heart problems, diabetes etc. With such conditions surgery may not be advisable.

[tsim]

If you decide on HDR brachy let me know. The best guy in the country is at Moffitt in Tampa. I've had it plus external beam radiation so if you have any questions.

Cheers mate,

[peterman]

Terry-777, I agree with the advice above but want to amplify two things. Take charge of your situation. Read, be active on venues like this and ask your doctors lots of questions.

As for finding a doctor, I agree with Tall Allen. I picked the top 3-4 alternatives for treatment and then sought out doctors that did each type of treatment. I met with and interviewed about a dozen doctors. Your urologist can get you started with some top docs. One question I asked each of them was "who else should I be talking to?" I learned a lot about each type and could decided which doctor I was most comfortable with. In the end I'm on active surveillance but I have picked a treatment and a doctor that does that treatment so that when the time comes for action, I am ready. That doctor is now my regular AS guy.

Oh by the way, as you interview all of these docs, bring someone with you. My wife was my hero through all of this. While I asked questions and doctors rambled with their answers, she took really great notes. That was important to sorting it all out once we got home and it allowed me to be engaged in the conversations.

Best of luck on your journey.

[JWS13 in reply to peterman]

Peterman...what was your gleason score when you went on AS?

[Hidden]

I agree with all the above but want to stress the importance of getting that second opinion...11/1/19 husband’s mri showed pirads4...biopsy mri guided we were first told 3+3 Gleason 6 in 3 out of 18 samples...urologist still strongly suggested we treat it due to mri report even though AS is fine for Gleason 6....due to these sites advice we wanted a second opinion and when slides were re read in 12/23/2019 it was upgraded to 4+3 Gleason 7 on one out of 3...surgery was just fine on 3/12 and pathology report shows organ confined clear margin but perineal invasion and one lymph node with extra capsular extension...01/03/20 clear bone scan before surgery ...wishing u the best but stay vigilant and do ur own research to stay ahead ....this site and fb group offer personal experiences and great advice...

[Hidden]

Great job catching it at stage 2. Big time in your favor. TMI on prostate cancer. You must follow a trusted professional. The caring and brilliant minds here can answer just about any question . Very good you found us early on so you get informed guidance. Take care .

[Terry-777]

Thanks for the great information and insight. Greatly appreciated. Cheers

[Retiredstate]

Yes any luck ?

[allshallbewell]

I wish you well. I have one core that is 3 +4. I am choosing to move slowly and go with the least invasive approach for now, Active Surveillance. I learned that I am not a good candidate for HIFU, due to calcification.

In my limited understanding, there are trade offs with each option. I am not recommending my approach and would never presume to tell anyone else what they should do.

I have stopped eating sugar and drinking alcohol, and given a family history, I stopped eating meat over 20 years ago.

I am leaning toward being affiliated with an integrative cancer center like Dana Farber, as I would like to embrace a more intentional approach to including optimal nutrition and other aspects of a more holistic approach to how I approach this.

I recommend reading a lot and asking a lot of questions. I try to be respectful of doctors but not submissive or overly deferential. If they seem dismissive of your questions or concerns, I would find a better fit.

I wish you well in your journey.