Prostate cancer T3b

Posted by leighnewman46 @leighnewman46, 3 days ago

Hi my prostate cancer T3b diagnosed to have radiation. Has anyone else been through this treatment and what was the outcome

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@heavyphil

That’s so unfortunate that your options are so limited - I mistakenly thought that Australia would be brimming with specialists. Do they practice socialized or government sponsored health care? If so there are always private doctors who cater to those who desire a higher standard of care - or at least a more attentive care provider.
I don’t know your financial situation so I can’t really give you a direction on this. I just know that sometimes paying out of pocket gets you a lot closer to what you need. Best of luck to you.
Phil

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Hi mate.

It took 4mths to get into this specialist. We live on an island called Tasmania. 550k ppl.

At the moment I'm considering my options. Can I afford to go to somewhere like Germany like a family member did who lives in Holland. Or just go to the mainland of Australia.
Next I'll be getting my results from the specialist here and sending for an second opinion

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@heavyphil

Cannot agree more emphatically with what jeffmarc has advised. Nowhere in your posts do you mention any kind of surgical consultation - you only question if it can be done afterwards.
You need to have all that info Jeff mentioned and THEN you have to sit down with a highly experienced surgeon and get the pros and cons.
I would also recommend a radiation consult from a DIFFERENT RO. The 3 week span seems odd- unless it is high intensity brachytherapy (seeds) followed by 5 sessions of SBRT; that could take a total of three weeks when weekends are factored in.
In any case, do NOT rush into anything….educate yourself, ask questions, come to this forum as well, and only then can your decision be made. Do not let any one DR. Tell you what to do, since most of the time they will steer you in the direction of their own specialty.

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Still learning I could be wrong about the 3 weeks

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@leighnewman46

I am learning.
I'll try to find out the Gleason score.
I had a biopsy that I think gave me the T3b outcome.
I'm considering traveling overseas as the medical industry here seems swamped.

I am getting a lot of good advice here. It is starting to confirm my wondering if surgery is the best option for me.
Im also think if I stay in Tasmania I may not be able to find another specialist.

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If your insurance allows it, you can come to North America. Both USA and Canada have excellent prostate doctors.

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@leighnewman46

I am learning.
I'll try to find out the Gleason score.
I had a biopsy that I think gave me the T3b outcome.
I'm considering traveling overseas as the medical industry here seems swamped.

I am getting a lot of good advice here. It is starting to confirm my wondering if surgery is the best option for me.
Im also think if I stay in Tasmania I may not be able to find another specialist.

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There are a lot of prostate cancer specialist in Australia. I’m not sure where they’re located but they have given talks at webinars and were very involved in getting Pluvicto approved. It is one place where you can get it a second set of 6 sessions without a problem.

Check the University of Auckland, One of the speakers, about DNA related issues, was a teacher there (Prof. Richard Mithen).. They may have a prostate cancer support team, or maybe they can give you more info about who to contact.

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@leighnewman46

Hi mate.

It took 4mths to get into this specialist. We live on an island called Tasmania. 550k ppl.

At the moment I'm considering my options. Can I afford to go to somewhere like Germany like a family member did who lives in Holland. Or just go to the mainland of Australia.
Next I'll be getting my results from the specialist here and sending for an second opinion

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Yes, PLEASE! go to the mainland. I looked on a map - since my geographical knowledge of your part of the world is limited - and you are VERY close to the mainland.
The specialists in Tasmania are probably few and overwhelmed and your treatment will be “expedited” - the quickest solution to get you in line and out the door to make room for the next patient.
Be your own best friend, get on a ferry or plane and go to a metro hub and at least get a consultation. If they agree with your doctor in Tasmania that his treatment plan is best for your situation, then you can do it in Tasmania if that works better for you.
This forum is filled with individuals who traveled many miles to get better care - and better lives - in the process!

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@heavyphil

Yes, PLEASE! go to the mainland. I looked on a map - since my geographical knowledge of your part of the world is limited - and you are VERY close to the mainland.
The specialists in Tasmania are probably few and overwhelmed and your treatment will be “expedited” - the quickest solution to get you in line and out the door to make room for the next patient.
Be your own best friend, get on a ferry or plane and go to a metro hub and at least get a consultation. If they agree with your doctor in Tasmania that his treatment plan is best for your situation, then you can do it in Tasmania if that works better for you.
This forum is filled with individuals who traveled many miles to get better care - and better lives - in the process!

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I'll second that. Before I had cancer myself, I spent years as a volunteer pilot with Hope Air, flying mainly cancer patients from remote communities to big cities like Toronto, Ottawa, and Montreal for treatment.

