Beginning prostate cancer treatment

Posted by upnort @upnort, Feb 1, 2022

GL score of 7, 4 +3 - suggested course of treatment: 6 month hormone therapy with radiation therapy. Nervous about this course of treatment because of potential side effects. I am supposed to begin my hormone therapy this week: bicalutamide (50 mg for 28 days) and Luprone injection, followed by radiation for 5-6 weeks. Do the final benefits outweigh the side effects? Looking for some reassurance and/or guidance here. Thanks.

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@ruste

I can relate to your perfect storm comment. A couple of years ago I did the 2 years of Lupron along with 43 treatments of Proton Radiation Therapy for my aggressive and advanced prostate cancer. I have been done with the Lupron for a year now and can report that my psa and testosterone numbers are good. However, I have now been diagnosed with Myleodysplastic Syndromes (MDS), a form of blood cancer. Radiation oncologist claims that this was not caused by the PRT, but I am not convinced. In any case, I have it and will be starting down that journey for myself while also being a caregiver for my wife of 58 years who has Lewy Body Dementia (LBD) - similar to alzheimers. And then there is the covid too.

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Thanks for your positive response. My very best to you and your wife as the journey continues.

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I'm 73 and I had a PSA of 11+ before Mayo found the location of the cancer in my Prostate. My Gleason score was 4+3. Before Mayo found it I had 2 other biopsy's locally that came back negative. Prior to the SBRT, I had a shot of the 3 month Eligard in July of 2020 and underwent the 5 radiation treatments of the course of 10 days in September of 2020. PSA has been <.01 through 3 tests with the fourth to come in March when I visit Mayo Rochester for another matter also. My Testosterone level is coming back very slow but it's a small price to pay to be cancer free.

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@cdcfbw

Sorry for your situation, mine is the same. I was recommended EBRT radiation +6 mo ADT (Lupron) back in April/21. I really did not know how long the Lupron was to be at first, Dr said "lets shrink and disable the cancer & then zap it with radiation" so not being a Dr myself I said OK and took the shot not fully understanding the SE. I did the 39 treatments of radiation with no problems and little SE from Lupron at first but by the time radiation was done and I went to my urol. for checkup he gave me another shot and said it would be the last one (I was so thankful for that to be the end). It is Feb./22 now and I am wondering when this nightmare will ever end. I understand if you are on Lupron for 6mo then it will take another 6mo to get completely over it. That is if your T comes back! I don't know how old you are but it is very difficult to go thru this in your 70"s like me and my T may not return so then what?
Good luck..

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Yes 39 treatments for me ! Almost 9 months so far on lupron .. doc wants two years.. I dont think so!!! Eager to be me again.

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I was diagnosed with Prostate Cancer in May of 2021 having a PSA reading of 7.9. My biopsy resulted in a Gleason of 7 (4+3).

Went through 28 treatments of Proton Beam Therapy at the Mayo Clinic in Phoenix -- with no side effects. I turned down, even though it was encouraged, a 6 month injection of Lupron. My radiation oncologist told me that a 6 month injection of Lupron was recommended, but NOT mandatory in his view.

Again, my PSA prior to PBT was 7.9 . Yesterday, I had my 3 month follow-up blood draw to test my PSA. My PSA came back at 1.9. Good results!

I turned down the hormone injection, even though “recommended” due to all of the side effects that I kept reading about.

As of right now, I am pleased with my results and happy that I did not take the 6 month hormone injection. I have another followup PSA test scheduled in 3 months (which will be my 6 month followup after my last PBT treatment). I guess time will tell if I made the right decision.

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@kansascityhusker

I was diagnosed with Prostate Cancer in May of 2021 having a PSA reading of 7.9. My biopsy resulted in a Gleason of 7 (4+3).

Went through 28 treatments of Proton Beam Therapy at the Mayo Clinic in Phoenix -- with no side effects. I turned down, even though it was encouraged, a 6 month injection of Lupron. My radiation oncologist told me that a 6 month injection of Lupron was recommended, but NOT mandatory in his view.

Again, my PSA prior to PBT was 7.9 . Yesterday, I had my 3 month follow-up blood draw to test my PSA. My PSA came back at 1.9. Good results!

I turned down the hormone injection, even though “recommended” due to all of the side effects that I kept reading about.

As of right now, I am pleased with my results and happy that I did not take the 6 month hormone injection. I have another followup PSA test scheduled in 3 months (which will be my 6 month followup after my last PBT treatment). I guess time will tell if I made the right decision.

