65 years old. PSA below 3 then 4.35, 3.06, 4.93, and 4.52. Had MRI and then biopsy
Diagnosed 19 months ago with PCa localized on left side with 3+4 on one core and 4+3 in second core, all confined to prostate.
Joined NanoKnife (Irreversible Electroporation (IRE)) focal ablation clinical trial. Pre ablation PSA was 5.76. Post ablation PSA 1.25, eventually rising to 1.96.
One year later, left side clean in MRI and biopsy. However, right side determined to have 2 cores with 3+4, and 4+3. Regraded through Johns Hopkins (thanks to reading here) down to both 3+4 with significantly less pattern 4 in both cores.
PROMISE trial genetic tests showed no gene mutations and Decipher scores were .34 and .36, well below .45 cutoff for more aggressive prostate cancer. Showed probability of metastasis of 1.2% for 5 years and 3.0% for 10 years with therapy
I am now considering MRI guided SBRT. I'm in the Chicago area but willing to travel. I keep reading about De Kishan at UCLA. Is there anyone like him in the Chicago area. Any reason to consider a different treatment?
Thanks
Written by
Piano777
To view profiles and participate in discussions please or .
I looked at Dr Hirsch and she is listed as working for Radiation Oncology Consultants. Does she do MRI Guided SBRT? I couldn't find that in any of her material.
It appears Northwestern has capability, but not having luck yet finding doctor doing the procedure.
Amar Kishan, MD, on Optimal Sequencing of ADT With RT in Nonmetastatic Prostate Cancer
Yearofthecow profile image
Yearofthecow•
6 months ago•7 Replies
"For patients with nonmetastatic prostate cancer, the optimal sequencing of short-term androgen-deprivation therapy (ADT) when delivered with radiotherapy (RT) has been uncertain. Only two randomized trials have investigated this question. Now, however, a study in the Journal of Clinical Oncology, has provided more definitive evidence.
Amar Kishan, MD, of the University of California Los Angeles, and colleagues pooled individual data from 7,409 patients in 12 randomized trials. The patients were treated with RT and short-term neoadjuvant/concurrent ADT (n=6,325) or concurrent/adjuvant ADT (n=1,084), and outcomes were examined by RT field size.
In men who received prostate-only radiotherapy (PORT), concurrent/adjuvant ADT was associated with improved metastasis-free survival (10-year benefit 8.0%, HR 0.65, P<0.0001) and overall survival (HR 0.69, P<0.0001).
"These data strongly suggest that when PORT is being delivered with short-term ADT -- as is recommended for men with intermediate-risk disease -- concurrent/adjuvant ADT sequencing should be the standard of care," the researchers concluded."
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
Fired first Urologist 
Advice for my husband, looking at treatment options
New biopsy: now G4+3
Just getting started
prostate cancer 3+4
