Gleason7(3+4) - treatment options recommendation

@manojsmishra I had gleason 3+4 as well. 10.2 psa. Looked into removal and radiation. Not all radiation machines are alike in terms of radiation exposure to healthy tissue and therefore side effects. Google the Mirage study that compares built in mri radiation machines, such as the MRIdian or the Elekta, to other types of non mri radiation machines. 2 mm margins vs 3-5 mm margins DO have an impact in terms of side effects and toxicity and what you see with the MRI is what you can treat vs fused images.

I was not comfortable with the % of re-occurrence with prostate removal and potential side effects though others were. Once radiated, prostate removal later on becomes more difficult. That was a risk I was ok with.

Once I picked the radiation machine, the MRIdian, I spoke with 5 radiation oncologists from centers of excellence or those that were trained at centers of excellence and made my decision as to where I was going to be treated, which was in Florida. I completed 5 hypo-fractional treatment in February of 2023 with minimal urinary restrictions that cleared up quickly.

By the way, if you are in the New York city area, on Sunday, September 22 from 10:30am-2:00pm at the New York Academy of Medicine (1216 Fifth Avenue New York, NY 10029), there is an event featuring presenters from Weill Cornell Medicine, Columbia University Irving Medical Center, and Memorial Sloan Kettering Cancer Center, to explore critical prostate cancer topics.

Thank you @bens1
I’ll do due diligence

Also I inquired that Mayo has proton based radiation therapy option which is by far the most advanced and there are some 30 proton based treatment centers in the country. But like you said taking radiation first and then surgery if required is difficult although not impossible

An excellent recommendation .
My team also looked at SBRT , NanoKnife and HDR Monotherapy ( Brachytherapy )

Investigate : HDR Monotherapy ( Brachytherapy ) , SBRT and NanoKnife .

What Radiation only ? Was it Monotherapy HDR - Brachytherapy ?

I'm a patient at Mayo (Arizona). At the time, my urologist recommended surgery with radiation treatment as a back up should the cancer return and/or the PSA rose ... which it did and I subsequently had the radiation treatment. Here's a question I would ask: If I have radiation treatment and it fails; would I still be a candidate for surgery?

I think the radiation will correct the situation that’s what my urologist said. There is nothing to surgery for prostate since it’s not there

On February 8th 2024 I was diagnosed with Gleason 4 + 5 equals nine and a PSA of 79. The cancer had spread through my spine my ribs and my hips.
I'm not a doctor nor do I play one on TV but here's what I did.
I got a shot of lupron and added 140 mg of Xtandi daily.

Then I worked on my attitude: victory over cancer is a decision not a happening. Got on as many prayer chains as people were willing to send me positive thoughts and prayers.

Then I looked at my diet. I immediately dropped all white sugar, white flour and processed food like bacon, sausage, lunch meat etc from my diet. I also dropped red meat mostly, one red meat a week and switched to chicken and turkey as well as green leafy vegetables and lots of broccoli. I drink coffee black, green tea, Gatorade zero, and lots of V8. And instead of bottled water I now drink alkaline spring water with a pH of 8.1 because my research indicated that prostate cancer cells hate the near acidic environment of the body.

Then I started with these supplements:
Two capsules of reishi mushrooms a day (research them)
3000 mg of turmeric garlic and ginger that's two capsules a day (you can find them combined in capsule form on Amazon)
Next was 10,000 mg of vitamin C, yes 10,000 mg.

Then, while doing that, I had five treatments of targeted radiation at the metastasized cancer cells.

I hurt a bit because any cancer that escaped the prostate caused damage to the nerves in the areas above and so I used ultra high frequency radio ablation to deaden the damaged nerve endings. My pain went from about five or six to about one or two on the scale of 1 to 10.

No surgery, no chemo.

On July 12th 2024 my PSA score was 0.0 (see image below).

My Xtandi has been dropped to 80mg daily and I see my ooncologist again in October.

My goal is to beat this thing, keep it down, and educate other people about how I handled it.

@clandeboye1
I had 30 rounds of proton pencil beam radiation treatments at UFHPTI.
After my Decipher test came back low risk, my PSMA was negative, and my bone scan was negative both Mayo Clinic Jacksonville and UFHPTI recommended radiation only and no hormone treatments.

Mayo originally suggested to add hormone therapy. However again after Decipher, PSMA, bone scan it was changed to radiation only. I got my second opinion on all tests and recommendations at UFHPTI.

Hormone treatment does not kill cancer it drastically slows the growth and thus a better outcome if you have agressive prostrate cancer or has spread outside the prostrate gland. This goes both for surgery and radiation treatments. This statement comes from my R/Os not my opinion.

I went with the recommendation of both R/O. Mayo and UFHPTI who recommended same. Mayo Jacksonville does not have proton radiation so went with UFHPTI which does and has been a major institution doing proton radiation since 2006. It is quite a modern facility with 5 proton radiation gantries (which means 5 different treatment rooms). They offer a wide variety of protron radiation treatments and for many types of cancers.

FYI: Jacksonville Mayo is building a new cancer center that will have proton radiation.