Can we trust AI analysis?

[Mgtd]

Like many of you I was faced with two major decisions when I was diagnosed with Intermediate high risk prostate cancer. Surgery vs Radiation and ADT short term vs long term.

In short I chose radiation and short term ADT - 2 months prior to radiation and 4 months post. In addition I chose to have my pelvic area radiated even though there was no cancer showing on the tests. The follow may help some of you decide on the level of ADT.

evidence.nejm.org/doi/full/...

I have two close friends who made different choices years apart.. The first chose no ADT with radiation and the second chose 12 months of ADT after surgery and follow up radiation after PSA rise. I guess only time and luck will tell if that was the correct decision for each of us.

I selected an Intermediate course of radiation of 25 sessions and very honestly I let the radiation oncologist determine the amount of radiation to the prostrate and pelvic area, etc. I had no experience in that area and that is why she was getting the big bucks and spent all that time in residency.

Hope this helps some of you as you move through your choices.

[janebob99]

Very interesting and relevant post. Why did you choose to do pelvic irradiation? Did y0ou have a PSMA-PET scan? What did it show?

Thanks,

Bob

[Mgtd in reply to janebob99]

I decided to do the pelvic radiation at the suggestion of my radiation oncologist. I did not have a PSMA test. I had the traditional CT and bone scan combo.

She said after reviewing my history and tests she felt that the possibility of microscopic cancer cells that even a PSMA would not pick up was probably pretty good. In her residency she had good experience with taking a more aggressive approach rather then a wait and see.

She explained that there was a argument to me made for both sides of the issue but she since I did not have a PSMA scan she felt she would prefer to radiate the pelvic area and take the more aggressive approach based on her experience. Honestly that made sense to me so that is what we did.

Long story behind the no PSMA but that is another issue for another day and really that train had left the station by the time I got to the RO and MO. Hindsight is always 20/20. It was time to get on with the treatment.

So far her experience and educated guess have had great results. Hoping it continues.

If I remember correctly I had either 70 or 80 GY to the prostrate and a lesser amount to the pelvic area. Once again she made those decisions.

[janebob99 in reply to Mgtd]

Thanks. Very interesting. I should get my PSMA-PET report in a few days.