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How soon should treatment start for aggressive cancer?
Prostate Cancer | Last Active: May 16 7:41am | Replies (25)Comment receiving replies
I would consider finding another Urologist or at least get a second opinion, A Gleason 9 with bony metastasis is considered (limited) oligo Stage 4. At this point I believe your care should be directed by a combination of a Radiation and Medical Oncologist. The Urologist opinion is less important, IMO. Many MO would treat you aggressively (maybe triplet therapy + radiation to prostate, pelvis and the pubic bone met) given your limited disease and G9. Almost assuredly you will be started on ADT so I would begin that ASAP. Get an opinion from a COE as soon as you can.
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About two years ago I was Gleason 9, rated stage 4b, metastatic. High PSA. My urologist at Mayo confirmed my diagnosis with intraperatoneal biopsy and PET Scan. Also had a biopsy on a lymph node in my chest, near my heart. I started treatment with Lupron. Shortly thereafter I started darolutamide and proceeded with six sessions of docetexal chemo. Next came twenty six sessions of intensity modulated radiotherapy. Follow-up PET scans were clear. By then my PSA was negligible as was my testosterone. I went off Lupron after 13 months but continued darolutamide. After all of that I am very weak. My testosterone is coming back (now at 40 ng per deciliter). I’m 74. i can play golf again but have to use a cart. Glass is half full. Thanks to Dr. Kwon and his Mayo-Rochester team.