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I was diagnosed with Prostate CA. 6 months ago. Have had all testing done, including MRI directed biopsy ,Decipher, PSMA etc. I’m 71 and in good physical shape. I have BPH (100cc.), PSA is 7 with Flowmax, and Proscar, so true reading is 14. PSMA scan was negative for metastasis. I fall into Unfavorable/Intermediate Risk category, with Decipher score of 94.Gleason mostly 3+3, with 3 scores of 4+3. I’m in the Philadelphia area, so have had 2 sets of opinions with multiple oncologists from Jefferson University Hospital Dr’s and Fox Chase/Temple Health Dr’s. I’ve spoken to multiple friends and others re: their experience with surgery and decided the side effects were not for me,and that includes effects from radiation. My Dr’s think I could be a candidate for HELOP, TURP, and maybe radiation follow up. Has anyone had any experience with the same type of treatment .
Replies to "I was diagnosed with Prostate CA. 6 months ago. Have had all testing done, including MRI..."
I think you meant HoLEP, right? Holmium Laser Enucleation of the Prostate.
Neither of those procedures removes the peripheral zone which is where most PCas occur, not in the transition zone, which is where most BPH occurs. I would not consider those options unless you have an unusually focal tumor in your prostate AND it is entirely located within the area of the prostate normally resected in BPH surgeries. 3 cores of 4+3 is nothing to mess around with IMO.
@docandy111 NOT ALL radiation and the machines are alike. The margins used have an impact on how much healthy tissue is exposed and your side effects. You might want to Google the Mirage randomized trial which compares radiation machines, like the Mridian or Elekta, that have a built in MRI vs radiation machines that use fused images and are forced to use larger margins. Healthy tissue exposure matters and one can have significantly different results depending on the machine you choose with your doctors (I spoke with 5 radiation oncologists).
Docandy, you seem like a young 71. So I agree with every post before mine in terms of killing the cancer one way or the other and not screwing around with these different methods that just skirt the issue.
SBRT - whether MRI or CAT guided is an excellent choice if you want to avoid surgery and have fewer side effects. My buddy just had Cyber knife at Sloan: No ADT even though he had two 4+3 cores since his Decipher test was low probability of metastasis. ZERO side effects 3 months out, PSA went from 8 to .8 and it’s not done coming down.
Best of Luck to you!
@docandy111, you might be interested in reading the experiences of others who have had HoLEP for prostate cancer here:
- HoLEP procedure experiences?
https://connect.mayoclinic.org/discussion/holep-procedure-experiences/
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Since you have at least one 4+3 your Gleason score is considered a seven. That is not something to just let go. That means you have cancer in your prostate and you really should treat it, it almost always spreads.
My brother had a 4+3 and at 76 he had 5 sessions of SBRT radiation to the prostate. That was done last January and he has been undetectable since then.
The effects of radiation are a lot less than the effects of surgery. I’ve had both and radiation didn’t affect me in any way and it didn’t affect my brother either.
If you speak to a urologist, they usually recommend surgery since they do surgery. You wanna speak to a variety of medical professionals including a genito urinary oncologist, the ones that specialize in prostate cancer.
If you don’t treat it soon, you should get ADT so that it stops it from growing, that works for almost everyone and allows you to think about it for a few months.