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81 with localized grade 3: I want quality over quantity. Thoughts?
Prostate Cancer | Last Active: 6 days ago | Replies (22)Comment receiving replies
@climateguy Can't tell you home much I appreciate your response.
I'm 81. Reasonably healthy. Never been a patient in a hospital & active. I'm weighing the possibility of the various available treatments to my life expectancy. Given the fact that I feel perfectly fine now & might have 10 years left, how much time should I spend letting the treatments making me feel awful either temporarily or permanently. If they cure the cancer, but the patient wishes he were dead, what has been accomplished. I am fortunate that I am 10 minutes from MD Anderson Hospital. I haven't made up my mind what to do yet, but you taking the time to describe your experience is very helpful. Thanks
Replies to "@climateguy Can't tell you home much I appreciate your response. I'm 81. Reasonably healthy. Never been..."
@nemco1 You could consider definitive therapy but no ADT.
If you are T3a or less, take a look at the TRIP study. For patients with localized PCa of any risk group as long as there was no proof the cancer was outside the prostate, if they had external beam plus brachy boost, there was no difference in any measurable outcome between the group who had 30 months of ADT and the group who had 6 months. Dr. John Sylvester, who is one of the most experienced brachy docs in the US, tried to run a study comparing 6 months of ADT with no ADT for patients treated like this but couldn't get patients to enroll - patients didn't want to be randomized to ADT or not as they were either willing to take or they weren't. He wonders if any ADT is useful in patients treated like those in TRIP.
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@nemco1
People with prostate cancer seldom feel anything. It can, however, get into the bones and cause pain in a fairly rapid sequence.
You do have a low Gleason score so it’s not real aggressive, That’s why I mentioned focal therapy. Just letting it go, may not be the best solution.
My brother at 77 had SBRT radiation. Only side effect was a little bit of urinary problems, which are resolved by taking Flowmax every other day. If you can get a spacer put in and have that radiation it can give you long-term remission. My brother is now 80 and has no side effects at all.