Gleason 7 (4+3) radiation, but ADT also? Over treatment?

Thanks again, I am coming to that view. Not sure my urologist will agree, but at this age, quality of life is important. For instance, as a musician I would find memory issues a bummer. Thanks again.

David

The answer is guitar and more specifically jazz guitar BUT it is a lifelong challenge as I am sure that you know. Played blues for thirty years and 'covers' + charity gigs but unravelling improvisation is for me the ultimate 'defie'.

And you?

Proton therapy delivers a beam of proton particles that stops at the tumor, so it's less likely to damage nearby healthy tissues, but this table of differences is quite interesting.

Not particularly relevant to the discussion, but what instrument and kind of music do you play? I play keyboards (not well) and have a great admiration for musicians who are better than me.

Ron,

Thanks again - really helpful. Not clear at this point about the difference Proton and IRMT but will research. Is there less likely hood of burns to the rectal wall with proton which I take to be more accurate/focussed?
My MRT came after an Echography which first revealed the tumour/nodule, then the biopsy and then a bone scan followed by CT scan.

End of questions!

Happy New Year

David

Thanks again, I am coming to that view. Not sure my urologist will agree, but at this age, quality of life is important. For instance, as a musician I would find memory issues a bummer. Thanks again.

David

(continued) This information gave me confidence to go in the direction I was already leaning toward which was no ADT.
Had six weeks of Proton radiation in May and June of 2022 and PSA has continued to decline to below 1 as of the most recent two quarterly PSA tests. Only minor residual side effects from radiation which are weak stream and an occasional dribble. Hope this helps! Best , Ron

(continued) This information gave me confidence to go in the direction I was already leaning toward which was no ADT.
Had six weeks of Proton radiation in May and June of 2022 and PSA has continued to decline to below 1 as of the most recent two quarterly PSA tests. Only minor residual side effects from radiation which are weak stream and an occasional dribble. Hope this helps! Best , Ron

(continued) I had a Decipher test performed which evaluates the aggressiveness of your particular cancer and mine was slightly below the mid range.
Decided I was leaning toward Proton Therapy and consulted with Proton Therapy radiologist who also strongly recommended ADT.
Consulted with widely known 2nd Proton Therapy radiologist who indicated that he believed expected lifespan gain from ADT was largely, but certainly not completely, offset by negative health effects it can bring.

David, my PSA had been increasing for several years and my PCP sent me to a urologist. It turns out that because I had been taking medication to help reduce the number of night "pee" trips, my actual PSA was double (9) the number that was indicated by yearly lab tests.
A biopsy was quickly performed which when reviewed by a pathologist indicated 6 out of 12 cores contained cancer , four of which were 4+3 with the remaining two 3 + 3.
Consulted with a urologist and radiologist both of which indicated ADT was required. In the meantime, I had an MRI to look for any spread and had a 2nd pathologist from John's Hopkins perform a review of the cores which confirmed the findings of the first pathologist,
I had to wait several weeks to have a PSMA pet scan to look for spread and it confirmed there was none outside of the prostate. Your research has probably made you aware that a PSMA pet scan is significantly more effective than an MRI in finding cancer outside the prostate .