Psa 30

[Karmaji]

I have psa 30 am 80 years old..

No main symptom

Healthy..no diabetes no heart or health problem

Erectile slow

Doc after DRE says T3

Going for CAP scan bone scan and biopsy....

Any comment...

[6357axbz]

I think you’re doing what needs to be done. Hopefully, if PCa, it’s still contained within the prostate gland. Curable.

[Karmaji in reply to 6357axbz]

Thanks

Doc was mentioning HRT

Wait for scans...

[Magnus1964]

At 80 any drastic treatment i.e. chemotherapy or surgery might not be advisable. However you can get a lot of years out of ADT drugs, immunotherapy, etc.

[Fairwind]

At 80 years old, you need to approach this a little differently.. At this point, the procedures and treatments can be worse than any possible prostate cancer..Even the biopsy is not without risk, but if you are otherwise healthy and in good shape, it can provide information no other procedure can...Knowing your Gleason score is a BIG benefit when it comes to choosing treatment (if any).. A Gleason 9 or 10 is not the same thing as the far more common Gleason 6 or 3+4=7 variety...Learn all you can before you make any decisions..There are some good books out there that will make you a PC expert...

[Tall_Allen]

Not much to decide until you get the bone scan/CT results. If it is positive, you can avoid the prostate biopsy. Let us know.

[Karmaji in reply to Tall_Allen]

Hello Allen

May you comment on CAT scan result...

============

Prostate right postero lateral development mass syndrome, with capsular crossing, extension to the right seminal vesicle, close relationship with the rectum. No suspicious element at a distance

[Tall_Allen in reply to Karmaji]

Stage T3b

[Karmaji in reply to Tall_Allen]

what to expect.....thanks

[Karmaji in reply to Tall_Allen]

Dear Tall_Allen

here is bone scan result

No hyperfixation of bone secondary appearance.....

Your valuable opinion....

[Tall_Allen in reply to Karmaji]

sentence fragment

[Karmaji in reply to Tall_Allen]

what it means sentence.......fragment

[Tall_Allen in reply to Karmaji]

I'm saying that you have to provide the whole sentence

[Karmaji in reply to Tall_Allen]

Tracer is oxidronate Tc99m

Gamma camera Symbia Intevo couple coupled with TDM scanner

The doc or robot is very brief....

No secondary bone hyperfixation has been observed over the whole skeleton

-------In French original it says......

Pas d'hyperfixation osseuse d"allure secondaire sur l'ensemble du sequelette

Can you enlighten me on possible treatments for T3b.......considering my age 80 years in good overall health....

Doc will take a biopsy next week.....

Thanks for your caring contacts.....

[Tall_Allen in reply to Karmaji]

Thanks. That's just a translation problem. Hyperfixation (French)=Increased tracer uptake (English). So that just means that no skeletal metastases showed up on the bone scan.

The Stage T3b puts you in the high risk category. You can discuss curative therapy with brachytherapy boost therapy with a radiation oncologist.

When you get your biopsy results, you can fill out the following nomogram that shows the odds of dying from prostate cancer vs from some other cause in the next 15 years:

webcore.mskcc.org/survey/su...

[Karmaji in reply to Tall_Allen]

Hello T Allen

Need your opinion

Am 80 years and as you say T3B

Doc says it can be cured

Awaiting Biopsy...in a week....

He strarts with Firmagen

...once each month...

Asked to contact RO for radiotherapy....

Question...

1. For ADT what you think

....this product or other..

and for how long..

2.....For Radio...

Imrt igrt..etc....

Or on some other machine to look for...

I dont know much about it....

What to look for....

===============

I will also consult oncologist at Marseille ..Paoli inst ..Dr Gravis...she is head of prostate section...

Any comment is highly welcome..

Not many studies on senior guys...

Thanks..

[Tall_Allen in reply to Karmaji]

1. They sometimes start with monthly Firmagon and switch to leuprolide or similar every 3 or 4 months. It doesn't matter as long as your testosterone and PSA come down.

2. Brachytherapy can be either high dose rate or low dose rate - there are specialists in each. The external beam part of the therapy should be IMRT.

[Karmaji in reply to Tall_Allen]

Thanks and a pleasure that there are still real humans around...like family members on this forum

I am shocked to find that docs have no human element left.

Better go to robots..soon

[whatsinaname in reply to Karmaji]

I agree, Karmaji. Doctors have changed a lot over the decades. They are far more commercial and ruthless now than ever before.

All the very best to you.

[j-o-h-n]

At 80.... Take it slow and easy.... you'll hit 90 before you know it...

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 06/02/2019 2:29 AM DST

[Karmaji in reply to j-o-h-n]

hello John

You mean that just let it be....

[Karmaji in reply to j-o-h-n]

Hello J-O-H-N

may you comment on this ....for healthy 80 yrear guy with PS 30 and DRE says T3

How doc knows this without biopsy

A finger may tell all ??

========

CAT scan...

Prostate right postero lateral development mass syndrome, with capsular crossing, extension to the right seminal vesicle, close relationship with the rectum. No suspicious element at a distance

=========

here is bone scan result

No hyperfixation of bone secondary appearance.....

Thanks a lot

gouri

[Karmaji in reply to j-o-h-n]

My doc says do not take it slow....

If I do nothing...i will live in real hell in 4 or 5 years...

So I have to look for ADT and some sort of RT..

Any laughing cure....

Que sera sera....

