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Not Good News after prostate biospy when MRI didn't look too bad
Prostate Cancer | Last Active: 20 hours ago | Replies (290)Comment receiving replies
That is what is strange, the RO was going to use ADT, I am not a doctor, but would consider ADT hormone therapy. I guess she meant cancer spread AND on hormone therapy? Notes from the actual RO doctor below:
I would still recommend hormonal therapy if you choose to undergo radiation therapy. I don't anticipate that the ADT will worsen your PVCs. We could always do the pill form of ADT, relugolix, rather than the injection (lupron) if you are concerned about your heart as it on studies has a better cardiac profile.
Logistics of treatment for radiation and ADT would be to initiate relugolix, approximately 1-2 months after starting relugolix we would place the markers and the gel and start with radiation therapy a few weeks after this for 28 once daily treatments, approximately 5.5 weeks. You would continue with relugolix after completion of the radiation therapy and then complete the remaining amount of relugolix for a total of 6 months.
Radiation bowel urgency, if it occurs, typically would happen toward the end of radiation and last for up to several weeks. This gets better with time. It is not typical for bowel urgency to become a chronic issue after radiation.
Blood in the urine or stools is possible 1-2 years out from radiation therapy. This is a long term side effect caused by development of telangiectasias (small, more fragile blood vessels) which do not occur until a year after radiation therapy. The bleeding occurs in approximately 2-10% of men. Typically, the bleeding is self limited and resolves.
From what I can tell Jeff, it looks like you and Phil had RP first? Surf, I am not sure what I think your spouse did first?
I am still leaning toward surgery, if I do have long bad incontinence there is always something called urethral bulking or mesh sling that might help. Seems they could spare nerves on right side as those 3 prostate lobes were benign (shows that in my first post). MRI showed Prostatic capsule: Intact, Neurovascular bundles: Not involved, Seminal vesicles: Not involved, Lymph nodes: No lymphadenopathy, Bones: No acute osseous abnormality. Still I guess they worry about microscopic issues that MRI wouldn't get.
Thanks for all your suggestions and responses, I know I ramble on and don't type that well. Hopefull, makes some sense.
Replies to "That is what is strange, the RO was going to use ADT, I am not a..."
My husband had radical prostatectomy.
You are not "rambling"- It is all very overwhelming, especially at the begging : (((. So much to learn and digest and all of that combined with feeling of utter panic and fear and feeling of helplessness, especially when scheduling becomes a problem and one feels like a "hot potato" tossed around. Just keep in mind that whatever you choose is a good choice in regard of attacking and possibly eradicating cancer. Studies sometimes show RP is doing a better job , some studies show RT does a better job - but they ALL do a pretty good job in controlling this obnoxious disease. At the end it all comes to one's personal choice and to what is making one feel more comfortable doing.
My husband had consultation with surgeon and with radiation specialist since his doctor insisted on that , but from the beginning he was more comfortable with surgery idea. Some people are more comfortable with RT idea and they try to avoid surgery any way possible, and that is absolutely OK !
The only mistake one can make is of NOT doing anything. All other options are good and have great potential to be very successful.
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@diverjer
Yes, I started off with surgery and 3 1/2 years later it came back and I had radiation for about eight weeks.
Your doctor wants to put you on hormone therapy if you’re having radiation. You might contact Dr. Parikh’s Office and tell them that, Also, the fact that you’ve got large cribriform, Which implies you may have a reoccurrence no matter what’s done.
You can Avoid the bowel problems by getting a barrier put in something like SpaceOAR, Barrigel, or BioProtect. Those can protect the rectum from damage during radiation.
While surgery sounds like it can do a complete job people do have problems with incontinence after. You really should be prepared for that and be doing Keagle’s ahead of surgery and plan on having physical therapy sessions with a pelvic floor specialist after. I got over surgery very quickly as did @surftohealth88 Husband. I was back at work full time seven days after surgery. The day after surgery, you usually only need Tylenol for pain and the scars heal very quickly, And disappear. ED After surgery, Even if they can spare the nerves, Can take months to a year or two get the erection back. There are some really good solutions if it doesn’t work.
If you have surgery and the urinary blockage is in the prostate, then that problem will go away. Yes, the sling is a possibility but if you need to have radiation after surgery, the sling will not work for you in the long run. You can get an AUS if you end up having to need radiation. If you don’t ever need radiation, the ProACT device probably is better than the sling. I don’t think there’s any guarantees you will not need radiation in the future if you have surgery.