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Gleason 9: ADT before radiation
Prostate Cancer | Last Active: May 14, 2023 | Replies (42)Comment receiving replies
I am 4+3...PSA 5.26, Biop/6 sites, on hit, 30%, grade group 3, 77 yrs old, excellent health, just did a work-mission trip overseas. Just had a CT & Bone, locally in Ashland WI...CT & Bone OK...during consult, Doc offered 20 treatment, one month photon program with MRI before. Also ADT/Luproloid (sp).
I am pretty confident with this guy & pre-registered at Mayo (6 weeks from now) for a 'second opinion'...im MY mind, I believe I am dealing with a high certanity here without the additional Mayo...BUT going to Mayo etc is not a hassle for me...I just see OK odds with the above inital assessment. What do my brothers think?
Rex/ed
Replies to "I am 4+3...PSA 5.26, Biop/6 sites, on hit, 30%, grade group 3, 77 yrs old, excellent..."
The question is what will a second opinion produce in choices? If the 2nd opinion is to undergo a PSMA PET, and, if done and it shows no positives outside the prostate, that might favor surgery, but I actually don't think your decision changes by much.
A positive PSMA PET would, I imagine, rule out radical surgery. If a negative PSMA PET? Note: I do not know the detection limit of PSMA PET, so a negative is a good thing but does not rule out spread beyond the prostate. You will still be stuck with choosing radiation or surgery. If surgery, then you are going for a "cure", because if the disease is confined to the prostate, if you cut it out and put it in a jar, you've likely got a cure. Having said that, I think going for a cure is a better choice for a younger man. At your age, they likely will recommend radiation. My situation (3 yrs older) is similar to you in age, health, PSA, and pathology. I chose radiation six months ago based on my estimate of side effects, quality or life, and the reality of actuarial tables.
That's one opinion. What do others think?
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Suggest getting the 2nd opinion and then decide.