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Seeking advice on treatment options

Prostate Cancer | Last Active: Oct 6, 2023 | Replies (35)

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@philipsnowdon

Hello, it sounds like you have been pretty thorough in your research. After monitoring my rising PSA levels, having a subsequent Prostate MRI followed by a Prostate Biopsy my Prostate Cancer had already surpassed “Active Surveillance and Watchful Waiting!” I needed to treat my cancer within 4-6 weeks through surgery or radiation. They both have the same efficacy and treatment outcomes. As a result, there is no one best or better treatment option. However, after you’ve completed enough research and consults with a surgeon and radiologist it will become more clear as to which option would be the best TRT choice for you personally.
For a number of reasons, I chose the surgical option.
Primarily because if my cancer returns within the next 5 years or so I can pursue the radiation option at that time. Conversely, if you start with the radiation option, you can’t utilize the surgical option if your cancer returns.
I also require “TRT,” TESTOSTERONE REPLACEMENT THERAPY to treat my HYPOGONADISM. Radiation normally utilizes “ADT,” ANDROGEN DEPRAVATION THERAPY through LUPRON injections or something similar. Basically, it’s Medical Castration. This is in direct conflict to the purpose and protocol of my “TRT!” Those were a few considerations I had to consider in making my treatment decision. In addition to some other important factors, it became obvious to me that the surgical route was the best personal choice for me.
When you have completed enough research you will know which choice will best suit you and your risk attitudes, personal risk attitudes and needs.
Best wishes and good luck.
GODSPEED

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Replies to "Hello, it sounds like you have been pretty thorough in your research. After monitoring my rising..."

I too was on TRT since 2008 but my PSA did not rise in over 5 years. It varied from 2.9 to 2.2. The only reason I caught it was because of my female endocrinologist did a full PSA test last year. She did the normal PSA but added the PSA FREE and PSA FREE %. My % was low which made me investigate further at Mayo Phoenix. Went for the MRI followed by the MRI Fusion Guided Transperineally biopsy when the MRI showed a 7 mm lesion. Had 30 cores taken due to the size of my 120-gram prostate. I had four positive cores out of 30. Two were 4-and two were 3-4 and the rest of the prostate was clean and normal. My PSMA Pet Scan also showed it confined to that one area. At 73 I did not want surgery as too many stories of incontinence for me to be comfortable with that option at my age. My radiation oncologist wanted me to do a 6 month Lupron shot and 28 proton treatments. I told him with my TRT I did not need it because my endocrinologist and I had already experimented with no testosterone, and I went castrate without a shot since I had been taking it for 15 years. I experimented once on my own and stopped the Androgel 2 days before my blood work and again I was castrate. He didn't believe me and had me tested after two week and I was at 12 ng/dl which is lower than the Lupron shot promises. I have been at 12 for 8 months and just started back on the gel today. I have a Dr. at Mayo who will watch everything. Instead of the 28 proton treatments I did the five SRBT treatments and my PSA after three months was less than .1 or as they said undetectable. Sure felt like crap without the Testosterone.