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@mikewo

I am 73 and 10 months old with three cores of 3-4 and two cores 4-3 which is the only thing that classified me as unfavorable intermediate risk PC. I am a T1C with a PSA of 2.9 and the lesion was 7mm. The five cores were all taken from the area of the lesion by a MRI fusion guided transperineal 30 core biopsy of my 120 gm prostate. It is a big one and that is why so many cores and all the rest of the prostate was clean and a PSMA Pet Scan showed it was confined to the prostate and had not spread. The reason I stated my age is important for those considering or being forced into ADT by your oncologist. Read "Radiotherapy with or without androgen deprivation therapy in intermediate risk prostate cancer". The study shows that if you are over 70 it makes no difference in biochemical reoccurrence or overall survival. From Urology Times "Adding short term ADT to dose-escalated RT does not improve survival in Prostate cancer" article dated May 6,2023. Since I had the 5 proton radiation treatments at Mayo Phoenix this is another article you need to read. "The role of proton beam therapy for patients with intermediate- and high risk prostate cancer". Now if you really want to scare yourselves about weather all these doctor know what they are doing read "Correlation of the primary Gleason pattern on prostate needle biopsy with clinicopathological factors in Gleason 7 tumors". This article shows that of the 4-3= 7 Gleason pattern from biopsies after a radical prostatectomy the primary Gleason grade 4 in 51%of patients stayed a 4, while 49% of patients had their tumors down graded to a primary 3 pattern. You can get that accuracy by flipping a dam coin!!! Yet we are to trust the pathologists who are grading the biopsy samples in determinig our course of treatment?

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Replies to "I am 73 and 10 months old with three cores of 3-4 and two cores 4-3..."

Hi Mikeo! We're pretty similar in diagnosis. I just turned 70, had a single 4+3 core, prostate smaller, PSA max was 3.4. I'm being treated at Mayo Jax by SBRT. We were debating adding any ADT and my RO wanted to see my genetic prostate score before making a recommendation. Unfortunately, it came back at .69 putting me in the high risk group. Given that, I'm adding 6 month of Orgovyx. Had Orgovyx not been an option, I don't think I would have done any ADT due to the higher risk profile of the other drugs. Given Orgovyx is a daily oral and recovery is much quicker than previous drugs, I was more comfortable giving it a go. My RO believes it will reduce my risk of distant metastasis in the next 10 years by half. I did read the articles you mentioned. Although the study showed no significant improvement in overall survival with the addition of short-term androgen-deprivation therapy (ADT) to dose-escalated radiotherapy in patients with intermediate-risk prostate cancer. Benefits were observed in rates of metastases, prostate cancer–specific mortality, and prostate-specific antigen (PSA) failure. Hopefully I'll have a chance to chat with you in 10 years and we can better assess our decision making (-: Best wishes!