NCCN guidelines for unfavorable intermediate risk

[ocman]

I thought I did my homework, but now I realize according to the NCCN guidelines, I could've chosen a different path.

I have Gleason 7 (4+3) unfavorable intermediate risk PCa and I chose the HDR Brachytherapy (monotherapy) path.

It looks like EBRT & HDR Brachytherapy is the SOC for unfavorable intermediate risk.

peace

[Tall_Allen]

HDR brachy monotherapy has very good results, even in high risk cases, and may have lower risk of side effects:

prostatecancer.news/2016/08...

[ocman in reply to Tall_Allen]

Since, I didn’t have a bone scan or a PSMA-PET prior to therapy, would you recommend getting a PSMA-PET scan now?

[Tall_Allen in reply to ocman]

You only get a test when there is a decision to be made. If you would do the same thing either way, you should not have a test.

[CarverD]

HDR-BT is quite successful as mono-therapy. Hope your's goes as well as mine did. I'm 6 months out and PSA continues to drop; now at .84 ng/ml. Side effects are minimal.

[ocman in reply to CarverD]

Thanks, that's great that you're having minimal side effects.

[curtisbirch]

Unfavorable intermediate vs. intermediate can be defined different ways using many different gradings systems. Also some doctors will rule you that way to justify more treatment. I was on the fence as a 50 year old about doing dual treatments and am really glad I chose HDR brachy monotherapy for both its effectiveness and lack of side effects. Per Tall Allen and backed by HDR brachy pioneer Dr Dimanes’ 30+ years of research and treatment, there is plenty of argument for HDR montherapy. This was the doctor that convinced me.

[judg69]

Hi ocman, I had very intense Gleason 4+3, with 9 of 12 biopsy cores cancerous with 5 being 50% or more, and 2 being over 80%. Treated 2 years ago with full course IMRT radiation and 6 months ADT ( Firmagon ) . Still here at 70 and now take Flomax ( tamulosin ) to aid in urination. No regrets at all. All best wishes to you, judg69

[ocman in reply to judg69]

Thanks brother, best to you too...