Recently diagnosed: Treatment options for early stage prostate cancer?

Posted by jdh697 @jdh697, May 18, 2023

Im 57 and was diagnosed with prostate cancer on 4/21/23. Following a 3t mri which revealed a pirads 5 leasion I had a targeted mri fusion guided biopsy. The pathology report revealed adenocarcinoma in 2 of 14 cores. Gleason 7 (3+4), grade group 2, 30% involved. Chronic inflammation was noted as well in areas around the cancer. My PSA started in 2109 at 1.8 and went to 2.1, 3.57, 5.91 and 6.7 a couple of months after the 5.91 and before the biopsy. My PSA density is 0.15. My urologist recommended surgery and a consult with a radiation oncologist obviously suggested radiation therapy but states active surveillance might be appropriate if the second opinion on my slides didn’t change. Any thoughts?

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Agree with all the above. Only to add that consult if you can with specialist who treat over thousands of patients a year for 10 years or more. At the end of the day, experience count.

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Do your research, surgery is radical and there are a lot more options to beat it. Active surveillance is one but recommend a complete lifestyle change, plant based diet, exercise, pomegranate juice and green tea daily, consider high dose IV Vitamin C, Hyperbaric treatments, HOCATT treatments and on and on… Don’t rely on one Drs opinion. Get genomic testing done on the biopsy samples etc. Bottom line is do your research and figure what is right for you as we all are different. Good Luck

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Buy Dr Patrick Walsh's book on Surviving Prostate Cancer and read sections pertaining to you.

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Don’t make any decision until you consult proton beam therapy. Unless you live in one of the 43 cities that have it, they don’t tell you about it.
My case similar to yours. Gleason 7 (4+3) in one sample and Gleason 4 in 3 samples. Surgery brutal - plan for diapers for a year. Radiation (photon X-ray) affects surrounding tissues. Proton radiation they can stop it at the tumor (less side effects).
I’m not a Doc - have done a LOT of reading and research. Beginning proton radiation therapy soon at UFHPTI IN Jax. Doesn’t cost anything to get a consult

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Jdh697: my results were similar to yours, except my PSA went to 10.2 and I am older, 70 now, but 69 when I was diagnosed.

I was concerned that if I waited that it could spread, and no doctor was able to make that determination for me. I spoke to five radiation oncologist and did research. I narrowed it down to two radiation machines. One was mevian’s proton therapy and the other was viewrays mridian machine. Both machines were available to me in the Orlando area through the same Cancer Institute.

I chose the Mridian machine because I felt protecting healthy tissue was really important to quality of life. This machine uses 2 mm margins of radiation into healthy tissue instead of 4 to 6 mm for proton therapy and most other radiation machines. It is also the only machine that has a MRI and radiation built-in so what you can see, you can treat, in real time.

I also did spaceoar to separate the rectum from the prostate.

As you can see in the string on this website from Mayo, there’s a lot of good information to collect to help with your decision. There are also a lot of grey areas. By coming here, along with multiple doctors opinions, you can make the best decision you can based on whatever data you collect and people that you talk to. Good luck.

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I am also 57 and was diagnosed with prostate cancer in September, 2022. My PSA tracked almost the same as yours and my biopsy showed Gleason Score 7 (4/3). I did a significant amount of research and talked to quite a few other men that had prostate cancer. Based on my age/health,/life expectancy/research, I opted for a radical prostatectomy. On November 2nd, 2022 Dr. Igor Frank and his team performed the radical prostatectomy, taking the prostate, seminal vesicles, and 7 lymph nodes. My experience at Mayo-Rochester was amazing. The medical team was so profession, thorough, and caring. If you decide on a radical prostatectomy, please do your research and pick center of excellence and a doctor that has done thousands of robotically assisted radical prostatectomies. The quality of life, for the rest of your life, will depend on your medical team.
For me, I could not imagine letting known cancer grow in my body. If you can get rid of prostate cancer early enough, before it metastasizes, you can forgo much suffering. The robotic assisted radical prostatectomy is not a bad surgery. For me, the catheter and referred shoulder pain were the worst part. After 1-2 weeks, significant improvement. If you decide on a RP and do it at a center of excellence, I would recommend staying in town for a week, until the catheter is removed. My wife and I did this in Rochester and was very happy with this decision.

Best of luck with your decision and hope all goes well!!

Jim

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Thank all of you who have responded with your insight and advice. Sorry it’s been late to respond sooner but I’m currently dealing with a intraventricular conduction issue in my heart requiring a cardiologist. Not exactly great timing but the heart issue is taking precedence before any decision on method of cancer treatment. Thanks again everyone, I’ll check back in later with an update.

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@jdh697

Thank all of you who have responded with your insight and advice. Sorry it’s been late to respond sooner but I’m currently dealing with a intraventricular conduction issue in my heart requiring a cardiologist. Not exactly great timing but the heart issue is taking precedence before any decision on method of cancer treatment. Thanks again everyone, I’ll check back in later with an update.

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Sorry to hear about your heart issue. I agree with hammer101. If you find a surgeon who has done hundreds of these you should be in good shape. I was 60 yo in good health when i had my RALP. Fully continent after catheter came out 8 days later. I did get a script from Surgeon for Pelvic PT after surgery just to male sure I was doing Kegels correctly. Youcould ask for the same but before your chosen treatment. Also if u have belly fat try to shed some weight before surgery as that supposedly helps the procedure be more successful. Good luck with everything. Surgery for me was quite a bit easier than I thought.

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@jdh697

Thank all of you who have responded with your insight and advice. Sorry it’s been late to respond sooner but I’m currently dealing with a intraventricular conduction issue in my heart requiring a cardiologist. Not exactly great timing but the heart issue is taking precedence before any decision on method of cancer treatment. Thanks again everyone, I’ll check back in later with an update.

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My husband had an ICD implanted 3 1/2 years ago. It has brought him out of v-tach at least a dozen times since then. He has been on degarelix for the last 15 months (Gleason 8). My best to you!

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