I am 76 years old and recently diagnosed with prostate cancer. A rise in PSA from 5.4 to 7.4 plus a bump felt on my prostate led to an MRI scan. That showed a 2.5x2 cm PIRADS 5 area on right side and smaller PIRADS 3 on the left. A biopsy with 20 samples, 12 random and 4 each of the two areas found by MRI was done. All 10 samples on the right side were Gleason 8, three samples on the left (from the targeted area) were Gleason 7 (4+3). The capsule on the right side was "disrupted".
I met with a radiation oncologist yesterday. His suggested course of treatment is 5 weeks of IMRT followed by brachytherapy. Lupron would start two months before radiation and last a total of 24 months. No scans yet. PSMA PET scan would be possible, but it would mean waiting 3 to 4 months because of backlog at UCSF. He doesn't like the idea of waiting that long but thinks he can get me an Axumin PET scan.
So I am full of questions. Would it be better to wait for PMSA PET? Is an Axumin PET scan good enough? Can it find cancerous lymph nodes? Should aberaterone be added to Lupron? Two years of hormone treatment is a long time, but I'd like to minimize the chance that anything will come back in a few years.