Confursed about the Cure?

[Mischa1111111]

I am writing from Spain with universal health care . I received a diagnosis and second opinion from Uiversity of Navara for curative treatment and of course one favored RP . The first opinion IMRT + 18months ADT. I am scheduled for RD (dont know when)but on the report I see possible T3? That to me might seem that that RT might be the best choice. But then again the the second opinion came from the surgeon ? Anyone famiiar with this experience ? All my best to everyone out there . Thanks in advance

[Magnus1964]

If your diagnoses is T3, meaning the cancer has spread beyond the prostate into the surrounding tissue, then a radical prostatectomy would not be of any use. The chances of removing all cancerous tissue is very unlikely. Radiation would be indicated. You might consider an orchiectomy. All the best.

[Mischa1111111 in reply to Magnus1964]

The diagnosis from the second opinion (from the same biopsy) was probable T3 , bone scan and TC were negative . But i was thinking along those lines

[Mischa1111111 in reply to Mischa1111111]

Appreciate your reply. Thanks again.

[Tall_Allen]

To a hammer, everything looks like a nail.

Even without the T3, with your unfavorable intermediate risk PCa, radiation has the best chance of curing you.

prostatecancer.news/2018/10...

You will need intensified radiation and 12 months of androgen deprivation therapy (if SBRT of HDR brachytherapy is available there) or 26 months if all you can get is IMRT.

[Mischa1111111 in reply to Tall_Allen]

thank you fot your insight . You seem to a maestro in this forum ., and straight a to the point . Much Appreciated . 26 sessions ofI MRT + 18months ADT bicalutamide50mg , Decapeptyl SR 22.5 mg . (the intention to cure was proposed by Genesis Care. Treatment would start sooner than the Spanish health system but i will ask. The urologist team (who no doubt would know better than me)still favor surgery over radiation .In part thart doubt has delayed my decision and my treatment . Meanwhile ive been training in the gym in anticipation of beginning treatment I am a profesional musician and would like to continue in that capacity. Thanks again . I will look at the link you posted.

[Hidden in reply to Mischa1111111]

I was T- 4 , imrt and adt has worked for me. I wish you the same!

[Mischa1111111 in reply to Tall_Allen]

It has been one month since i posted my doubts about treatment based on my diagnosis . Today I started my first RT treatments of IMRT but so far i have not been instructed to start with the ADT . It was my understanding that the 2 treatments would start at the same time. Is there an ideal sequence ? If the answer or study has been posted please lead me to it please . Will meet with the MO hopefully tommorow and want to be prepared . Thanks to everyone here who shared their experience with me . Much appreciated.

[Tall_Allen in reply to Mischa1111111]

ADT usually starts before or at the same time. Ask your RO.

[Mischa1111111 in reply to Tall_Allen]

Thanks for confirming that.

[Mischa1111111]

That to me is The vote of confidence i needed to hear.

[Aodh]

Hi there, I was diagnosed as T3bNxMx with a PSA of 87 and spread to the seminal vesicles. My urologist was willing to perform surgery and was honest enough to admit that after surgery I would need radiation and ADT.

I chose radiation and 3 years of ADT (standard of care then in Ireland for high risk prostate cancer). I had my last shot of ADT in February this year. My PSA since completing external beam radiation in 2020 has been consistently <0.08

I wish you the best no matter what course of treatment you choose. I remain happy with my decision and outcome.

Hugh

[Mischa1111111]

Thanks for reaching out and sharing that. Did you do an excercise regimen to deal with ADT sideeffects or a change of regimen. Appreciate any advice you might have on that .

[Desanthony]

Yes, I had possible T3 as at MRI the tumour could be seen to be pushing out at the back of the capsule so T3 disease could not be ruled out and the possibility that there was local microscopic spread so Hormone Therapy and Radiotherapy was the way to go so that if there was microscopic spread it could be dealt with. I was PSA 13 and Gleason 7 (3+4). I had 9 months of Hormone Therapy (prostap 3 injections) and 1 month of radiotherapy and nearly 6 years later my PSA is undetectable. To all intents and purposes the “cure” my urologist, oncologist and interventional radiologist promised.

[Mischa1111111 in reply to Desanthony]

Thats great to hear . I am canceling my surgery tommorow and going for RT. Thanks for sharing the specifics . I am greatful you and the entire community here.

[Desanthony in reply to Mischa1111111]

I hope it is as successful for you as it has been for me. Don’t forget that most of us can’t really believe in “Cure” as every PSA test still has us and our loved ones worrying that it has not been dealt with. Though after 6 years of what would be termed “remission”it must have been.

Make sure that you are doing the right thing for yourself and weigh up the pros and cons of both treatments before making your decision as it is your decision and you have to live with it - not me.

All the best.

[treedown]

I was T3N1M0 with 24 months ADT and 44 treatments of RT 80gy. I have been off ADT for going on 7 months now and am doing well, for now. My treatment was with curative intent. Time will tell.

[Mischa1111111]

Time will tell and your experience with this condition and how you dealt with it is yet another sign of encouragement for me to take the plunge and start this adventure and get on with it .

[Hidden]

Mischa! Please Don’t delay . Take care🍀

[Mischa1111111 in reply to Hidden]

Thanks Lulu. Started the first of 25 RT treatments today.

[Mischa1111111]

My appointment is for next week.

[Dogdays1]

Mischa, I was at a PSA of 12.4 and a GS9, highly aggressive involving most of my prostate. My urologist, a surgeon, as they all are, recommended surgery of course. I took my case to Memorial Sloan Kettering in NYC. I met with a surgeon and the head of radiation there. They both agreed radiation was the only “cure” because of the level of my cancer. I had LDR brachytherapy, followed by 5 days of SBRT, along with 18 months of ADT. My last Lupron shot was in July of 2018. My PSA is currently .07. The only down side at this point is my Testosterone has not come back to the level it once was, bringing along the side effects of that. Good luck with your choice

[Hidden]

T3b, PSA 12, Gleason 4+3. Spoke to two surgeons, who, like yours, wanted to operate, then to a radiologist, who recommended EBRT.

Thoroughly confused, I then spoke to the head of department(a surgeon) who said surgery was a possibility but he would also want to follow up wit EBRT, so may as go with EBRT by itself. This I did and so far so good.

Re exercise, I went to a couple of sessions organised by the local Prostate Support Group (Prosfit) then bought some weghts and did the exercise at home because of distance. Also continued with golf which, on my course, is an 11km walk.

Yes, I've had muscle loss from the ADT in that I can't hit the golf ball as far, but little weight gain, so exervise is well worthwhile I reckon

[Mischa1111111]

Thanks for replying. It is a common doubt and I'm glad I posted . I have an appointment with the radiation team on Tuesday . They also told me not to cancel my appointments with the surgery dept. But thinking it out and feeling the logic and conviction of my decision , I really want to go for the radiation + ADT . Glad to know you seem to be doing fine with your excercise program. Wishing you all he best towards your recovery. Will keep you and the others who encouraged me posted.

[Mischa1111111]

I wanted to start RT treatment this week and when they went to the TAC they couldnt because of gas in the intestine . Taking 2 medications for that plus the diet they reccomended and will try again nect week .