← Return to Second opinion for husband's stage 4A prostate cancer? And update

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@cheriekhan

I met with the Cornell team and the oncologist was against surgery and now they are suggesting radiation for two weeks 5 times a day by MRI guided machine and ADT for two years. So no surgery.

Have a consult with Memorial Sloane Kettering next week then will make our decision. Feeling confused as want hubby to make the best decision that will give him full recovery from this disease.

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Replies to "I met with the Cornell team and the oncologist was against surgery and now they are..."

Best of luck -- it's tough right now when all the decision demands are flying at you.

Surgical removal of the prostate would have seemed like an unusual choice for cancer that has already metastasised, but a) I'm not a physician (much less an oncologist), and b) best practices are evolving so fast these days it's almost impossible to keep up.

I'd think that radiation would be at least as effective (if not more so, because it can treat the areas around the prostate as well), so I don't see any cause for concern — they're just sparing him a bit of unnecessary extra surgical trauma and recovery (again, in my layperson's opinion).

As I mentioned in the other thread, I didn't get prostate surgery for my stage 4b prostate cancer (just radiation, ADT, and ARSI), and I've had no cancer progression at all 2 1/2 years later.

Did you mean 5 times per day or 5 times total over a two week period?

I consulted with both Dr Nagar and Dr Samadi. I ultimately chose surgery at the urging of family and friends even though it was my last pick!
But even though I had no spread, etc. my cancer seems to be coming back with slowly elevating PSA’s.
When I want to kick myself for going thru life altering surgery and not doing Meridian I just think back to Dr Nagar’s advice: “Whatever you decide will be the right decision”. In retrospect I guess what he was saying is that no one has a crystal ball and there are no guarantees. The most important thing is to be comfortable and confident in whatever path you choose.
After that it’s a waiting game and a fingers crossed lifestyle - or if you are religious, something else.
So my outcome probably would have been the same no matter what I did. Clean margins, negative lymphs, etc don’t account for a cell ir two that got away. Surgeons can’t see them, scans can’t see them and that is the unvarnished truth.
Best of luck with whatever you decide and your partner will definitely live a lot longer no matter what treatment he gets!

Sounds like my treatment for Gleason 9 prostate cancer that had spread to pelvic lymph nodes. Only I had radiation for 9 weeks (5 days per week) for 9 weeks. Also went on Lupron for 18 months ( one shot every 3 months ) Had my last shot almost 4 months ago. Doing well so far. PSA is at 0.10.

Most important thing is to stay active and exercise including weight training. Join the Y. It makes such a difference as to how well you feel and how well you deal with the side affects of the hormone Lupron. I'm in my 80's and never missed my Monday, Wednesday and Friday 2 hour workouts at the Y, not even on the days I had radiation. At home I did everything in my large yard as I always did..EVERYTHING, if not more.

I read of others like me that had the same results to the treatments by being active........ it's all up to you.

God bless you and your husband.

cheriekhan, one advantage of the MRI guided radiation is less damage to urinary and sexual function. Another advantage over surgery is that radiation is comfortable during and after (no catheter). Of course, the main issue is the best chance to beat the cancer. Nobody really knows. Bless your decision with luck.

We got 3 opinions, 2 surgeons and a radiologist. Gleason 8 stage 3b. All 3 recommended radiation over surgery. Removal would not get all the cancer, so why go through the risks and side effects if you know you will need radiation and ADT anyway.

ava11:
My testerone was never tested those i8 months. It was 780 before I was diagnosed with prostate cancer. At my last visit they did blood work for PSA and Testosterone. PSA came back at 0.10 which is what it was 3 months earlier. They tested it every 3 months. Testosterone results had not come back so will find out what it is at the next visit. I just want a base line to see how fast it rises after being off Lupron.

I don't believe working out raises Testosterone. I have a workout buddy also in his 80's who gets a Testosterone shot every 2 weeks since his level is low, around 200. The shots put it in the 700 range.

My usual workout starts on the treadmill for 1/2 to 1 mile at a 3.5 to 4 mile /hour pace. I then go to the machines and free weights for 2 hours. usually doing push exercises on Monday, pull on Wednesday and a combination on Friday. Usually do 3 sets on 8 to 12 machines and or free weights. At my age, 85 soon, they recommend more reps and less weight. I just do the opposite.........as much weight as I can do........ sometimes only 5 reps but most times at least 10. Never worked out until the Y about 10 years ago. I was amazed at how much muscle an old man can put back on even with busted up shoulders. I was very lucky that I was already working out when diagnosed. It would have been difficult had I not..may not have happened.

Hope this helps.