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@hibernianstpat
You are going to get a lot of options on treatments. If you do not then seek a different opinion. I had same Gleason Score and surgery was discussed but not proposed, photon radiation with hormone treatment, then proton treatment with no hormone.
I don't want to imply your score of 7 from a 3+4 is anything to not be concerned with but you will probably here form your doctors a lot of treatment options at that Gleason score.
I did not have surgery and did not want surgery. I was advised of surgery but since I have heart failure and have a ICD/Pacemaker it was per my R/O and urologist not something they wanted to recommend with my Gleason Score.
Here are some suggestion based on my experience with this. A urologist is most like pro surgery. Ask to be brief on the pros and cons of all treatments for you specifically, surgery, photon radiation, proton radiation, hormone treatments. Then do your own research.
Again from my experience my Mayo R/O were good and recommended additional test beyond my Gleason Score. I had a Decipher test which came back low risk versus intermediate risk I was given after biopsies. This changed my treatment plan from radiation with hormone to radiation only.
Asked for a Decipher test, PSMA, bone scan or at least discuss them with your urologist. I think most of us based on our experience would suggest like we did to get second opinions.
I can only pass on (I was 76 when diagnosed with cancer) what my experience was but making sure you get in depth briefing on all options for treatments, do your own research. and consider doing a second opinion. You are at the start of your journey with prostate cancer and you are going to have many many more questions. Just remember it is your cancer, your body, your mental health, your medical history so it should be specific of what is best for you not what others did.
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Your situation is very similar to mine, right down to the low risk DECIPHER ue and no ADT, except my Gleason was 9, and no heart issue. I had proton radiation, based on its lower side effect profile than photon (X-rays).
No ADT was a choice - it was part of a clinical trial protocol if I wanted to join, or otherwise I would have it. I spent a lot of time and research before deciding against ADT. My Mayo PCP strongly agreed, BTW. But that issue is complex, and the clinical trial is to find out if, for high risk PC (Gleason 8+), risk stratification could advise amount and type of ADT, including none for the lowest risk group. So my decision is personal, and not a recommendation either way.
I also consulted with both Mayo radiation oncologist (Mayo R/O) and also a Mayo urologist who would do the surgery if we decided to do so. He was unequivocal: I was not a good candidate for surgery and shouldn't want it, so I went with radiation.
A comment on that from a *non expert* (me): surgery fixes things quickly, but with certain near term morbidity (or even, unlikely, death), and the risk of permanent side effects, depending on one's condition and luck. After surgery, if the cancer was confined to the prostate, it's gone (barring undetectable metastases).
Radiation takes some time, tests and one surgery for preparation (at least it does for proton, not sure how much for photon), and then 5-28 days of painless treatment. I had 28 days - usually 40 minutes from arrival to departure, with parking reserved for radiation oncology patients being treated - Mayo Phoenix. The one surgery was under anesthesia and painless - they use needles in two spots to implant x-ray bright markers in the prostate, and a radiation shield material under the prostate. I think mine took 45 minutes total.
But, the cancer takes some time to die after the radiation, and the prostate likely has cells dying for awhile. I don't know the details on all that, but PSA is not going to drop to extremely low for a long time if ever, even with successful results. The PSA trajectory is a complex topic that I don't fully understand - I'll know more in a month after my first post-treatment PSA test and R/O consult.
Radiation can have side effects, some lasting a few weeks after the radiation, some can be permanent. Common are fatigue towards the end of the treatment, and a few weeks afterwards, and bladder irritation causing urgency. Others are possible - again, I'm no expert. I still have bladder irritation and some infrequent but embarrassing incontinence. A friend who had the same diagnosis and treatment did not experience that AFAIK.
So I recommend consulting both specialties, doing your own research if you feel like it. I did, plus spoke with a number of friends in my age group who had had either surgery or radiation, with and without recurrences.
Hope this helps.