Gleason 7, localized. Which treatment LD Brachy or SBRT ?

[ShepherdG]

Gleason 7, locailized. Which treatment LD Brachy or SBRT ?

[Tall_Allen]

GS 4+3 or GS 3+4? T stage? PSA? Cancer volume?

[ShepherdG in reply to Tall_Allen]

3+4=7. Most recent PSA 4.8. [biopby showed, Right side only at ROI, grade group 2, (20-25% pattern 4) involving 15% of tissue. 5 out of 5 cores]. 25 cores total. PSMA pet scan negative. Decipher .2. Trying to decide on SBRT or LD Brachy. Prostate size 34cc

[Tall_Allen in reply to ShepherdG]

Either will do the job. I chose SBRT over HDR brachy because it was less bother.

prostatecancer.news/2018/10...

[NanoMRI]

Multiple opinions of my mpMRI provided tumor surrounding margin details that led to my treatment decision. Mine was not as localized as we thought and despite multiple pathology opinions my 3+4 was determined to be 4+3 after treatment. All the best!

[ShepherdG in reply to NanoMRI]

What treatment did u decide on ? And how did the results turn out ?

[NanoMRI in reply to ShepherdG]

Ended up being RP due to insufficient margins for radiation and other focal treatments (I strived to avoid RP for all the negative chatter).

My continence improved (prostate dam gone) and penile function recovered naturally although wish I had known back then (nine years ago) ago pumps. My cancer was out so it took salvage RT then salvage lymph node surgery - latter seven years ago. My uPSA just days ago 0.029, no ADT.

[CarverD]

I was 7 (3+4) 20%. Opted for HRDBrachy and have been quite satisfied with the results.

[LiveLongAndPropser]

Like Tall_Allen said, need more info. That's not much to go by. Age and other favorite also weigh in. I was 51 and went SBRT with 4+3, localized PSA 11.0 when treatment started.

[Wifey21]

My husband's presentation was very similar to yours. Had all options open to him. Took 3 months to consider all & opted for LD Brachytherapy.. No enlargement to prostate so had 75 seeds inserted Jan 2023. PSA was 6.6 at point of treatment. Treatment successful. Latest PSA (Nov 2024) 0.9. Minimal side effects during treatment. Only ongoing side effect after over 2 years is an occasional sense of urgency on standing (very controllable) which he's been told is a result of irritation from the radiotherapy effects, so would have encountered this whatever. He's very pleased with his choice.

[fast_eddie]

There's another option you might consider. 8 1/2 years ago I had to go out of state to get full gland HIFU ablation surgery. A google search revealed the following:

"Yes, Mayo Clinic in Phoenix offers High-Intensity Focused Ultrasound (HIFU) for prostate cancer treatment, including focal therapy. "

So the times they are a changing. HIFU is now endorsed by Mayo. My HIFU treatment was very successful and without any troubling side effects.

[addicted2cycling]

10 years ago next month was my urologist's TRUS biopsy diagnosis. NOT relying on a TRUS or MRI scan my treating doctor performed his Saturation Transperineal 3D Prostate MAPPING Biopsy that provided 100+ core sample showing that the Gleason 10 tumor was confined in the right half of my prostate.

His Hemi Cryoablation has kept me GL10 clear as I type and hopefully his experimental 1 time Immunotherapy Injection will also continue to keep me met. free.

Different strokes ------