4 + 3 = 7: Should I involve a prostate cancer specialist?

Since you are close to Minn., I would tell you to get yourself to Mayo. I had a SBRT Proton treatment of 5 times over the course of 10 days. Visit with both surgeries and radiation Oncologists departments to get your options listed. I chose radiation because as someone else put it, I don't want to be dependant on Depends. Best of luck and again, go to Mayo!

mikewo-will be interested in what your doc says...I am still trying to understand if the treatments are attacking the cancer ONLY or the whole prostrate as kind of a blanket/shock & awe approach
My doc does not have a pet scan machine in Ashland and stated that insurance companies may/may not pay for the pet scan...just wondering if you pursued that point/thx
rex

Rex,
I agree with others that getting the best on your team is the only approach worth taking. I reside in Portland, OR area but made the trip to Mayo Rochester for 5 dose Proton Beam treatment. Completed a month ago and other than some minor difficulty urinating I have experienced no observable issues. I also agree that reading Dr. Walsh's "Surviving Prostate Cancer" is the first step toward choosing a treatment strategy.
Best of luck on this minor detour from your very active lifestyle!

Comment about Dr Walsh's book, which I recommend to all men for the info for them, or their family and friends, and consider it to be my "Prostate Cancer Bible":

4th Edition published 2018.

Some treatments are newly available and some protocols have evolved.

Example; I am on Orgovyx, approved in 2021.

The book is great, but after BCR especially, some meds and txs have evolved. Just something to keep in mind, especially for the newly diagnosed.

You might want to look at Viewray’s MRIdian. Only machine that has radiation and MRI built into the machine to see healthy tissue more clearly. 2 mm margins (ask about the margins in other radiation machines) and automatic turn off. 5 Treatments.

My RO told me that the normal procedure is to cover the whole prostate and that the millimeters beyond that can affect healthy tissue. Picking the radiation machines that limits those millimeters made sense to me. Some machines set margins greater than 4 mm, the MRIdian margins were set to 2 mm for me. MRI shows a clearer picture of healthy tissue, CT less so. I am not a dr but that’s what I have heard and so far my side effects are minimal from the MRIdian.

None of those machines are near me so they are off the table.

Medicare now covers a PET scan. I strongly and highly recommend you get one. Once you personally see the results of a pet scan, the value is incredible. I’ve had aggressive, advanced invasive, prostate cancer for 15 years and had almost every treatment option. The pet scan gave me the best and most comprehensive view of all the different cancer in my body. The spread of bone cancer was very interesting. Doctors do not treat bone cancer until it becomes painful, they usually just let it spread. Which I have been fighting against but too little avail. I should actually start a discussion on bone cancer and its treatments .
My first treatments were a ADT and Lupron- followed by HDR Brachytherapy and 44 radiations.
My cancer has never disappeared- only been restrained. So personally I am in favor of over treating. Living thru this is a pain.

Yes. I'm going on 74 and last August had a Gleason of 8. Don't wait till it reaches 8. I waited, or stalled, for a couple of years and could have caught this earlier. See a specialists but whatever path you choose, surgery, radiation, waiting, research everything possible, including info from this group before making your decision.

I consider 70's middle aged!

That said, I'd make and move forward with a plan.

Good luck

Mayo would be such a good option for you. It is worth going. Get all the info, from radiation people and surgeons. We were told The side effects with surgery are immediate but improve. Radiation comes with ADT which has its own side effects. Do your research.