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ADT, Brachytherapy, IMRT...done!

Posted by callibaetis @callibaetis, Feb 10, 2025

Just thought I'd share. Started this journey in spring 2024. Gleason 4+3. Decipher 0.78. PSMA scan negative outside of the prostate lesion. PSA 13.4 when I started Orgovyx in early August. Testosterone 582. LDR brachytherapy in early October followed by twenty-five sessions of IMRT (completed in early December). Finished six months of Orgovyx last Thursday.

So, blood panel today. Testosterone up to 5 (wow, it more than doubled, last November, and I presume last Thursday, it was less than 2.5 😁). PSA 0.06. The rest of the blood panel was good, lymphocytes excepted (which is normal post radiation). Will recheck in one month, then every three months thereafter for two years.

Now it's a matter of watching, waiting, hoping and living.

And I forgot....shoveling snow.

All the best to all!

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capatov | @capatov | Apr 28 8:55am
In reply to @johnsonjn "@capatov thanks for the post - how old are you? At 58 almost all urologist suggest..." + (show)
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@capatov thanks for the post - how old are you?
At 58 almost all urologist suggest surgery - Rad Oncologists say IMRT w/ or w/o ADT and i should be good.

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@johnsonjn I was 66 when I was diagnosed and treated

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callibaetis | @callibaetis | Apr 28 9:14am
In reply to @johnsonjn "@callibaetis I am starting my journey and just found your post. My case - Recent PET/PSMA..." + (show)
Profile picture for johnsonjn @johnsonjn

@callibaetis I am starting my journey and just found your post.
My case - Recent PET/PSMA is clear, Current PSA 5.8, Clinical Stage - T2a , Gleason 7 (3+4), Decipher Score .9 (high risk)
I am considering IMRT/VMAT with ADT and I would love to know how your doing now after this many months?

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@johnsonjn

Doing pretty well I suppose. My most recent PSA in early March was 0.15, so that continues a downward trend. Testosterone was 319.

Had a Dexa Scan in late December which showed me to be osteoporotic. Unfortunately, I didn't have a scan prior to initiating treatment, and therefore, have no baseline for comparison. I'd have to recommend that anyone starting this journey, especially if it involves ADT, get a baseline Dexa or REMS scan. In addition, where ADT is on the table, perhaps consider the estrogen patch as an alternative? The present plan for me is to do a repeat scan in a year or so and go on from there.

I've upped my calcium intake via some variable daily combination of calcium citrate w/D and milk/cheese/yogurt. I'm aware of the dairy thing with prostate cancer. I'm not going to agonize over it though.

All in all, I feel pretty good. I'm fairly active, but it varies seasonally and with the weather. I prefer to do things outdoors, and....hike in the mountains as much as possible. I weight train too, but don't go overboard. My joints and body aches dictate what and how much I do.

I still believe that I made the best choice in selecting a treatment based on my interpretation of my situation. Best of luck in making a treatment decision.

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