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My Prostate Cancer at 4.1 was treated with radiation and chemicals back in 1998. It wasn't until 2018 that I found blood in my urine. In 2021, the flow of blood was excessive enough to warrant 45 days of wearing a catheter (because of blood clots). I was never told of the long term consequences of my treatment, not I would have much of a choice to make. The blood comes from the damaged prostate.

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Don't know where to start. I'm 71 and have had colon, intestinal and prostate cancer (not to mention several heart and other significant issues). My body has been challenged in many ways, scars line my chest and stomach, but it has responded well and I 'look' pretty normal and feel good. After surgery and radiation my PSA started to creep and just in this month, I had a PSMA PET scan that located metastasized prostate in lymph nodes near the kidney and aortic arch. External beam radiation therapy is being prescribed. Been no mention of concurrent hormone treatments or otherpotential paths. Is Radiation the only way to go?

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Radiation is a way, given that the imaging shows where the recurrence is, your radiologist should be able to build a treatment plan that includes boosts and wide margins around those locations.

There may be micro-metastatic PCa which the imaging cannot see. That may be a consideration for adding short term ADT, six months, to the treatment plan.

You don't say where the radiation you had previously was but if possible, consider having the treatment field includes the entire PLN system, not just the sites identified in the imaging.

Kevin

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@kansascityhusker

I was diagnosed with Prostate Cancer in May of 2021 having a PSA reading of 7.9. My biopsy resulted in a Gleason of 7 (4+3).

Went through 28 treatments of Proton Beam Therapy at the Mayo Clinic in Phoenix -- with no side effects. I turned down, even though it was encouraged, a 6 month injection of Lupron. My radiation oncologist told me that a 6 month injection of Lupron was recommended, but NOT mandatory in his view.

Again, my PSA prior to PBT was 7.9 . Yesterday, I had my 3 month follow-up blood draw to test my PSA. My PSA came back at 1.9. Good results!

I turned down the hormone injection, even though “recommended” due to all of the side effects that I kept reading about.

As of right now, I am pleased with my results and happy that I did not take the 6 month hormone injection. I have another followup PSA test scheduled in 3 months (which will be my 6 month followup after my last PBT treatment). I guess time will tell if I made the right decision.

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Thanks for sharing, @kansascityhusker. My situation mirrors yours, almost to a T. I was diagnosed with prostate cancer in June '21 with a 6.5 PSA and Gleeson 7 (3+4). I, too, turned down Lupron/ADT. My 28 Mayo Phoenix Proton sessions ended last Thanksgiving. My first follow-up blood draw is next month (March '22) ... looking forward to PSA result similar to yours.

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@gankster

Thanks for sharing, @kansascityhusker. My situation mirrors yours, almost to a T. I was diagnosed with prostate cancer in June '21 with a 6.5 PSA and Gleeson 7 (3+4). I, too, turned down Lupron/ADT. My 28 Mayo Phoenix Proton sessions ended last Thanksgiving. My first follow-up blood draw is next month (March '22) ... looking forward to PSA result similar to yours.

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Hi gansker!

Wishing you the best of luck as we travel these parallel pathways. Please let me know how your test turns out.

A little more background on my situation. My the initial reading from my biopsy came back with a Gleason of 7 (3+4) — just like yours. Because that biopsy was read by a lab not affiliated with Mayo, Mayo re-read the biopsy and changed it to a Gleason of 7 (4+3). With the initial Gleason score from the lab not affiliated with Mayo, Mayo told me they would not recommend a 6 month course of Lipton. After Mayo read my biopsy and upped my Gleason score, they then came back and DID recommended that I do a 6 month course of Lipton.

With that new recommendation, I did a lot of research, and given all of the side effects that I read about, I turned down the Lipton…. Hoping that was a good decision. So far, so good….

Best of luck on your upcoming PSA test! Please stay in touch!

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My Gleason score was 10 so I'm the heavy hitter so far. My treatments were done at Mayo Clinic and that was a good choice. My choice was Proton Beam Therapy. Prior to Proton treatments I started Lupron therapy. The tumor feeds on testosterone so testosterone reduction is a wise choice. Lupron reduces testosterone and thus slows tumor activity. Once that is accomplished Proton therapy begins. With minimal tumor activity Proton therapy effectivness is maximized. I had 28 treatments that were of the entire prostate as my Gleason was 10. Initially my PSA was 34, I believe. It is now 0.32. I'm feeling fine and there was no treatment discomfort. All went well. Urination difficulty is minimized with Flomax, it works well. So far, so good.

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