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Gleason7(3+4) - treatment options recommendation
Prostate Cancer | Last Active: Oct 7 1:02pm | Replies (237)Comment receiving replies
Respectfully, focal treatment is still experimental. I was the local poster boy for local therapy in Chicago. I was treated for low-grade Gleason 6 prostate cancer. The problem was there was no metric to decide if 1.) the treatment was successful, and 2.) my rising PSA after reaching nadir was the result of a RT “bounce”, and 3.) at what point should investigation of possible recurrence take place.
The result was that focal treatment failed and I now have Stage 4 locally metastatic prostate cancer all because I was a sucker for a sales pitch for unproven treatment.
Replies to "Respectfully, focal treatment is still experimental. I was the local poster boy for local therapy in..."
What year did you have the NanoKnife procedure and what was your Gleason score at the time
I'm confused . You had Focal Therapy , yet you felt your increase in PSA may be attributed to to your procedure .
PSA bounce is a result of Radiation Treatment - Not focal therapy .
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Thank you for sharing that. That's my concern about too tight a focus with radiation. Current imaging can't see isolated cancer cells, so if your radiation therapy is so focused that it hits only the cancer they can see, what about the cancer they can't?
It must be a very difficult decision. I'm guessing (as a layperson) that they take things into account like Gleason score, speed of growth, PSA, number of sites, etc before deciding on recommending photon vs proton and tight vs loose focus for radiation. There's probably no "right" answer, just a complex balancing act between risks and side-effects. I'm so sorry that it didn't work out for you.
There's also a tendency to over-apply new technology -- it's a very human response. The Gartner Group has a "Hype cycle" curve showing how new things (like generative AI) initially get overused, then there's a backlash, then they settle in somewhere in the middle where they're genuinely useful (but not the answer to everything). I'm sure that applies to new medical breakthroughs as well, though at least they tend to be tempered by formal studies and peer review.