can I survive PC (Gleason score 7) with just external beam radiation?

Posted by worldcup22 @worldcup22, Jun 14, 2023

I was diagnosed with PC in Jan of this year. it appears from my biopsy that i am in a high-risk category and my urologist advises a combo of radiation which i started this week and hormone therapy. I balked at Lupron, and he suggested orgovyx. I would dearly love to avoid any sort of hormone therapy and was wondering if anyone on this forum has ha experience with just radiation given my information above? thanks

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I too have had external beam radiation along with eighteen months of lupron depot hormone therapy. My Gleason score is 7,(3+4) and my oncologist tells me I am in the low end/high risk category due to core sample results from my biopsy. He has given me a fairly positive prognosis. Overall, I am feeling pretty good but the EBR and lupron depot treatments have not been without side affects. Unpleassnt but manageable. I too questioned whether I could go with just EBR but doing so was not recommended. Based on my urologist's assessment and that of my radiation oncologist I am feeling fairly confident about the recommended course of treatment for my PC. Time will tell.🤷‍♂️

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If you are 7, you are not high-risk.

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@ozelli

If you are 7, you are not high-risk.

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Thank you. That is reassuring.
Just going by what my oncologist wrote in his assessment to my urologist. He upgraded my staging to t3b.

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worldcup22: I too was gleason 7 but it makes a difference if you are 4+3 vs 3+4 as does the makeup of the cancer based on the biopsy and in this case, a little after the fact, but a Decipher test using your biopsy material to judge aggressiveness. I went to 5 radiation oncologists, 4 were from centers of excellence. One recommended hormone therapy. My psa was 10.2. None put me in high risk. I was put in Intermediate. I chose the mridian from viewray for radiation. Finished 5 treatments in February. No hormone therapy. My brother is on Lupron as he has a high risk prostate cancer and used the mridian at Weill Cornell in NYC. He is trying to get off Lupron because of the side effects. Dr's talk about all the outcomes being the same with some toxicity discussion but VERY little short, medium and long term quality of life discussion. Also, what machine you use and what margins are used with that specific radiation machine to expose healthy tissue makes a huge difference.

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I had 4+3 intermediate with PSA of 8.9. Was advised to take 3 months of ADT which I did not want to do. Had 29 sessions of Proton Therapy completed one year. Continued drop in PSA to 1.7 just recently. So far, so good. Ron

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@alwayspositive92

I too have had external beam radiation along with eighteen months of lupron depot hormone therapy. My Gleason score is 7,(3+4) and my oncologist tells me I am in the low end/high risk category due to core sample results from my biopsy. He has given me a fairly positive prognosis. Overall, I am feeling pretty good but the EBR and lupron depot treatments have not been without side affects. Unpleassnt but manageable. I too questioned whether I could go with just EBR but doing so was not recommended. Based on my urologist's assessment and that of my radiation oncologist I am feeling fairly confident about the recommended course of treatment for my PC. Time will tell.🤷‍♂️

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I am on a similiar treatment journey:
Gleason (3+4)
Treatment plan has been EBR,Lupron and Casadex…18 months of treatment and so far PSA is undetectable….I share the same side affects with Lupron.
I am 73 years old …with current treatment I have 99% chance of survival after 5 years…90 percent chance of survival after 10 years ….I will journey on and am grateful to have a good oncologist ….thanks for sharing your journey💕

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I was also diagnosed in January with Gleason 3+4 and a high Decipher number. Originally my urologist mentioned hormone injections, but my RO was adamantly against it. His position was that I have low grade cancer that can be cured without dealing with the QOL issues associated with ADT. The small reward associated with ADT was not worth the risk, in his mind. The two docs got together and now they uniformly state that I will be cured without ADT. I am currently undergoing IMRT/IGRT and keeping my fingers crossed that the docs are right.

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I just finished my 20 proton treatments for a Gleason score of 3 +4. Classified as an intermediate risk. No hormone therapy at this time. Post treatment evaluation not until August with radiologist.

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What you really seem to be asking is whether anyone has a 10 year success story having been treated only with radiation.
Treatment protocols appear to be evolving toward ADT beginning prior to radiation and continuing with either a short course (4-6 mos) or a longer term (12, 18 or 24 mos) of hormone therapy.
My Rad Onc at a center of excellence overcame my resistance to ADT as part of salvage radiation by explaining that the long term success improved by 20 points from about 50% to 70%.
He recommended 4 mos of ADT, and I accepted and took Orgovyx.
All of us want to minimize and limit treatment if possible. Obtain information, try to understand and make decisions that are comfortable to you.
However, there is a reason that there are Rad and Med Oncs.

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@bens1

worldcup22: I too was gleason 7 but it makes a difference if you are 4+3 vs 3+4 as does the makeup of the cancer based on the biopsy and in this case, a little after the fact, but a Decipher test using your biopsy material to judge aggressiveness. I went to 5 radiation oncologists, 4 were from centers of excellence. One recommended hormone therapy. My psa was 10.2. None put me in high risk. I was put in Intermediate. I chose the mridian from viewray for radiation. Finished 5 treatments in February. No hormone therapy. My brother is on Lupron as he has a high risk prostate cancer and used the mridian at Weill Cornell in NYC. He is trying to get off Lupron because of the side effects. Dr's talk about all the outcomes being the same with some toxicity discussion but VERY little short, medium and long term quality of life discussion. Also, what machine you use and what margins are used with that specific radiation machine to expose healthy tissue makes a huge difference.

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bens1 - thank you for your insights. I couldn't agree more on the secondary discussions about mental health or quality of life. I am very active and would suffer depression if I couldn't bike / hike etc. the side effects that u discuss re your brother is exactly what i am trying to avoid and hence my consideration of orgovyx

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