Decision Time: Getting ready to make a... - Prostate Cancer N...

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Decision Time

NickyDJr profile image
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Getting ready to make a treatment decision now that all my tests are in.

Age 64

Good health

PSA 4.8

MRI

Biopsy

Stage T2C

Gleason 6/7 (3+3 and 3+4)

Total body bone scan - nothing indicated

Genomic - high risk

Consulted with a surgeon and radiologist

Thoughts?

Experiences?

Thank you all!

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NickyDJr
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Tall_Allen profile image
Tall_Allen

Where do you live? Can you travel for treatment?

Why do you say "Stage T2C"? Was that based on a biopsy, or a DRE? What percent of your biopsy cores were positive?

Considering your high genomic risk, you are probably best off being treated as "unfavorable intermediate risk." That means that all of the following are good choices:

• SBRT

• HDR brachytherapy monotherapy

• Brachy boost therapy (external beam radiation+seeds)

Treatment will probably include about 6 months of ADT.

You have to meet with radiation oncologists who are specialists in each of those (not the generic radiologist you plan to meet with).

Surgery has inferior results for unfavorable intermediate risk. You can see what the expected cure rate is by filling out this nomogram:

mskcc.org/nomograms/prostat...

You may want to read this article:

prostatecancer.news/2018/10...

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