My treatment decisions

[drzaius]

I want to thank this forum for men helping other men. I will list my experience in the hope it may help others. I especially want to thank Tall-Allen, whose advice and work on this forum is, to me, a truly meaningful endeavor, and when all is said and done, this is what life is about.

I was diagnosed in September with a Gleason 3+3, grade 1. PSA 4.4

Had 3 out of 14 cores that showed prostate cancer, most cores were <50%

Also the pathologist noted PNI, which is cancer cells near the nerve.

They offered that I could do active surveillance.

My Father died of Prostate cancer when he was 74, my current age.

I also had been checking my PSA for years because of this.

I couldn’t reconcile having been checking all these years to catch it early only to wait on active surveillance.

I then chose to have a genetic test (Decipher) done. It came back a .76 (high risk).

Between all these factors, I chose to get it treated. Then the choice was what treatment.

RP - They said normally they don’t like to operate on 70+ year-olds but I was in good shape so that was an option.

HIFU - Focal or even whole gland treatment

Radiation - SBRT(SARS) or IMRT

HIFU seemed to not have as a long history as RP and Radiation and the outcomes in my opinion were’t as good

RP seemed like an option but I decided that some of the side effects I didn’t care for at a personal level, especially the incontinence.

Radiation - The outcomes are pretty much the same for RP and radiation, but the side effects differ somewhat. This option for me personally I thought was best. The SBRT option is a higher dose but a shorter course of treatments. But the location would have me travel a much longer distance and the side effects could be more acute for my age. So I decided on the 28 session, 5 1/2 weeks, only 10 minute drive. They had a fairly new machine and my oncologist was very experienced. I had a moderately hypo-fractionalized dose each time. I had a gel pack put in to move the rectum out of the way.

I finished my treatments on Feb 9th. My side effect was some frequent urination, but I had that before diagnosis but it was slightly more after radiation. I took flomax and that helped a lot. other than that, I didn’t experience anything else but some fatigue after playing a sport for an hour. The 28 sessions were a grind but all in all, I think it was the right decision for me.

So now I’m in the land of probabilities but I did all I could do and had good treatment so no regrets.

[Don717]

Nice. Sounds like you selected wisely based on the data!! Good luck to ya!!

[Tall_Allen]

Thanks for your kind words. If you're like most guys your nocturia will improve over time. I never wake up to pee anymore.

[janebob99]

Congratulations! Did you do ADT?

I'm hoping to do SBRT (5 fractions). Meeting with the RO this morning.

[drzaius in reply to janebob99]

no, they said with my gleason and grade, there wasn’t a benefit. I think if your gleason is higher, then benefits out weigh the side effects. My 28 sessions was grind. If the SBRT was closer, I would have considered it. Very best to you on your treatments.

[conbio]

Congratulations on finishing the radiation - been there, done that. I think there is relief when coming to a decision about treatment and then getting through the sessions. Best of luck to you. 😀

[drzaius in reply to conbio]

Thank you-appreciate that. I still am coming to terms with it, but a definite relief as you say. Best of luck to you also

[Papillon2]

Sometime PCa puts you in a position where you have to fight. Congrats and Best of Luck. BTW TA is ASI ( Artificial Super Intelligence) He had me fooled too until he tripped up one day. He answered one of my questions before I could even ask it!

[drzaius in reply to Papillon2]

Thank you-appreciate that. Also ASI- very funny! Needed a laugh.

[rivsmom]

My husband is doing the 5 treatments in Sept. I am curious if there are any issues doing the 5 higher dosage sessions? Trying to find info in this group to read up. Any help is greatly appreciated! I am glad your decision was a successful one.

[drzaius in reply to rivsmom]

there doesn’t seem to be any difference. My oncologist told me at my age, there could be more acute (temporary) side effects. I’m 75 but in good shape. The short version has a special trained team. The advantage is that my 28 treatments seem to on forever. Even the 28 treatment is a shorter version then years ago.