PSA numbers: Questions about new treatments

Mercer WI

I just watched the Q and A on prostrate cancer from Mayo Clinic posted on Oct. 3. It has a lot of useful information about psa testing, biopsies, treatment options, side effects, and reoccurring cancer. I wish I had seen this video when I was diagnosed with cancer a year ago. I discovered that my local urologist didn't use the most current procedures in my diagnosis. It reinforced my decision to seek out a research hospital like Mayo to pursue my treatment. They followed some procedures in my diagnosis that my local doctor left out.
My Mayo radiation oncologist also used a treatment that included proton beam radiation with Antigen Deprivation Therapy that increased my survival chances by 20% over just radiation. By the way, you can go on the American Medical Association web site and register as a patient and access their reports on prostrate cancer. I used the site to verify my radiation oncologist's treatment choice. Unfortunately, the report indicates that many doctors don't use that treatment option for advanced forms of my cancer (Gleason score of 8+).
I think my anxiety level would've been a lot lower, if I had known that the medical staff were using the most recent knowledge to determine If I had cancer and it's extent. Also, what are the factors that determine the best treatment option.
The two main take aways I got from the Q and A were have an MRI before having a biopsy. It will not only tell if you have cancer, but also focus the biopsy. The second was the difference in the treatment based on age. My radiation treatment was appropriate for my age (73), but if I was younger, surgery would've been more appropriate.

Hope this is helpful.

I used Focal Laser Ablation see Dr Sperling - Sperling Prostate Center in Florida.

Thank you yes helpful

Hey @stoney, thanks for offering to be contacted directly. You'll notice that I removed your personal telephone number from the public discussion. We recommend sharing personal contact information by using the secure private message function. Learn how it works here https://connect.mayoclinic.org/get-started-on-connect/

Here's the link to the Video Q&A that Wayne refers to as well as 2 earlier Q&A sessions archived on Connect:

Video Q&A about Prostate Cancer with Dr. Erik Castle and Dr. Scott Cheney - Oct 3, 2019
https://connect.mayoclinic.org/webinar/video-qa-about-prostate-cancer-1/
Video Q&A about Prostate Cancer with Dr. Mitchell Humphreys - Sept 25, 2017
https://connect.mayoclinic.org/webinar/video-qa-about-prostate-cancer/
Video Q&A about Prostate Cancer with Dr. Erik Castle - Sept 28, 2016
https://connect.mayoclinic.org/webinar/on-facebook-live-urologist-erik-castle-m-d-talks-prostate-cancer/
Wayne, I like how you outlined your decision making criteria. It's not easy.

Thank you, Colleen. I was not aware the private message was an option. Awesome!

You may wish to look at focal laser ablation or hifu, or an alternative Rick Simpson Oil - Phoenix Tears

Hi semeon.........I sent a reply but it didn't appear to work right and don't think it went out. Pardon if this is a duplication. I've looked at the Sperling site and am in contact with Mayo but don't have any 1st hand knowledge yet. No one I have spoken to knows about the Laser Ablation and you are the 1st person I;ve seen to actually have the procedure. I missed 1 of the basic markers of their criteria so I'm not sure if they will take me. I have a Gleason 7 and Genomic text was above the median and marked as more aggressive. So have been considering Surgery but have a very short time (about 3 months) to figure out if the Laser Ablation is an option for me. You mentioned you had it done twice, and I'm curious if they didn't get it all the 1st time or you had some recurrence so they did it again. The good thing is the procedure can be done more than once. Also I would be happy to have the extra imaging done to actually see what is there which I believe is done for the Ablation. I've been told that if I do surgery or radiation they don't do extra imaging and only go by the biopsy itself. If you have anything you feel you can share, I'd love to hear..............Regards, Dave

Hi Dave, you are where I was a year ago. I was looking for the best treatment with the least amount of side effects. My Urologist gave me a book by Dr Patrick Walsh from John Hopkins that went through all of the treatment options. Walsh wasn't too keen on targeted Ablation because of the chance of missing cancer cells in the prostrate. He felt the Ablation of the entire prostrate had serious effects on the urethra and rectum. He was speaking from several years ago and the procedure may be better now.
I chose the proton beam therapy, because the men I talked to had few side effects, except irritation of the urethra during treatment. However, my Gleason score was 8, and
my radiation oncologist said by adding hormone therapy to the radiation increased my changes of survival by 20 per cent. I've talked to several men who had the proton beam therapy without hormone therapy and they resumed normal activity after treatment. There is a group that formed out of proton beam treatment at Loma Linda Med Center called the Brotherhood of the Balloon. They have a web site you can access for more information.
You actually have better diagnostics then I had and a radiation oncologist can tell you what would be your treatment option. You may have gone down this road already.
Hormone therapy shrinks the prostrate and can kill cancer cells that may have gotten in your blood stream. I just saw a study where they found cancer cells in blood of 30 of 37 men who had a prostatectomy. Their Gleason score was 8-10. My concern is killing all cells, even if I have to live with Lupron side effects for 18 months. I believe that up to 40 per cent of men treated can get recurrent cancer.
The good news is that surgery and radiation treatment result in same survival rates, so it does come down to what you are willing to live with that goes with the treatment. There's a book written by Robert Marckini, You Can Beat Prostrate Cancer, where he used a table of pros and cons for different types of treatments. It might help. His is a little old and may need
updating.
I wish you well. I know how hard this is.

Thanks for the different ideas! I haven't been real keen on radiation so far but there are a lot of guys who do opt for it. Have a friend who had surgery and a while later had some cancer in another area and he just did radiation and hormone therapy together and it worked great and he was surprised at how little side effects he had. Much less than expected. .........The book may need updating as procedures seem to be advancing rapidly these days. .........I've gone to a support group a few times and heard lots of stories but a lot of different approaches taken and people have different medical things going on so hard to pinpoint 1 thing or protocol to take. They have a different medical professional each meeting. After I told my story and about meeting with the different radiation and oncology people and then trying to make a decision about what protocol to follow, trying to decide about something I knew nothing about a few months before and still know very little, this Dr. was rather taken aback that such an important decision isn't helped along more by group interaction with all the medical professionals involved. Basically that we have to troll around and find out whatever we can and then make the decision ourselves when we barely know what is going on.............