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Are all treatment options given at diagnosis?

Posted by layingthegroundwork @layingthegroundwork, Jun 21 3:57pm

First, I want to wish all of you a very happy Father’s Day!
I’m posting today because there is a recurring question on my mind that I wanted to open up to the group. When I was first diagnosed with prostate cancer, the doctors did a great job explaining that I had a very low-grade type. However, they didn't really walk me through the alternative treatment options.
I’m not necessarily saying I would have made a different choice—I am comfortable with having chosen active monitoring over immediate treatment. Still, it bothers me that I wasn't told what those other treatments were, or what I would be up against if my cancer ever progresses past a certain stage.
Even though I can’t change the past, I still find myself wondering if my choice would have been different if I'd had all the facts. Has anyone else experienced this kind of gap in their initial diagnosis? How do you handle those "what if" thoughts?

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

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jim18 | @jim18 | Jul 5 11:25pm
In reply to @mpetermax "I just got diagnosed and have a Gleason score of 6, PSA 3.9. We are monitoring..." + (show)
Profile picture for mpetermax @mpetermax

I just got diagnosed and have a Gleason score of 6, PSA 3.9. We are monitoring thus far. However, at this stage, I think that I have a chance to try alternative treatments. I found these alternatives to fight Prostate Cancer

I have been told to preserve the prostate gland-as long as it does not kill the gland it should be ok. Check PSA every month.

1. Photo Dynamic Therapy (PDT)
Are there good evidentiary studies that can prove this? What are the pros and cons?

2. CRYOTHERAPY
Apparently, they freeze the prostate? The Cancer? I was told to make sure the freezing does not kill the prostate. Are there good evidentiary studies that can prove this? What are the pros and cons?

COVERED BY INSURANCE

3. Ivermectin and MEBENDAZOLE
There are studies out there which show that this therapy can stop growth, shrink tumors and some that kill the cancer fully. Are there good evidentiary studies that can prove this? What are the pros and cons?

4. Vitamin C IV: Allegedly can kill cancer at high levels.
Are there good evidentiary studies that can prove this? What are the pros and cons?

5. Recommends Androgen Deprivation Therapy
This removes Testosterone with high doses of Estrogen, trying to starve the cancer of testosterone. Are there good evidentiary studies that can prove this? What are the pros and cons?

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@mpetermax Unless your biopsy showed a lot of positive cores or other aggressive factors (IDC, Cribiform, etc.) why would you want any treatment with main side effects of ED and incontinence? Another name for ADT is medical castration. It gives all the side effects of physical castration. See the post Low Testosterone. When you stop the medication, it usually reverses but you usually do not get 100% back and sometimes very little testosterone returns (highly correlated with age and length of ADT).

Focal treatments have a high failure rate (cancer recurrence in a few years). That is why at a 3+3 Gleason most men just wait until it progresses to 3+4. The Focal therapies (partial prostate ablation) are still available at this stage. Besides Cyro there is also HIFU/Tulsa Pro, Laser, and IRE (electric also called NanoKnife). Make sure focal (vs. whole gland) Cryo is covered by your insurance. All treatments including radiation and surgery destroy the prostate. Focal treatments may only destroy part of the prostate preserving some function. If the reason you want to treat now is due to a family history of prostate cancer and genetic testing has shown problematic gene variants you might as well go for surgery. If the word Cancer made you nervous remember the cure is almost always worse than the disease at 3+3.

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