Advise about treatment options, questions when meeting with our dr

I have stage 4 PC, Gleason 9 at biopsy last August
I was put on ADT, immediately with an injection of Firmagon and oral Nubeqa. Essentially this reduces your testosterone to almost zero and cancer starts to shrink and die off since it lives off testosterone . I had a PSMA PET scan about 2 weeks later. Cancer had spread to one lymph node and 4 places in my pelvis.
Going on ADT pretty much stops the cancer from further growth, essentially putting it to sleep. Currently my PSA is undetectable from a high of 62 when I was first diagnosed. All of my cancer areas had significantly reduced in size after the first 6 months of ADT treatment. Keep in mind that everyone’s cancer is unique and treatment protocols will vary per individual case.
I was lucky and responded very well to ADT, but some guys don’t. Your docs should also order a genetic test to identify the cancer’s makeup and for the BRCA 2 gene. This helps guide treatment down the road.
Hope this information helps a bit.

Ask about having genetic and somatic testing. The first one is to see if he has dna mutations that run in the family. They take a swab in your mouth for the test. I think the other is used to find specific information about the cancer cells themselves. For this one they use the tissue from the biopsy. A good doc will have these tests done as they are used to plan treatments. Not sure if I explained this correctly. Please correct where necessary! (My husband is a Gleason with many aggressive features.)

Getting both of those tests may make sense, but it’s a little too early to get a somatic test. As long as you live in the United States, you can get the hereditary test for free at

Prostatecancerpromise.org

Don’t check the box that you want your doctor involved or they won’t send you the kit until after talking to your doctor.

Takes about three weeks for the results and A genetic counselor will call you to discuss the results. You will also get a printout of the results.

The somatic test can tell you, whether or not the cancer itself has created genetic anomalies. If they have, you can get treatment for some of the things found. They can use blood or tissue for the somatic test.

Once they have done the PSMA pet test You will know whether or not the cancer has spread outside the prostate. They frequently want to put you on ADT to stop the cancer from growing and spreading. Depending on what they find in the biopsy (It would’ve really helped to see the biopsy results) They may recommend radiation or surgery.

The biopsy results tell an awful lot about what’s really going on, If they find anything other than just adenocarcinomas, that can be very important. It might take a close look at the biopsy results and post that information.

They did find 8 out 12 adenocarcinomas. I don’t think there was anything else. Do you know if laser treatment is an option for aggressive prostrate cancer?

Thank you so much for your response. That was very helpful and encouraging.

Linda

Thank you so much for your response. I will definitely ask about that. And yes, both of my husbands parents died of cancer.

Linda

Thank you so much for your response..I appreciate it!!

Linda

I am not sure what you mean by laser treatment, I suppose it is one of the focal treatments that are available. If you have a high Gleason score, they normally don’t want to use those types of treatments. This is something you need to discuss with the doctors that are treating you. Everyone is different when it comes to these kind of treatments.

Normally, with a high Gleason, they want to do surgery or radiation.

The PSMA scan will be super informative.