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Newly diagnosed

Posted by vinny59 @vinny59, May 13 8:46am

Hello, new to group, short history, had Squamous cell carcinoma of the head and neck in 2006 , in 2011 I was diagnosed with stage 4 Non Hodgkin's Lymphoma I'm in remission of both. Then my PSA numbers started to go up from .02 to 7.3 within two years. Had a MRI of prostate it showed lesions, biopsy showed gleason grade group of 5, and gleason score of 5+4. 8 out 12 biopsies showed positive. with three sites with perineural invasion. Had bone scan that showed a suspicious lesion in the hip. Finally having my PMSA Pet Scan the 21st . Still up in the air with treatment choices, any insight if the PSMA scan comes out positive for metastasis? So Sorry for the long thread!

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retireddoc | @retireddoc | May 16 5:36am

Welcome! Sorry for the news. Actually your intro is quite a bit shorter than most and the more info the better.
Just my observations/opinions based on my personal experience and information gained over the years.

I was in a fairly similar situation to you. At 69 years old had rising PSA, biopsy revealed G9. Had Robotic prostatectomy. Six months later a PSMA PET revealed a solitary T8 met treated with radiation (SBRT) with good result. PSA continued to rise so had another PSMA PET 4 months later with positive node in pelvis. Sought consultation with Medical Oncologist (MO) at Johns Hopkins and was immediately treated with triplet therapy-ADT/Lupron, Chemo (Doxetaxel) and Anti androgen receptor/Darolutamide. Rapid response with PSA undetectable (11/22) and has remained so since. After the triplet therapy I had 37 radiation treatments to my pelvis with boost to the positive node and prostate bed.

Many MO are getting aggressive with oligo metastatic (limited mets < 5) disease. At your age, some suggest a prostatectomy to remove the significant majority of the tumor. Then follow with triplet therapy (ADT started immediately after the PET ) and radiation to your pelvis. That's probably the best chance for cure ( they don't know yet if oligo can be cured but some believe it can in some patients) or long term remission.

As one poster said, your history is complicated by your other cancers. Best advise is to get a very experienced Team at a Center of Excellence where they treat a lot of prostate cancer.

Good luck!

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vinny59 | @vinny59 | May 16 6:33am
In reply to @retireddoc "Welcome! Sorry for the news. Actually your intro is quite a bit shorter than most and..." + (show)
@retireddoc

Welcome! Sorry for the news. Actually your intro is quite a bit shorter than most and the more info the better.
Just my observations/opinions based on my personal experience and information gained over the years.

I was in a fairly similar situation to you. At 69 years old had rising PSA, biopsy revealed G9. Had Robotic prostatectomy. Six months later a PSMA PET revealed a solitary T8 met treated with radiation (SBRT) with good result. PSA continued to rise so had another PSMA PET 4 months later with positive node in pelvis. Sought consultation with Medical Oncologist (MO) at Johns Hopkins and was immediately treated with triplet therapy-ADT/Lupron, Chemo (Doxetaxel) and Anti androgen receptor/Darolutamide. Rapid response with PSA undetectable (11/22) and has remained so since. After the triplet therapy I had 37 radiation treatments to my pelvis with boost to the positive node and prostate bed.

Many MO are getting aggressive with oligo metastatic (limited mets < 5) disease. At your age, some suggest a prostatectomy to remove the significant majority of the tumor. Then follow with triplet therapy (ADT started immediately after the PET ) and radiation to your pelvis. That's probably the best chance for cure ( they don't know yet if oligo can be cured but some believe it can in some patients) or long term remission.

As one poster said, your history is complicated by your other cancers. Best advise is to get a very experienced Team at a Center of Excellence where they treat a lot of prostate cancer.

Good luck!

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thanks so much for the insight, still waiting for PMSA Approval , once I have all the information we can come up with a game plan , but if scan shows activity we will be doing the three prong attack

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