My husband, 71, G8, PSA 8, PSMA PET no spread, has planned surgery for September. He ruled out radiation options because of required 18-24mos ADT. But after extensive reading about less invasive Proton and Cyberknife procedures, I have nagging doubts.
If you chose one of these options w/ G8, did you also need hormone therapy and if so, for how long?
Update: Surgery was last week and so far so good. Very long (6.5 hours) procedure because of enlarged prostate issue, but nerves were spared and doc said he didn't see anything worrisome cancerwise. Husband had very minimal discomfort and zero pain - only took tylenol and Alleve. Walked 1-1.5 miles a day around the house starting first day home, and in general was a happy camper, other than catheter which was yucky. Doc ordered cystogram at post op visit before cath removal and was very happy with recovery. Only minor leaks, fewer each day. Still waiting for pathology report...Fingers crossed!
Husband had 9 of 18 positive cores, four 4+4. Waiting for Decipher and second opinion on biopsy from JHU, but I doubt this is a 'low 8.' Time is running out - he's feeling ok about the scheduled RP in 3.5 weeks.
I'm trying to find Proton without Lupron studies, not much luck.
Update: JHU downgraded biopsy slightly, said only two cores were 4+4. Decipher was .61 which is still high risk, but just over the intermediate risk mark. Now that surgery is over, waiting for pathology.
Wow, congrats. I think it's too late psychologically to change course, but just for curiosity I might call Mayo and find out if no ADT is an option for G8. The proton center in San Diego said it wasn't.
I m 66 years old . Had prostate cancer treated 15 years ago got treaded with proton therapy now tested with psa 4.6 PET scan showed that the cancer has spread to lymph nodes and pelvis areas and one core biopsy tested positive G. Scores 3+4 =7 in the prostate area. Now my Doctor is recommending ADT and proton therapy. Scared of ADT side effects just got married. Can proton alone cure the cancer or is there any ADT medications without no down side effects on erection and Lobido etc. Please I’m thinking too much no symptoms.
I m 66 years old . Had prostate cancer treated 15 years ago got treaded with proton therapy now tested with psa 4.6 PET scan showed that the cancer has spread to lymph nodes and pelvis areas and one core biopsy tested positive G. Scores 3+4 =7 in the prostate area. Now my Doctor is recommending ADT and proton therapy. Scared of ADT side effects just got married. Can proton alone cure the cancer or is there any ADT medications without no down side effects on erection and Lobido etc. Please I’m thinking too much no symptoms.
Radiation therapy might cure cancer (especially if it's spread to only a few places, aka "oligometastatic"), but doctors can't promise anything because there's no medical way to detect if there are still dormant cancer cells or micrometastases lurking around. That's why they talk only about "remission" rather than "cure" when we're at stage 4. But with the help of radiation, ADT, an ARSI (like the -lutamides), and maybe other treatments later if there's any progression, your so-called "remission" could potentially last until you die of old age or something else unrelated to cancer, which would make it hard to distinguish from a "cure". 🙂
I'm over 3 1/2 years in functional remission, and hoping for decades to come. I'm also likely going to be on ADT and ARSI for life, or at least until there are new medical breakthroughs. The ADT side-effects have been manageable for me, but they have brought about life changes.
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Update: Surgery was last week and so far so good. Very long (6.5 hours) procedure because of enlarged prostate issue, but nerves were spared and doc said he didn't see anything worrisome cancerwise. Husband had very minimal discomfort and zero pain - only took tylenol and Alleve. Walked 1-1.5 miles a day around the house starting first day home, and in general was a happy camper, other than catheter which was yucky. Doc ordered cystogram at post op visit before cath removal and was very happy with recovery. Only minor leaks, fewer each day. Still waiting for pathology report...Fingers crossed!
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Update: I did contact Mayo and ADT would have been required with the 5 proton treatments - dealbreaker for husband.
I m 66 years old . Had prostate cancer treated 15 years ago got treaded with proton therapy now tested with psa 4.6 PET scan showed that the cancer has spread to lymph nodes and pelvis areas and one core biopsy tested positive G. Scores 3+4 =7 in the prostate area. Now my Doctor is recommending ADT and proton therapy. Scared of ADT side effects just got married. Can proton alone cure the cancer or is there any ADT medications without no down side effects on erection and Lobido etc. Please I’m thinking too much no symptoms.
Radiation therapy might cure cancer (especially if it's spread to only a few places, aka "oligometastatic"), but doctors can't promise anything because there's no medical way to detect if there are still dormant cancer cells or micrometastases lurking around. That's why they talk only about "remission" rather than "cure" when we're at stage 4. But with the help of radiation, ADT, an ARSI (like the -lutamides), and maybe other treatments later if there's any progression, your so-called "remission" could potentially last until you die of old age or something else unrelated to cancer, which would make it hard to distinguish from a "cure". 🙂
I'm over 3 1/2 years in functional remission, and hoping for decades to come. I'm also likely going to be on ADT and ARSI for life, or at least until there are new medical breakthroughs. The ADT side-effects have been manageable for me, but they have brought about life changes.
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