[j-o-h-n in reply to Karmaji]

I meant don't do anything radical.... but as I mentioned on 06/02/2019 "or if you wish take the ADT (Hormonal approach) and it's crappy side effects" is a way to go.

Most of us using hormones are tolerating the side effects but we are still around to complain about them. So if you choose the ADT approach TRY TO LAUGH, it might not cure you but it ain't gonna kill you....

From google translate:

Profitez de la vie dans le sud de la France

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 06/23/2019 1:43 PM DST

[Karmaji in reply to j-o-h-n]

You are lovable old routard.

Keep us in high mood

[j-o-h-n in reply to Karmaji]

Oh thank goodness... for a moment I thought you wrote "old retard"...

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 06/23/2019 6:54 PM DST

[Karmaji in reply to j-o-h-n]

What I mean is that you people are young experienced travellers in unpredictable moving land of PC

Have a nice summer week...

[j-o-h-n in reply to Karmaji]

I figured as much when I looked up the French word "routard" = traveler, hitchhiker. Thank you and Have a nice summer week too...

Good Luck, Good Health and Good Humor.

j-o-h-n Monday 06/24/2019 5:57 PM DST

[j-o-h-n]

Hello Karmaji: Where are you located?

If I were you all I would do is "watchful waiting"... or if you wish take the ADT (Hormonal approach) and it's crappy side effects. If you were under 75 then you might want be more aggressive. I am definitely not a doctor but just speaking from experience and what I read here. Whatever you decide I wish you -

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 06/02/2019 11:50 AM DST

[Karmaji]

I am in south France Toulon....area

Let us see after scans......

Question of autopsy stays....

the docs were going for Hormonal stuff.....

Keep sharing your views and thanks a lot....

One doc was saying if I do nothing... can be OK for 5 years ....

other doc was worried....

Then Bye bye.....

[j-o-h-n in reply to Karmaji]

Hello again "Gouri"

You're correct How would the doctor(s) know without a biopsy? He/she must have some really educated fingers. I am not a doctor but if you wish have the biopsy but insist that the doctor puts you under anesthesia, because it's not a pleasant test by any means. If you can go to the US or Germany (or Paris) for more experienced medical oncologists you might feel better for any decision that you will make. My preference would be do nothing dramatically except for Hormonal treatment and live till you're at least 90 in beautiful southern France. Hope I am of some help... We all have been in your situation, but most of us were much younger than you. so -

Good Luck, Good Health and Good Humor.

j-o-h-n Friday 06/14/2019 12:54 PM DST

[Kaliber]

Hi Karmaji, thanks for posting, looks like you may have been lurking a while. Great guys here and some of the best PCa info plus perspectives available. Btw: I hope you meant biopsy and not autopsy yayahahaha. Probably most all of us prefer the premortem view rather than the postmortem one. I’d much rather be soaked in alcohol ( vodka ) than be soaked in formaldehyde , Just say’in . Yayahahaha 💪👍

[Karmaji in reply to Kaliber]

Yes it is biopsy....

John was suggesting watchful observation...

May be Hormone therapy..

I am bit confused...

Tumor is out of prostate capsule but local...

CAT scan says no metastasis outside...

Any suggestion...

Thanks to this family of sharing

[Kaliber]

I’m no expert, like so many others here are. Just your basic metastatic stage 4 M1 dead duck . Straight out it looks like you still need to know lots more from tests to make any informed choices. Most important is to work with your medical team and trust your onc doc. Then see what the initial results are and check back in here. If you caught it early and it’s not metastatic maybe localized surgery and / or radiation treatments. This even cure you. If it’s late and well spread metastatic, then probably ADT treatment would be appropriate first.

I think what JOHN was gesturing at was at your age and if it’s early in your progression ( very localized ) the likelihood of you passing away from natural causes before the slow growing cancer will kill you is high, around 97% as I understand it. Advanced age presents it’s own set of problems tho related to surgery and radiation risks. It’s medically tricky to make this kind of determination on advanced age patients and every one is different. This would be a call you and your medical team should make together. Best wishes and hang in there. Sounds like you could be one of the lucky ones. You got this. 💪💪💪

[Karmaji in reply to Kaliber]

Thanks a lot....

I am a rookie in this family.....

Trying to feel mindset of docs....

Not sure they know well....

In USA 10000 cancer docs....

Only 20 Cancer prostate....

Urologist play a strange game....

a bit confused.....

[Drphil1938]

What was your PSA previous to the last one? How far apart? Might give you an idea of how fast it is growing. If it tripled or quadrupled in a short time you may not want to wait on treatment. I am 80 and was told to wait, but my PSA tripled in 3 mos and tripled again in the next three mos. I found another doctor. We found after biopsy Gleason 9 and the tumor showed on a 3d MRI it had moved to the seminal vessel. Bone scan showed it had metastasized in 7 areas. Immediately began lupron and bilutimide treatment with very little side effects.

So my advice is be proactive dont wait to see if it gets worse. It will. Find a good Mo and listen to him.

[Karmaji]

A very caring contact...

My PSA story has not much trace...

Last was in 2008...1.76

And in 2012 CAT scans were ok..

I never visited a doc....

Just by chance I did PSA test

....a good luck in a way..

So far no metastases

With CAT scan and Bone scan.

.according to Tall Allen it T3b....

Biopsie next week and protocol of treatment a week after...

It seems ADT and I will do some homework for Radio etc...

All my thoughts for your journey and stay in touch

I am in south France..