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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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mikewo | @mikewo | Jun 14, 2023
In reply to @ozelli "I think AS it totally appropriate in this case. Just get regular psa numbers and use..." + (show)
@ozelli

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.

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I went from a 2.3 to a 2.9 over 5 years. Lesion was 7mm and I did the 5 treatment proton at Mayo Phoenix. I had two cores that were 4-3 and three that were 3-4 out of 30 cores and the 5 were all from the area where the MRI showed the lesion. I still wonder if I should have waited but the oncologist was worried about the 4-3. Only problem is that a study showed that after a prostatectomy that 51% of the 4-3 stayed a 4-3 and 49% were actually 3-4. You can get that accuracy flipping a coin. Do the people that examining these samples even know what they are looking at? Remember these hospitals don't make money unless they do something to you. The week after I finished radiation the study from England came out that every group had the same overall survival weather, they did nothing, had a prostatectomy, or underwent radiation. Does not make one feel all warm and fuzzy about making a decision.

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shelby29 | @shelby29 | Jun 14, 2023

Radiation treatment and ADT are no picnic. I am 71 and what I care about is enjoying my hobbies, cabin visits, grandkids and my 51 year relationship with my wife and just plain being alive! No sex drive, a little less body strength and stamina, hot flashes, some bathroon issues after radiation, but damn...all worth it to continue to enjoy my retirement years. Sometimes attitude is all its about. Happy to be recovering....

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southgeorgia | @southgeorgia | Jun 15, 2023
In reply to @bolovino "TY for responding...I recently had a talk with a doctor at a local hospital who is..." + (show)
@bolovino

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...

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Is that document available online anywhere? I would be interested in reading it as my first telegraph visit with Mayo was leaning toward AS. (Gleason of 3-3)

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1 reply
bolovino | @bolovino | Jun 15, 2023
In reply to @southgeorgia "Is that document available online anywhere? I would be interested in reading it as my first..." + (show)
@southgeorgia

Is that document available online anywhere? I would be interested in reading it as my first telegraph visit with Mayo was leaning toward AS. (Gleason of 3-3)

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Yes it is..that is where I got it.
Blue Heron Health News
blueheronhealthguides.com
Called: Prostate Protocol
Any questions feel free to email me back...

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1 reply
bolovino | @bolovino | Jun 15, 2023
In reply to @bolovino "Yes it is..that is where I got it. Blue Heron Health News blueheronhealthguides.com Called: Prostate Protocol..." + (show)
@bolovino

Yes it is..that is where I got it.
Blue Heron Health News
blueheronhealthguides.com
Called: Prostate Protocol
Any questions feel free to email me back...

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I'm sending you the contents...
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craftsmanctfl | @craftsmanctfl | Oct 21, 2023

I just now read your post, as I have only recently joined this discussion group. Your case sounds similar to mine. I had a genetic/genomic test done, in my case the Prolaris test. It came back showing I was a candidate for AS, so that’s what my urologist and I decided on. Most would rather do AS than actual treatment if it is medically appropriate.

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craftsmanctfl | @craftsmanctfl | Oct 21, 2023
In reply to @mikewo "I also had 3-4 and 4-3 and chose 5 proton radiation treatments at Mayo Phoenix with..." + (show)
@mikewo

I also had 3-4 and 4-3 and chose 5 proton radiation treatments at Mayo Phoenix with no regrets so far. Too many horror stories of bladder incontinence after a RP. Did not want to take a chance on wearing diapers for the rest of my life. You are also much younger than my 74 years old. Even if the radiation fails and I only get 15 more years that puts me at 89.

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Was your radiation treatment fully covered by Medicare or is it considered a drug under Part D? Thanks.

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1 reply
michaelcharles | @michaelcharles | Oct 22, 2023

In general:
Radiation is a covered treatment, subject to any applicable deductible, copay or coinsurance.
ADT hormone therapy can be covered by Part B (injectables) or Part D drug (Orgovyx).

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mikewo | @mikewo | Oct 22, 2023
In reply to @craftsmanctfl "Was your radiation treatment fully covered by Medicare or is it considered a drug under Part..." + (show)
@craftsmanctfl

Was your radiation treatment fully covered by Medicare or is it considered a drug under Part D? Thanks.

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It was covered by Medicare, and anything was not covered was paid by my secondary insurance. I did not get any androgen deprivation drugs.

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1 reply
web265 | @web265 | Oct 23, 2023
In reply to @mikewo "It was covered by Medicare, and anything was not covered was paid by my secondary insurance...." + (show)
@mikewo

It was covered by Medicare, and anything was not covered was paid by my secondary insurance. I did not get any androgen deprivation drugs.

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Just curious, did you decide to not take them or did the docs not recommend them?

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