Yes or No to Radiation

Same position, with several bone mets, but, my oncologist is recommending me to postpone radiation as much as possible, reasoning, im in good shape and as the less invasive we are the better. Radiation apparently can cause on a ver small % a secondary cancer on the long run (8 to 10 years down the road....)

Im being treated in Silvester Cancer Center of the University of Miami

Agustin

Hey @genovadm04
There is a LOT to think about there.
It sounds to me like Dr. Moffitt might be trying to make the decade as good as he can. Get the PCa in check and let you get on with your life as soon as possible, this is likely because of your being healthy, strong and active.

My surgeon put it the folksy way. "Remove, Kill it or watch it" Including treat with meds and watch it. These are the options. Different docs have different philosophies on this. Some factor age in more than others. etc. etc. etc.. Ultimately, you have to decide what is right for you.

Postponing as long as possible sounds oddish to me. As if it were inevitable, If we postpone it 5 years then the doc feels it's time and there's a need, you would both likely be less healthy, strong and active by then.

@agustinferrari
At the risk of sounding a little "jarring", is a secondary cancer at around age 94 a big concern? Particularly when it only happens to a "ver small % " of patients? I really hate to make statements like this, but, I think these things have to be factored in.

Best of Luck to both of you!!

The Moffitt Cancer Center has the mridian viewray machine which uses automatic shut off capabilities and has a real time built-in MRI. It exposes 2 mm of healthy tissue as opposed to 3 to 5 mm for other types of radiation so side effects become important. MSK does not have that machine but you may want to consider Proton radiation as well.

My brother had cancer outside of the prostate last year as well as the prostate itself and used the MRIDIAN machine as well as Lupron which he is still on.

I am wondering why One of your doctors does not recommend radiation on top of the medication. It might be worth asking that question and understanding why he doesn’t think it’s right for you.

He said he was 84 years old, and you are talking possible cancers 8-10 years down the road? Really.

My thoughts exactly. I am 74 and went for five proton radiation treatments. If I get 10 to 15 years, it puts me at 84-90. I don't know about you but I would prefer not to die in a nursing home.

I was in a similar situation, but no bone mets yet: 59 years old; Gleason 9; PSA 17; 4cm lesion on prostate, spread to local lymph nodes, seminal vesicals and hilar (chest) singular lymph node.
My docs position at Mayo was to kill it, get out in front of it, and avoid it coming back. I was originally scheduled for radiation following my Lupron (by my university hospital doc). We switched our care after we learned it was important to get the treatments in the right order and timing. We switched to Mayo, continuing Lupron, immediate chemo to weaken the cancer, then radiation (external beam) to clean up anything left. Less radiation this way.
I went from stage 4 to no evidence of disease. I’m at 9 months post radiation and going for a scan in two weeks. I was also concerned about secondary cancers years down the line from the radiation, but more concerned about Gleason 9 and spread of my existing disease.
This lessened the necessary radiation and got a better outcome.

Best wishes for your decision and out come.

This is a non professional opinion and nothing more to assist your personal decision.

When you have a cancer one of the things you really, really want to hear is that the cancer is localized and has not spread to any other part/parts of your body. If it has spread the medical term for that is metastatic. When a localized cancer is properly dealt with that's the best news of all. It usually means it's the end of the story and all is happy. If it spreads, it's metastatic. If it's metastatic you have other immediate problems to deal with.

Your lymphatic system is an internal pathway to most of your entire body. If a cancer has metastasized to lymph nodes of your lymphatic system you then have a possibility of it spreading to any or all parts of your body. So now realize that a metastatic cancer has a chance to be on the move. The higher the Gleason score the more dangerous this cancer is. You are batting a 9 out of 10.

Whatever your decision, understand their implications. Educate yourself as much as you possibly can. Then move.

My choice was chemical abatement and then when appropriate Proton Beam radiation.

@genovadm04, what did you decide?

<p>I was diagnosed recently with PC, Gleason score 9, cancer had metastasized to several lymph nodes in the pelvic area. I'm being treated at Moffitt Cancer Center in Tampa, but I've also been in contact with Sloan Kettering. As things have turned out, I'm getting the Hormone therapy recommended by MSK at Moffitt. So far I have had 3 monthly injections of Degaralix. A week ago I began taking daily doses of Abiraterone and Prednesone. I've tolerated everything extremely well. No significant side effects. I've reached the point where Moffitt is prepping me for 5 weeks of radiation. However, the oncologist at MSK told me to seriously consider no radiation as it can have negative effects on quality of life. I'm not sure which way to go. Aside from the PC I'm a very healthy 84 year old. I have two weeks to decide. Any thoughts?</p>

Have they staged you? If your lymph system is involved you have my situation . Stage 4 cancer cells circulating in your lymph system. My question is what does pelvic radiation do for metastasized cells? I have been on zytiga/ orgovyx /prednisone since march. Psa is undetectable. The most pessimistic of my oncologists says I can last only 3-4 years before psa failure. Another says 10yr maybe. I am 72. My quality of life isn’t bad considering .At your age adt might offer you less misery if you can escape side effects.4-10yr added to your age makes you elderly.