In Canada and the U.S., there's a huge healthcare gulf between rural areas and small towns/cities on the one hand, and big cities with teaching/research hospitals on the other — it can quite literally be a question of life or death in some cases.

I suspect the same applies in Oz, so it would be well worth getting at least one consultation in a major Cancer Centre somewhere like Sydney or Melbourne if you're physically and financially able to make the trip. As @heavyphil wrote, even if that just confirms the diagnosis and treatment plan you got in Tasmania, at least you'll know you did due diligence.

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@leighnewman46

Hi mate.

It took 4mths to get into this specialist. We live on an island called Tasmania. 550k ppl.

At the moment I'm considering my options. Can I afford to go to somewhere like Germany like a family member did who lives in Holland. Or just go to the mainland of Australia.
Next I'll be getting my results from the specialist here and sending for an second opinion

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Don't forget that there are MANY doctors around the globe that will consult with you over video conference (i.e., Telehealth) to provide their advice. Of course it will come with a fee, but you can almost literally see any specialist in the world if you choose to do so. Make some calls to prominent hospitals and they'll let you know how to set this up.

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@heavyphil

Yes, PLEASE! go to the mainland. I looked on a map - since my geographical knowledge of your part of the world is limited - and you are VERY close to the mainland.
The specialists in Tasmania are probably few and overwhelmed and your treatment will be “expedited” - the quickest solution to get you in line and out the door to make room for the next patient.
Be your own best friend, get on a ferry or plane and go to a metro hub and at least get a consultation. If they agree with your doctor in Tasmania that his treatment plan is best for your situation, then you can do it in Tasmania if that works better for you.
This forum is filled with individuals who traveled many miles to get better care - and better lives - in the process!

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Very excellent advice. I'll look into who will see me in. Melbourne our second largest city. I also plan to ask some advice from an old family doctor who is now retired.

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I was in a similar situation, living in the Yucatan peninsula of Mexico. I had the same stage as you and was Gleason 8. I went to Mexico City and consulted a very reputable surgeon at a top notch hospital. He’s a surgeon so he recommended surgery. I had a PSMA scan that showed seminal vesticle invasion, but the surgeon convinced me he had a good chance of getting it all. Well he didn’t. So I ended up traveling to Houston and received IMRT radiation at the Dan Duncan cancer center. So far so good. The advice i would give is seek out a facility with latest generation radiation equipment and a great Radiation Oncologist. I believe that a well planned treatment delivered by newest generation equipment can give you the best results with the least collateral damage/side effects. I have seen many studies where Australian doctors and facilities were involved. I’m confident there are some good options there for your treatment.

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@leighnewman46

Very excellent advice. I'll look into who will see me in. Melbourne our second largest city. I also plan to ask some advice from an old family doctor who is now retired.

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Wonderful country Australia! I used to travel there so many times a year, I felt more comfortable in Circular Quay than here at home in Palo Alto...albeit, I never had the good fortune to make it to Tasmania.

You found your way here, so you clearly know how to leverage internet resources. I'll add a few points to what you've already heard from our 'brotherhood',..eh mate.

- My cancer diagnosis was roughly similar to yours, noting they are all unique. I ended up doing a tri-modal: 4 months ADT/Orgovyx; 2x Cyberknife boost (UCSF); 24x IMRT (Stanford).
- There are a number of diagnostic tools that you want to take into account, some are widely used and others not, including, but not limited to: PSA test; MRI with Contrast; Biopsy (transperineal or transrectal); PSMA PET Scan; Decipher Grid etc.
- Once you have all this data you can get several second opinions. Stanford and UCSF are top rated institutions and Mayo is rated somewhat higher. I considered Mayo, but, the decision, for me, was also a function of which Dr. you can get and the Mayo Dr. I wanted had left to lead a new facility in the Middle East. The local guys I was referred to are also world famous and I have a high level of trust in them. You can research all the Australian Drs. and institutions to determine who you want to work with.
- Since you are already heading down the radiation path, there are a number of choices that you will encounter including: Photon vs. Proton; Cyberknife and other SBRT; IMRT, and the list goes on and on...
- Like you, I have a 'family friend' who is a retired urologist. His advice was crucial in evaluating options. ALL of the institutions stick to a protocol and will suggest mostly similar treatments plans. e.g. if you are going to Mayo, they'll offer proton radiation (they paid $150M for the technology and need to use it). My friend was able to speak to all the treatments and to the individual Drs, many of them he knew personally, completely off the record.
- In conclusion, I expect the right choice for you is a short trip from Hobart, but, only you can make that call. Best wishes, lots of things I miss from Australia, like a draught Red Back in Fremantle.

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