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Gleason7(3+4) - treatment options recommendation

Prostate Cancer | Last Active: Oct 7 1:02pm | Replies (237)

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@robertmizek

Respectfully, let me clarify:

For the record, I confused Nanoknife (which uses electroporation to kill cancer cells using electricity) with Cycberknife which, according to their website delivers, targeted highly focused radiation. As I understand it both can be used for focal treatment of prostate cancer.

When radiation is used as the primary treatment for PCa the PSA drops until it hits its lowest post, referred in clinical terms as a nadir. It is not uncommon for the PSA to rise temporarily 18-24 after treatment. This is called a “bounce”. If treatment is successful the PSA hits a new nadir. Many professionals in the medical community consider that treatment has failed if PSA rises 2 points above the nadir or on consecutive tests.

Speaking not as a doctor but as an engineer that worked on medical devices I see potential for cure in some prostate cancer patients. I considered it in 2020 when I was originally diagnosed and my insurance wouldn’t cover the procedure. As with any other treatment, careful monitoring of PSA post treatment is critical to detect Biochemical Recurrence before it becomes a serious issue.

I received focal treatment in the form of low dose brachytherapy. My peak PSA was about 7.0 prior to treatment. I was sold on the premise that I’d be cured without risking incontinance or ED. The doctor had no established post treatment guidelines for PSA levels. As a result I was blindsided when after a steady then rapid rise is PSA I was diagnosed with Stage 4 Gleason 9 PCa. I hope that patients receiving treatment with Nanoknife have a care team that avoids the same as I had.

Here’s a link to reasonably recent published study on Nanoknife: https://www.mdpi.com/2072-6694/16/12/2178

Good luck to you on your journey.

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Replies to "Respectfully, let me clarify: For the record, I confused Nanoknife (which uses electroporation to kill cancer..."

Thank you — that's how I read your original post, even if some of the terminology might have been unfamiliar.

If I understand correctly, you had very focussed radiation treatment to your prostate on the promise it would prevent most side-effects, it didn't catch all the cancer, the doctors misinterpreted the PSA rise afterwards, and now it has metastasised (stage 4).

I'm so sorry for your experience. It's great that there are excellent treatments to control our advanced prostate cancer now and possibly even let us live out our full lives, but it's still not somewhere anyone wants to end up.

Thanks . Now I totally understand your situation . I am also an engineer Mechanical & Aeronautical . I agree that post procedure monitoring with frequent PSA ( every 3 months at first ) followed by an MRI at no later than 12 - 14 months to determine if there are any concerning changes . I have my MRI , with & without contrast for improved quality , on the 3T machine not the older 1.5 model .
Keep well .

But brachytherapy is not new, right? Been around for decades and pretty successful for a time until Cyberknife snd Robotics came to the fore. My RO’s even discussed it with me as a first line treatment 5 yrs ago since it had made a comeback with some new isotope or something.
So was the ‘low dose’ the new fangled part of the equation? That could certainly be responsible for the seeds not being strong enough to kill all the cancer. Sorry you went thru all that for nothing, but monitoring saved the day as it does with us all…