1. < Prostate Cancer

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

Posted by zooblio6 @zooblio6, Dec 26, 2024

Hello,

I will be 80 next August and apart from newly diagnosed PC am in good overall health. I have a diagnosis of Gleason 7 (4+3) Grade 3, T2a with a five year PSA of 0.6. Six cores positive in the recent biopsy. No spread to the bones or organs as indicated by CT scans etc. I see my urologist on 7th January and am concerned that he will propose ADT in addition to the inevitable RT ( I suspect IRMT ).

The side effects concern me ( although I already have erectile dysfunction ) mostly those concern possible memory loss, bone and muscle loss and cardiovascular risk ( I have controlled high blood pressure ).

I have read several recent reports that indicate that ADT may represent overtreatment in older patients and the more so where the cancer grows more slowly. Quality of life is key for me and my wife.

Can anyone please give a measured/qualified overview please. Thank you.

David

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

zooblio6 | @zooblio6 | Dec 29, 2024

Does anyone know just how effective IRMT ( RT ) for 35 days is against a case like mine ( Gleason 7 ( 4+3 ) without ADT actually is?

REPLY
2 replies
zooblio6 | @zooblio6 | Dec 29, 2024
In reply to @clandeboye1 "I am approachiing 85 . My recommendation would be to consider one of the Focal Therapies..." + (show)
@clandeboye1

I am approachiing 85 . My recommendation would be to consider one of the Focal Therapies .
HIFU , NanoKnife which is exploding worldwide with great success ( slower in the USA ) TULSA PRO (invented at Sunnybrook Hospital in Toronto by Dr. Chopra ) Cryotherapy ( An associate had this treatment recently in Calgary , Alberta He was also a Gleason 4 + 3 = 7 age 75 . He is happy with the result )
My other option would be MONOTHERAPY SBRT - 5 sessions - Mon Tues Wed and Mon Wed the following week . Short recovery time , no anestetic , no catheter and importantly " NO ADT ."

Jump to this post

That is really helpful, thank you. A friend in the UK ( I am in France ) had HIFU recently and seems happy so far, not sure if it is available here yet. PSMA - Pet scans only available so far in major centres like Paris, Toulouse, Bordeaux. However am looking at SRBT as an option.

Many thanks,

David

REPLY
zooblio6 | @zooblio6 | Dec 29, 2024
In reply to @scottbeammeup "Been learning keyboards but am adept at music mixing and using a DAW. I'm decent at..." + (show)
@scottbeammeup

Been learning keyboards but am adept at music mixing and using a DAW. I'm decent at writing song lyrics and do OK with melodies. I like to make custom mixes of my favorite songs that are just for me and occasionally a friend. REALLY want to get better at keyboards though.

Jump to this post

My teacher simply says 'Time on the instrument' !

Impressed with your range of activities.

David

REPLY
clandeboye1 | @clandeboye1 | Dec 28, 2024
In reply to @zooblio6 "Thanks again, I am coming to that view. Not sure my urologist will agree, but at..." + (show)
@zooblio6

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

Jump to this post

I am approachiing 85 . My recommendation would be to consider one of the Focal Therapies .
HIFU , NanoKnife which is exploding worldwide with great success ( slower in the USA ) TULSA PRO (invented at Sunnybrook Hospital in Toronto by Dr. Chopra ) Cryotherapy ( An associate had this treatment recently in Calgary , Alberta He was also a Gleason 4 + 3 = 7 age 75 . He is happy with the result )
My other option would be MONOTHERAPY SBRT - 5 sessions - Mon Tues Wed and Mon Wed the following week . Short recovery time , no anestetic , no catheter and importantly " NO ADT ."

REPLY
1 reply
scottbeammeup | @scottbeammeup | Dec 28, 2024
In reply to @zooblio6 "The answer is guitar and more specifically jazz guitar BUT it is a lifelong challenge as..." + (show)
@zooblio6

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?

Jump to this post

Been learning keyboards but am adept at music mixing and using a DAW. I'm decent at writing song lyrics and do OK with melodies. I like to make custom mixes of my favorite songs that are just for me and occasionally a friend. REALLY want to get better at keyboards though.

REPLY
1 reply
hotelito | @hotelito | Dec 28, 2024
In reply to @topsz "Did anyone have low RBCe and have to stop treatments?" + (show)
@topsz

Did anyone have low RBCe and have to stop treatments?

Jump to this post

Low RBC, WBC, lymphocytes all normal w RT +ADT, abnormally low may lead be more problematic.

REPLY
zooblio6 | @zooblio6 | Dec 28, 2024
In reply to @jeffmarc "Proton therapy delivers a beam of proton particles that stops at the tumor, so it's less..." + (show)
@jeffmarc

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.

Jump to this post

Thanks for that. Cyber knife has an unfortunate ring to it!

REPLY
zooblio6 | @zooblio6 | Dec 28, 2024
In reply to @scottbeammeup "Not particularly relevant to the discussion, but what instrument and kind of music do you play?..." + (show)
@scottbeammeup

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.

Jump to this post

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?

REPLY
1 reply
jeff Marchi | @jeffmarc | Dec 28, 2024
In reply to @zooblio6 "Ron, Thanks again - really helpful. Not clear at this point about the difference Proton and..." + (show)
@zooblio6

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

Jump to this post

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.

REPLY
2 replies
scottbeammeup | @scottbeammeup | Dec 28, 2024
In reply to @zooblio6 "Thanks again, I am coming to that view. Not sure my urologist will agree, but at..." + (show)
@zooblio6

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

Jump to this post

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.

REPLY
1 reply
View MoreView Less
Please sign in or register to post a reply.