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When to start ADT treatment of 4+3 score?

Prostate Cancer | Last Active: 3 days ago | Replies (13)

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@pdcar4756

I am struggling right now with "fear of overtreatment". I have Gleason 3+4, one 1.5cm lesion, less than or equal to 5% pattern 4. 1 of 13 cores showed cancer. Cancer confined within prostate. PSA 8.5 on last reading. Prostate volume 100cc. PROSTOX test shows low risk for
greater than G2 long term side effects. Mayo Rochester radiation oncologist is advising SBRT of entire gland. I'm told I'm not a candidate for active surveillance because my Decipher Score is 0.78. I'm trying to assess if I'm a candidate for Focal Therapy and don't have an answer to that question yet. Some moments I feel like I'm hitting a thumb tack with a sledge hammer with SBRT. I don't know how to make this decision yet. Others have this challenge?

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Replies to "I am struggling right now with "fear of overtreatment". I have Gleason 3+4, one 1.5cm lesion,..."

I could write volumes on why I feared over treatment given that nearly every indicator came with a set of 'qualifiers...think disclaimers'. At one point, I asked if they were using a Quija board to make my diagnosis. I do not want to recall all that trauma and will merely add that the one advantage PCa guys have is the slow progress of the disease that allows for quite a lot of time to get multiple second opinions and do research. It may not be the same for all/most insurers, however, for me there was no limit to how many second opinions and how many institutions that I could consult with. In the end, I went along with a fairly aggressive treatment, that addressed the 'possible Xs', e.g. T1c (*possible* T3a based on MRI). However, my plan was corroborated by many fine Drs. and research studies that I read giving me a moderate level of comfort in my decision.