1. < Prostate Cancer

PET/PSMA / Decipher test results back (0.69). Radiation/hormone now.

Posted by greg52 @greg52, Aug 23 8:26pm

Well. Was diagnosed with PC back in Oct of last year (53 year old).
My numbers are/were Gleason 7, Stage 2, PSA 8.8, so intermediate risk prostate cancer.
From posting here with my initial diagnosis of PC to now, after researching, weighing my treatment options, and just dealing with the other aspects of life, I finally decided on radiation rather than surgery. So had a PET/PSMA scan a few weeks ago and sample sent in for decipher test. I just got the results of a PSMA/PET scan and Decipher test. While the decipher test is not part of the normal process, I was hoping that results might show a less aggressive type of cancer that might possibly allow me to just have the radiation and forgo the hormone therapy. Unfortunately, even though the PET/PSMA did not show any spread outside the prostate, it is right up against the rectum, and apparently a decipher score of 0.69 is also considered high. So now I will need to start hormone therapy with radiation and possibly some additional drugs for treatment.
It seems that even though my docs advised that I could take my time making a decision on treatment ("Take weeks, months, but not years"), now, based on these latest test results, there seems to be more urgency for treatment. Can't believe it's been over 10 months since my initial diagnosis. Just hoping I didn't take too long to get all these additional tests and decide and put the success of my treatment at risk. I think just an inability to make a decision (surgery vs radiation) and life distracted me.
Interested what others might have to say. Just got off the phone with my doc so just processing the reality of starting treatment as soon as next week and the recent urgency that was conveyed from my oncologist to start treatment.

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

bolovino | @bolovino | Sep 12 1:34am
In reply to @jeffmarc "You are a Gleason six. You really don’t want to do anything now. You could have..." + (show)
@jeffmarc

You are a Gleason six. You really don’t want to do anything now. You could have them check your PSA every month, but that’s not normal with a Gleason six every three months is the standard, and if something comes up, it isn’t going to be horrible since you caught it early

Both radiation and surgery are worse than what you have now. If you don’t have hormone therapy after radiation, the cancer can come back sooner vs never. After surgery you usually can’t get an erection.

You need to find a user group where they discuss active surveillance. Some people stay on it for many many years without the cancer ever getting active. Check out Ancan.org for an active surveillance group that meets online. They’re not the only one there are others. Talking with other people and similar situations can relieve your anxiety.

Jump to this post

TY for your feedback...What is your situation...if I may ask???

REPLY
1 reply
jeffmarc | @jeffmarc | Sep 12 10:32am
In reply to @bolovino "TY for your feedback...What is your situation...if I may ask???" + (show)
@bolovino

TY for your feedback...What is your situation...if I may ask???

Jump to this post

I was diagnosed in 2010 Gleason 3+4. Had surgery and they found it to be a 4+3. 3 1/2 years later my PSA started rising, so I had radiation. 2 1/2 years later, I came back again and I started on Lupron. 2 1/2 years later, my PSA started rising, so I was put on Biclutamide. One year later, my PSA started rising and I was put on Zytiga. 2 1/2 years later after a third and serious Afib event my oncologist told me off of Zytiga and put me on Darolutamide. A few months later, I had my one metastasis zapped with SBRT and my PSA has stayrd below .1 for the last 10 months. Just a matter of time before Darolutamide fails and then I can start a PARP inhibitor since I found out I am BRCA2 two years ago and that’s why it keeps coming back.

Now on Orgovyx instead of Lupron, 7+ years with ADT which is so feared by many, not a real problem.

14.5 years now and I really have no side effects from all the drugs, other than some hot flashes and a little brain fog.

REPLY
VancouverIslandHiker | @vancouverislandhiker | Sep 13 11:01am
In reply to @greg52 "I actually was going to have the SpaceOAR procedure before my radiation. But after the PET/PSMA..." + (show)
@greg52

I actually was going to have the SpaceOAR procedure before my radiation. But after the PET/PSMA stating,

"There is relatively focal increased Pylarify activity within the left inferior, posterolateral prostate gland, best appreciated on PET images 43-46 (SUV 5.6). This focus is in close proximity to the left anterior rectal wall, with invasion into the rectum difficult to entirely exclude."

My doc recommended against the SpaceOAR. Even though it sounded like a good extra precaution to take, he did not seem concerned with me NOT having the SpaceOAR as this type of cancer has been successfully treated for years without SpaceOAR with minimal to no impact to rectum (apparently) so I'm trusting him on that. And the fact that it is so close to the rectum with spread to the rectum not completely ruled out by the PET scan.
As a 53 year old, surgery does seem to be the traditional recommended treatment. But based on my research, and the fact that I really connected with the Oncology doc, it seems that the main reason more younger PC patients opt for surgery is based on the potential side effects of radiation "down the road". But with the modern and more accurate radiation methods, it is less of a concern. And a lot of people just want the cancer out and would rather come in one day and have it removed than come in for consecutive days of radiation over several days/weeks because they can't. For me, being semi-retired and caring for my senior parents who live in my home, going in Mon through Fri for 5 1/2 weeks to get a 30min radiation treatment in the morning will have minimal impact on my life.

Jump to this post

I think your on the right course. You're being proactive- thats important . Both methods ( Surgery and Radiation) have similar outcomes from my study , depending on how you go into each setting . One point to ponder on surgery is that you get to do entire pathology on prostate - this is helpful to see exactly what the biology of the prostate is . However , you probably knew this. I had the surgery 3 years ago .... then radiation ( external beam ) 2 years ago at 0.14 PSA . My PSA was rising slowly , so had 22 sessions of radiation. PSA has since gone from 0.14 , then 0.072 , then 0.056 . Next PSA test tomorrow ....hence anxiety . You have this . you seem very well studied ! God Bless . Keep us informed of how your doing Sir . God Bless . James on Vancouver Island .

REPLY
View MoreView Less
Please sign in or register to post a reply.