Connect
Surgery? Radiation? Can I have an independent suggestion?
As a Canadian, I apologize in advance for my self-centered question. I have done all the preliminaries and now must make a choice. When asking urologists, they’d advocate for “cutting”. When talking to radiation oncologists, they’d say “radiate” - statistically, the odds are equal or better, and the side effects - well, perhaps, eventually, you might have to deal with those. Which leaves me, as someone reluctant to understand issues related to cancer that I never wanted to know, to make a decision.
In short, here are the parameters: over 4 months, PSA readings of 26, 21, and 25. Biopsy showed cancer in the left nodule, Gleason 3+4 in 5 out of 12 cores. Cribriform and suspected perineurial invasion. Bone scan and CT scan showed no metastasis. PET scan shows a significant uptake (3.7) in the prostate but also, no metastatic activity, except for a minuscule uptake in L4 lumber (but judged to be benign). That doesn’t eliminate microscopic events, I suppose. Also had a prior appetizer of a heart attack and had CABG (9 bypasses).
The question now: what would be an optional approach for me, specifically. ChatGPT says a short course of agonist/antagonist ADT, Brachytherapy, and EBRT. The urologist says “if you want it gone, call me”. The radiologist says “the isotopes are at your service”. How on earth can I make an informed decision that’s best for me if everyone advocates for what they do/know as the best approach?I suspect some answers might be - it depends what consequences you want to deal with - granted. But medically, what gives me the best chance to conquer this, well, shit?
Where would you take it?
Like
Helpful
HugInterested in more discussions like this? Go to the Prostate Cancer Support Group.
Connect
What did you select for treatment?
I went with beam radiation and 4 mos ADT , but after 3 months on ADT my Artera AI test suggested no ADT so I stopped a month later. Under Dr supervision
Everyone that did the radioactive seeds plus some radiation ( external) are really Cancer free . One friend had some incontinence but it was temporary and he is still alive and his cancer free did this treatment in 2013 for Darrell my friend so yeah you’re just getting started on. I’m probably PSA. My PSA is probably over 60 right now which I know some can go over 100 but you’re just getting started. Keep fighting ! trust God prayer a lot.
handscasteels Where and how did you get a PSA PET CT Scan with your Gleason Score ?
I find Urologists in Ontario very reluctant to request a PSA PET CT Scan unless it is advanced cancer .
In my case, I learned about my Gleason score 7 (3 + 4) after my urologist took 12 (or 14) specimens last Feb 14, at Mackenzie Health Richmond Hill, Ontario. He ordered a "Nuclear Medicine whole body bone scan + SPECT + CT X2 Panel" -- finding "No scintigraphic evidence of metastatic disease; Rule out metastatic disease from prostate." CT scan of my pelvis and abdomen will be on Feb 28. I sure hope for a similar finding of no metastatic disease. My urologist referred me to an oncologist at Sunnybrook Hospital -- a teaching (research) hospital affiliated with the University of Toronto. My initial consultation with Sunnybrook is tentatively set for March 6, but they will find an earlier date if possible and let me know. (As another poster indicated in this discussion thread, if a case is serious it will be seen sooner than usual.) I am 68, thinking of prostatectomy, but after reading the above posts, I am reconsidering if I should instead opt for SBRT. I will discuss with the oncologist.
@vircet If you consider SBRT 5 Treatments Mon - Wed - Fri and Mon - Wed the following week .
Inquire abouut Monotherapy SBRT - NO HORMONE ADT SHIT , The side effects are worse than the
cancer . Your quality of life would change immensely . I am G 3+4 = 7 and on active surveillance . I met
Dr. Bayley , Radiation Oncologist at Sunnybrook . Also an Oncologist & Urologist at Princess Margaret .
PLEASE KEEP ME POSTED ON YOUR SUNNYBROOK EXPERIENCE .
Apparently one has to "qualify" in Ontario. PSA has to be < 20, Gleason score is irrelevant. This tumor also has cribriform cells as well as perineural invasion. Hence was considered risky, and voilà, I qualified. There are only a few hospitals that offer this scan - if you're close to London, chose that one (London health Sciences).2week wait time vs. 4=6 weeks anywhere else,
@hanscasteels . Thanks for your response .
I was aware of the OHIP qualifications -- My issue is finding a Urologist to refer me for a "Private Pay Test " -- No success with four so far . One in St. Catharines & Three in Toronto which includes Princess Margaret Hospital and the Head of Urology at another major Toronto Hospital . There are several private clinics in Toronto , tthe cost is $ 5000.00 -- However they require a referral .
It typically is an oncologist that will refer you. Not a urologist.
hanscasteels The Private Clinics in Mississauga will accept a referral from a GP or a Oncologist -- It's all about money. My GP tells me to get a referral from my Oncologist ( passing the buck )