Connect
Finally the journey begins for me....
Officially started treatment today after several months of 2nd & 3rd opinions, video consults with Dr Scholz, and endless hours of research. I just took the initial dose of 3 Orgovyx pills (4-6 month course). Will be traveling from NJ to CA (UCLA) in Sept to have Brachytherapy procedure with Dr Chang then have 5 SBRT sessions back at home. Here are my stats:
Age: 69, PSA 35, Gleason 4+3 Grade 3
MRI:
FINDINGS: PROSTATE GLAND: measures approximately 5 x 4.4 cm corresponding to a volume of 45 mL. PERIPHERAL ZONE: No evidence of prostatitis. CENTRAL GLAND: Moderate changes of BPH. Lesions 1 PI-RADS score: 5 Location: Right TZ Mid at 11 o'clock Max dimension: 3.66 cm (slice: 14) Volume: 9.492 ml Extraprostatic extension: - none
Extraprostatic Tumor Extension: Slight bulging of the prostatic capsule but no visible tumor extension beyond the capsule. Neurovascular Bundles: Normal. Seminal Vesicles: Normal. Urinary Bladder: Normal. Pelvic Lymphadenopathy: None. Pelvic Osseous structures: No suspicious osseous lesion identified.
TransperineaL Biopsy , 17 cores 14 cores benign, 3 cores from same area (transistion zone) (50-60% pattern 4)
(2nd opinion on slides reviewed by chief pathologist at Univ of Penn who concurred with original findings)
PSMA:
1. Marked PSMA-avid disease in the prostate consistent with biopsy-proven prostatic adenocarcinoma.
2. The minimally PSMA avid largely symmetric pelvic lymph nodes are favored to reflect reactive/inflammatory uptake. No suspicious PSMA avid lymph nodes identified.
3. No radiotracer avid distant metastases
Prostox text for SBRT late term toxicities: Low Risk
Thanks to everyone for the great information shared on this forum and sure I will be posting in the near future for support. Prayers for all!
Like
Helpful
HugInterested in more discussions like this? Go to the Prostate Cancer Support Group.
Connect
Good luck with your treatment, you got this!
-
Like -
Helpful -
Hug
2 Reactions🙏🏽
-
Like -
Helpful -
Hug
1 ReactionCopyman, check out the beaches https://www.instagram.com/reel/DWSVjobD-bX/ Best luck.
-
Like -
Helpful -
Hug
1 ReactionI wish more people would take your carefully considered approach. Unfortunately fear sometimes overrides patience and wisdom. Not everyone agrees with the best path forward but with prostate cancer, thorough research and multiple opinions are wise choices. Kudos!
-
Like -
Helpful -
Hug
5 ReactionsExtraprostatic Extension - none…
Extraprostatic Tumor Extension - …bulging, but no VISIBLE extension…
What the eye can’t see is a big problem - very wise choice in going with Orgovyx👍
Phil
You're not alone. We are with you. Good luck.
-
Like -
Helpful -
Hug
3 ReactionsHi,
Good luck……
Dave 3+4
-
Like -
Helpful -
Hug
3 ReactionsGood luck and stay positive. I was interested to see that your tumor was “bulging” against the capsule. My tumor abutted the capsule but no EPE. I’m starting Early salvage Radiation at the end of August but my RO is Not recommending ADT. I too am 69 and in pretty good health so I think I will have another discussion with him regarding the ADT. My Decipher score was also a .56 which in my opinion is close to a High Score. Good luck with your travels and your treatment. Sounds like you’ve done you homework and that you are getting care at excellent facilities, etc.
-
Like -
Helpful -
Hug
3 Reactions@zmarkv
If I was going to take my time to write something , it would be pretty much exactly what you said. Good luck to the original poster.
I wanted to add that this was perhaps the hardest decision I've ever had to make, and took several months to sort it out and get educated about PC. There are great hospitals here on the east coast like John Hopkins, Sloane Kettering, MD Anderson Camden NJ, to name a few who I could of treated with. The two COE's I consulted with near my home were Univ of Penn & Fox Chase, both great cancer centers. Penn offered me a trial of HDR Brachy, 5 sessions of proton & short course of ADT. Fox was same triple therapy but 23 sessions of IMRT first then the HDR brachy after with short course of ADT. I decided on Dr Chang because of his experience with Brachy plus his procedure doesn't require heavy general anesthesia with being intubated & on ventilator for 4 hours like Penn & Fox. Dr Chang does brachy procedure and rectal spacer in under an hour using Propranolol anesthesia. Plus he was highly recommend by Dr Scholz and all the positive things I've read from others who had treatment with him at UCLA. One problem I'm running into because I can't stay out in CA for 3+ weeks and have SBRT done there is finding an RO back at home to do the 5 SBRT sessions and take over my care. Penn will only do 25 proton sessions not the 5 SBRT if I have Chang do procedure. Penn said they only do the 5 SBRT as mono treatment unless you are in the trial. Asked Fox and waiting for a response but they will probably say no as well because these doctors ego's get in the way, thinking why don't I trust them to do the Brachy procedure. I told both RO's from Penn & Fox who have done many Brachy procedures that I trust their expertise to do the Brachy but it was the long anesthesia I didn't want. Hopefully Dr Chang can call an RO here on east coast on my behalf and setup the SBRT. It's different when a doctor asks another doctor. Plus most doctors know of Dr Chang. My family & friends think I'm crazy to go all the way out to CA when we have these great COE's close to home but this is what I feel comfortable with. Sorry for this long post.