Treatment Path with Simultaneous Radiation, HT and Chemo

Posted by rick137 @rick137, May 2 2:15pm

After a PSA of 37 which indicated a PSA doubling in 6 months, an MRI with two PIRAD 5 tumors in my prostate, a biopsy which showed the two tumors were Gleason 4+5 and a PET/CT scan which showed the cancer had metastasized to my pelvic lymph nodes and one in the pelvic side wall, I would say that I have an aggressive form of prostate cancer. The good news is that there were no tumors outside my pelvic region large enough to appear on the PET/CT scan.

I began HT last week and will begin proton therapy at the end of the month. However, what about chemo as well? Perhaps because I just turned 83 it is not advisable to have proton, HT, and chemo simultaneously? The side effects just too much? Perhaps the path is to begin chemo and continue HT after radiation completed?

I would be interested in the experience of anybody of a similar age who has had all three simultaneously. As an addendum, in the week after beginning Lupron no side effects whatsoever. Nature has cut me a little slack.

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

northoftheborder | @northoftheborder | May 3 8:41pm

Chemo is pretty toxic to the body as well as to the cancer, and it can kill you on its own (though that's much, much rarer than it used to be).

I know some oncologists are using chemo up front now for stage 4 prostate cancer as part of a "triple therapy" when the cancer is already castrate-resistant and/or widely metastatic, but if it's more localised or has few metastases (oligometastatic) and is responding well to radiation together with ADT + an androgen-reception signal inhibitor, adding chemo to the mix could be hopping out of the frying pan and into the fire (or might just be what saves you; who knows?). It's worth a long talk with your onco team to go over the costs and benefits.