My treatment of a Gleason 3 +4 measuring 11 mm x 4 mm , near apex

[thierry]

Hello everybody . Has any of you underwent radiotherapy plus six months ADT as an alternative choice to RP plus lymphnodes dissection , both treatments presented as equivalent . For my condition , I chose RT plus ADT as less invasive . I was diagnosed Pirads 4 in January 2020 , plus biopsy , two cores in left lobe , apex 3 mm and median 4 mm including 7 % of Gleason 4 Which gave Gleason 3 +4 = 7 . My treatment started on May 7th , precedented by one month of bicalutamide 50 mg per day and two injections of Lupron , my last shot was on the 29th of July . The RT , True Beam Novalis , with three gold seeds in my left lobe was 38 sessions with a total of 76 Gy on prostate and 54 Gy on seminal vesicles . When I asked why also the SV , which were not involved , the RO , a nice lady told me that in my case of Gleason 7 there was a ^probability of SV invasion . I have nearly finished my treatment , did not have many problems , or very bearable but I have the feeling that I was rather strongly treated for this intermediate risk Pca . My Psa was at 3,8 in Dec 2018 n the first ever in my life , and rose to 4,9 in Dec 2019 and now 0,08 . In conclusion I feel OK but I have a Strange feeling of overtreatment . Best to you

[CHPA]

At the end of the day one has to trust their doctor and be comfortable with the treatment. I’d rather be a little over treated than under. I think this is a good question ask if only to be informed.

I’m curious your age and overall health.

[thierry in reply to CHPA]

Hello CHPA , I am 68 y.o , in good health , fit , and I must say that my treatment RT 38 sessions at Monaco's Princess Grace hospital did very few discomfort on me , I have theorically six more weeks of ADT effects from today . Regards

[doc1947g]

Hello, I am 73 y.o. And I had 6 biopsies out of 12 positive G4+3=7 Grade 3 very aggressif and average 80% (70% to 100%) of the 6 cores that were an average of 17 mm.

My PSA was 20.4 pre-treatment. I had 2 injection of Lupron Depot 22.5 mg/12 weeks (from May 31st 2020 + August 24th) and VMAT Hypofractionnated RT of 20 X 3 Gy for 60 Gy on a very wide margin, about most of the pelvic bed (139.37 cc while the prostate is 45.83 cc and my SV are 4.50cc) in all the directions (which cover the whole SV) and half of the blader with 58 Gy from June 8th 2020 to July 07th 2020..

I am risk Intermediate unfavourable.

My last test showed PSA 0.18 ug/Land testosterone <0.2nmol/L or <5.7684ng/dL.

I will have another test on the September 15 and a meeting with my RO on the 28.

I am happy even if the second injection of Lupron Depot hit me very hard. Hot flashes very intense and numerous, changes of mood and agressivity wich did not last..

But it is temporarily and I hàve 1 daughter and 4 sons and 2 grandchildren that I want to see growing up so I will put on with every treatments.

Your are right. Here in Montreal, Canada, you woukd have been put on Active Surveillance. But like T.A. said, what is done is done.

BTW how is the temperature in France.

[Tall_Allen]

I agree with you about overtreatment for your "favorable intermediate risk" prostate cancer. But what's done is done. Hopefully, your testosterone will recover quickly and you will have no residual effects of treatment, other than dry orgasms.