What is treatment for Gleason Score 8 at 80 years old in good health?

@jeffmarc

I still do not understand. If a 3-month Lupron shot is actually effective for at least 6-months, why do they give you a 3-month shot every 3 months? The goal is very low testosterone and the 3-month shot does this for 6 or more months. This does not look like rocket science.

@pesquallie
The three months shot completely leaves your body within a few days of three months. The half-life of Lupron is 3 hours, so it is quickly out of your body.

If you are referring to the fact that your testosterone doesn’t come back right away that is accurate but as the stampede trial showed having testosterone over 50 is a problem. For most people, it won’t come back that quick, But you never know.

People who have aggressive prostate cancer need to keep their testosterone quite low all the time, Or at least until they become castrate resistant, and in that case, maybe a high dose of testosterone actually might help.

I keep a record of every single PSA blood test. I had my 6 month Lupron shot late by three weeks one time. Instead Of my PSA being undetectable this was the reading after I was three weeks late

PSA 0.6 11-14-17 lupron shot late

The next month, my PSA went back down to undetectable. So yes, not getting the shot on time can make a major difference in your PSA.

@jeffmarc

Based on what you said, the Lupron must be keeping the PSA numbers low and not the low testosterone level it creates. Your PSA level rose when Lupron was late, but testosterone was still low.

The only radiation I would consider is Proton Beam therapy. We don't know what your urinary continence is like as an 80 year old, but my RO told me that if/when I need radiation therapy, it would be a nearly 100% probability of lifelong urinary incontinence after radiation. I am now 10.5 months post-RP, and STILL have little dribbles and accidents. I wear a thin "Shield", and while I am now 95% continent and in control, I just can't make it to 100% yet. There is no way that "I" would personally tolerate lifelong incontinence after traditional radiation therapy, as well the the (low 1-5%) chance of cancer to follow in the years after (bladder/urethral and rectal). That is what got me researching, and Proto Beam therapy was the clear winner. The problem with traditional radiation is that while it irradiates the prostate "bed", that radiation is uncontrollable...it passes through the prostate bed and radiates other healthy tissue causing problems. But...Proton Beam therapy focuses the beam to the prostate bed, but that form of radiation does not pass through to other health tissue. So, you have far fewer side effects, if any. I too would stay away from hormones. I already feel like a girl since I have no had one erection since my surgery, so why allow your hormonal balance to be played with, and see you take on the emotional feelings of a girl?
Good luck

The only radiation I would consider is Proton Beam therapy. We don't know what your urinary continence is like as an 80 year old, but my RO told me that if/when I need radiation therapy, it would be a nearly 100% probability of lifelong urinary incontinence after radiation. I am now 10.5 months post-RP, and STILL have little dribbles and accidents. I wear a thin "Shield", and while I am now 95% continent and in control, I just can't make it to 100% yet. There is no way that "I" would personally tolerate lifelong incontinence after traditional radiation therapy, as well the the (low 1-5%) chance of cancer to follow in the years after (bladder/urethral and rectal). That is what got me researching, and Proto Beam therapy was the clear winner. The problem with traditional radiation is that while it irradiates the prostate "bed", that radiation is uncontrollable...it passes through the prostate bed and radiates other healthy tissue causing problems. But...Proton Beam therapy focuses the beam to the prostate bed, but that form of radiation does not pass through to other health tissue. So, you have far fewer side effects, if any. I too would stay away from hormones. I already feel like a girl since I have no had one erection since my surgery, so why allow your hormonal balance to be played with, and see you take on the emotional feelings of a girl?
Good luck

I forgot to comment on radiation issues. Others have given you some really great ideas. Proton radiation would be useful, The photon radiation is pretty close in side effects and also works well.

My brother at 77 had SBRT radiation and at 80 is doing quite well. That is the preferred technique for somebody your age. Either SBRT or IMRT radiation can take care of the problem. Either of those usually causes some urinary issues, but they can be resolved with Flomax for most people.

Jeffmarc did have stage 4 mestatic PC when you was first diagnosed; I forgot what you told me.

What type of radiation and hormone therapy would you suggest for a 80 year with a Gleason Score 8 contained to prostrate, particularly the hormone blockade, since that can potentially be devastating both physically and emotionally.

@rlpostrp I don’t know why your RO would make a statement like that, unless your PROSTOX test came back high risk. Then it ‘might’ have an advantage.
If it didn’t, he’s probably pushing Proton therapy for the hospital system he works for. Those machines are very, very expensive and after they are advocated and lobbied for by either the head of radiology, a board trustee or some other muckety-muck, you had better use it a lot!
Not saying there’s anything wrong with it, but its vast superiority to photon radiation seems a bit overblown.
Did you ever read anything positive about photonic radiation in an article advocating/describing proton beam?
They make photonic radiation seem medieval compared to space age photons; meanwhile photonic radiation has evolved tremendously and it is a far cry from the treatments of yesteryear. If you do a search for side effects of proton beam radiation, you will find the same SE’s listed as for photonic. Best,
Phil
Phil

@heavyphil All I needed to read is that traditional radiation therapy not only targets the tissue intended, but the nature of that form of radiation is that it travels right through the target-tissue, and irradiates surrounding healthy tissue that does not need to be irradiated. It can cause damage to the bladder, urethra, and rectum, plus lymph nodes depending on where the radiation was focused.
That does NOT happen with Proton Beam therapy. The "radiation" goes "to", but not "through" the target-tissue. Your bladder, urethra, rectum, and other surrounding tissue are not at risk of being irradiated. And...in my initial consultation with an RO, he flat out said that the unfortunate consequence of traditional radiation therapy, is that nearly 100% of men will have urinary incontinence for the rest of their life due to damage and scarring, again, because they can't really control the radiation from irradiating the bladder, urethra, and rectum. And, while low, there is a 1-5% chance of bladder, urethral, or rectal cancer a few to many years later. That's all I needed to know. I will never have traditional radiation therapy, if in fact I need it if/when I experience BCR and enough prostate tissue growth that indicates one or more targeted areas of growth recurrence.