1. < Prostate Cancer

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

Posted by zooblio6 @zooblio6, 5 days ago

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

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jeffmarc | @jeffmarc | 3 days ago
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

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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.

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2 replies
zooblio6 | @zooblio6 | 3 days ago
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.

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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?

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zooblio6 | @zooblio6 | 3 days ago
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!

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scottbeammeup | @scottbeammeup | 3 days ago
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.

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1 reply
clandeboye1 | @clandeboye1 | 3 days ago
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

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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 ."

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zooblio6 | @zooblio6 | 3 days ago
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

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zooblio6 | @zooblio6 | 3 days ago
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

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zooblio6 | @zooblio6 | 3 days ago

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?

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2 replies
heavyphil | @heavyphil | 3 days ago
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

That is a really interesting chart, Jeff. I realize that it is produced by a group that obviously promotes Cyberknife, but I thought the marginal accuracy of proton beam was on a par with SBRT?

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pattyp46 | @pattyp46 | 2 days ago

Recently received IMRT 28 sessions and started Orgovyx one month before start of radiation therapy. I was Gleason 8(4+4) with PSA at 17, after many years at 3.5-5.5! PET scan showed no signs of spread outside of the prostate(yay!).
1 month from IMRT finish, PSA was < .5 and testosterone was 3.
I’m optimistic that on next urology visit, my PSA will remain low or get even to undetectable as my urologist said IMRT doesn’t kill all cancer cells immediately and continues “killing” for 1-2 months post treatment.
At that juncture should PSA get even lower, I am considering stopping Orgovyx at 6-8 months total.
Thoughts from the group????
Pat

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