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Pre diagnosis function considerations
Prostate Cancer | Last Active: Mar 18 12:22pm | Replies (11)Comment receiving replies
@jeffmarc
I am 65 and a decent surgery candidate. My first thought was surgery but have had to postpone for work related issues. It has given me more time to explore other options. Some of the new tech in other treatments are quite attractive than that of surgery. I have checked with proton center and a cyberknife center. Proton would be a challenge even with arc method, The hips present issues with efficacy and predictability. Not what a person wants to hear involving radiation. Cyberknife say they "can " do it and have some experience dealing with these. I have some reservations making a challenging treatment even more challenging and possibly an increased chance of error. It seems from most of posts I have read on here that radiation tends to exacerbate whatever existing conditions in most cases. I have a Decipher test in the works. And I believe my Dr. would refer a pmsa pet scan if it would help with decision.
Replies to "@jeffmarc I am 65 and a decent surgery candidate. My first thought was surgery but have..."
@mtsenior You don't mention whether you've had an MRI. I believe MRI is generally regarded as superior to PSMA PET for detecting cancer within the prostate. My urologist used the MRI result to partially guide where to take biopsy cores. PET is the tool for detecting if the cancer has metastasized. I.e. Medicare approves MRI before biopsy, whereas PET is afterwards only if indicated.
When my PSA rose from around 3 to nearly 7 within a bit more than a year, my community urologist ordered an MRI. The result was "highly likely" that "clinically significant" cancer was present. This caused me to accept a biopsy. Since the MRI showed "seminal vesicles involved", the urologist, when he did the biopsy, took several cores from my seminal vesicles.
The seminal vesicle cores contained cancer. Because of this, my case was staged as cT3b, i.e. "high risk", meaning the docs will tend to throw everything in their toolbox at it. Without the seminal vesicle involvement, given the rest of the data available, i.e. PSA below 10 and nothing palpable on DRE, my case would have been staged as "intermediate", either favorable or unfavorable. The treatment proposals compared to "high risk", and the long term outcomes, are quite different.
All the tests leading to a diagnosis are not perfect, even though most people, docs included, use words when they talk about the results that seem definite.
Anyway, if you haven't had an MRI, ask your doc why not.
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@mtsenior
Get that pet scan. That can show if the problem is bigger than 3+4. If there happens to be metastasis outside the prostate, then they preferred to do radiation instead of surgery.
Cyberknife/SBRT is quite effective. I know a lot of people who have had it and have been clear for a long time. A low decipher score can really tell you a lot too. Makes radiation more likely to help long-term.
If you’re planning on getting surgery, make sure the doctor can spare the nerves, that way you can probably get an erection after.