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.