Recently diagnosed: Treatment options for early stage prostate cancer?

Bolovino: I had 3+4 = 7 Gleason. My PSA was 10.2 and monitoring was given to me by one of my radiation oncologist that I spoke to, as was radiation and adt by another, and radiation only by the others. I would suggest you use your biopsy material to get a Decipher test. Doctors do use it. It takes a couple of weeks to get the results back and may give you a feel for the nature of its aggressiveness.

I did not feel comfortable having a cancer growth inside of me as I could not judge the risk of how quickly something like that could grow even though I took the decipher test. I knew I would be thinking about further problems regarding treatments and side effects if I did not take action. Also, I wanted to avoid chemotherapy and hormone therapy, if possible.

I did my research on prostate removal or radiation. I looked at the different types of radiation machines and narrowed it down to either Mevion’s Proton Therapy or viewray Mridian’s photon radiation therapy. I spoke with five radiation oncologist from four centers of excellence. I chose the viewray mridian (viewray.com). My focus was on minimizing exposure to healthy tissue so that my side effects would be as little as possible.

Unlike Proton and other radiation machines, the Mridian was using 2 millimeter margins as opposed to all the others that were exposing healthy tissue from 3 to 6 mm. In addition, the Mridian had a built-in MRI so that they were treating my cancer in real time so they could see “it” more effectively versus other methods that involved fusing images together. The Mridian also had an auto turn off feature that shut the Radiation off if your body started to move, internally, or externally, and the radiation in progress wandered to the edge of the Mapped area.

I had the spaceor put in which gave me 1/2 inch of additional space between my rectum and the prostate. I finished my treatment in February of this year, five of them. My PSA has gone from 10.2 to 4.6 a month and a half ago to 2.99 a week ago. I was on Flomax until 2 weeks ago but never had any pain or blood anywhere.

Finally, the discussions in the medical community seem to focus on 10 to 15 years with any of the treatments while touching on the five-year term. My hope was that in the worst case I could get at least five years cancer free and by that time some of the trials going on now related to smart targeting of cancer would provide me with some new solutions.

Hi @bolovino, I joined your discussion to this active and related discussion:
- Recently diagnosed: Treatment options for early stage prostate cancer? https://connect.mayoclinic.org/discussion/recently-diagnosed/

I think you'll appreciate the conversation and connecting with others.

Have you made a treatment decision?

Hi … i need clarity in a confused state … my Dad was diagnosed at 70 Radiology report showed this
Prostate carcinoma with infiltration of the seminal vesicles, nodal, osteoblastic and Pulmonary metastases and Biopsy showed this -MICROSCOPY:
Sections shows cores of prostatic tissue with infiltrating malignant epithelial neoplasm. The cells are predominantly in sold sheet pattern (Gleason patlern V). These cells are fairly uniform with mildly hyper chromatic nuclei. There is no perineural or angio vascular tumour permeation.
DIAGNOSIS: PROSTATE BIOPSY: ADENOCACINOMA GS 5+5=10, ISUP V

Urologist said he is too weak for Chemo so we were placed on Abereterione and presidone tablets .. Pls who has used this for prostrate cancer and whats the survival rate ?

Your Dad appears to have a very aggressive and difficult case and he appears to have other serious health issues. I suspect that even his doctors have some difficulties in deciding his treatment. I think that he needs expert experienced medical care at an highly rated facility and then follow the advise of his medical team. Best of luck to him and your family.

I have to agree your dad needs professional advice. A second opinion is definitely in order. All we can do is share our experiences.
When I was struggling as to whether to continue with my Lupron therapy I spoke with other urologist in the group and used 2nd MD.
I was very impressed with 2nd MD. I gave them permission to review all of my records and then made a Zoom appointment. I was sent the bio of the doctor I was to "meet" and he was very well qualified. It was reassuring to me to have more opinions than just that of my attending urologist.
Best of luck as you deal with this. Remember to seek support from those who have been there.

I agree. From the experience I have and listening to others he has an aggressive form. You really need some very professional and expertise guidance. Mayo Clinic Phoenix, and Mayo Clinic Rochester have outstanding prostrate treatments including proton. I am not sure where you live but from web sites and feedback of others these two providers seem to have latest equipment and treatment plans.

Get consultations. I too had some other health issues. I have heart failure and a ICD/Pacemaker. My provider worked with my cardiologist and they had a physics department also. Just go to a well known and experienced provider who has latest equipment and treatment.

Good luck!!!!!!!!!!!

I think AS it totally appropriate in this case. Just get regular psa numbers and use those to guide you. The chances of a Gleason 3+4 metastasizing at diagnosis is about 1%. There is a research paper on it somewhere. 4+3 is about 3%, so the numbers are very small. The numbers are quite appealing.

I watched my psa go from 6 to 17 over 7 years. Lesion went from 5mm to about 14mm during that time. Just pulled the pin and opted for proton treatment.

TY for responding...I recently had a talk with a doctor at a local hospital who is affiliated with Mass General. He went over the three choices open to me...AS, photon radiation treatments or having my prostate removed...which did not sound to inviting.
At this time I have a follow up appointment with my doctor about what my decision will be ...
I'm going to start what is called a prostate protocol offered by Blue Heron Health Science. I read their 164 page in depth information on the prostate, the reasons why in gets enlarged and the 12 week protocol an array of specific foods, vitamins and supplements to help shrink the prostate, reduce the frequency of bathroom visits and increase the prostate overall health.
I agree, AS may be a good option for now...

There is no evidence that true Gleason 6 will ever metastasize. Shouldn’t all people with Gleason 6 go on AS?

My brother-in-law is Gleason 6 and has been watching it for two years with no change.