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← Return to Gleason 7 (4+3), ECE, PSA 3 – Considering IMRT + ADT vs. Surgery –
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Gleason 7 (4+3), ECE, PSA 3 – Considering IMRT + ADT vs. Surgery –
Prostate Cancer | Last Active: Jul 31 1:03pm | Replies (13)Comment receiving replies
Honestly one of my major concerns is doing the Robotic Assisted RP and either immediately or later on having to do salvage radiation + hormonal therapy. My pathology report did mention that the Cribriform pattern was present which from everything I can find is NOT a good thing. This makes me think that recurrence is probably likely. The Radiation Oncologist didn't seem particularly concerned with the Cribriform pattern being present.
My father had prostate cancer in the 1980-1981 time frame unfortunately I don't know any specifics concerning type or treatment other than he had surgery. He never had any further incidence involving prostate cancer for the remainder of his life (he was ~60 at the time of surgery). The Radiation Oncologist does want to do genetic testing my Surgeon/Urologist didn't mention any plans for the additional testing.
Thanks so much for the good news concerning Orgovyx/relugolix as this is what my Urologist plans for the ADT Treatment, that certainly helps to minimize my strong concerns regarding that leg of the treatment. My Radiation Oncologist told me that IMRT is essentially on-par with Proton treatment; however, it's difficult to evaluate this statement since the available data for Proton treatment is small as compared to RT. I travel to Emory in Atlanta next week to get an additional opinion. I'm truly 50/50 on this but the worst case in my mind would be to have to go through RP, Radiation and ADT all.
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Was your cribriform over .25 mm? That makes it much more aggressive. Surgery is usually the best thing with Cribriform. SBRT (cyberknife) is not sufficient. Brachytherapy may be necessary to completely remove it.
IMRT can get it but again Brachytherapy may be necessary. IMRT cannot get the narrow beam like proton.
If you watch the 2023 PCRI Video and see Dr. Carl Rossi talking about radiation you find some interesting things. For one he’s been doing Proton radiation treatments since 1994 when they built a building for the machine in San Diego. The first patient was the person that invented it, He lived to over 100. He has done Proton radiation on over 13,000 prostate cancer patients.
That video link is
Proton therapy definitely causes less secondary cancers than other radiation therapies. They prefer to use it in children to avoid secondary cancer risk over their lifetime. Proton therapy machines have been extremely expensive to build or treat patients, which is why it is so much more expensive and less used. They have finally been able to get a proton machine built in one and two rooms, which will greatly reduce the expense. Eventually, it seems proton, will probably be equal in priced to other techniques and will be used much more often.