Help finding a study re treatment: EBRT plus ADT vs ADT alone

It’s amazing how much you learn over time. I regularly use the phrase “If I only knew then what I know now!” That phrase certainly applies to prostate cancer diagnosis and treatment decisions.

Even with just PSA there are quite a few numbers to know; and with MRIs there are quite a few numbers to know; and with biopsies (4+3=7) there are quite a few numbers to know; and then with biomarker, genetic, and PSMA PET scans, there are quite a few numbers to know. So much information is needed to know how things really are.

So, a 4+3 (like I had) may or may not have been caught early……it depends on all of those other tests and results. A 4+3 (intermediate unfavorable) is where the concern starts, because that “4” cell structure can be the start of trouble.

PSA going from 8 to 15 in that short of time is unusual. Then again, knowing those other numbers and results from his PSA, MRIs, biopsies, biomarker, genetic, and PSMA PET scans, might have given some insight as to what might be coming. However, It’s easy to second-guess decisions, but that isn’t helpful.

> When you mention that “We paid for a PSMA on April 29….” - was that out-of-pocket or did insurance pay for that?

So, brachytherapy is out of the picture, he’s had a hormone therapy injection (which one?), is on Zytiga, and has started radiation.

> Did he use a rectal spacer (SpaceOAR, Barrigel, or BioProtect) prior to his radiation treatments starting?

> Are they hitting his lymph nodes with radiation?

> Has he had genetic (germline) testing?

> What have they proposed to kill the cancers? Chemotherapy?

As for staying on hormone therapy forever, that’s not a desirable option (for a number of reasons).

Novartis announced the results of a Phase 3 trial, called PSMAddition, that has shown positive results when used in combination with hormone therapy for patients with metastatic hormone-sensitive prostate cancer (mHSPC). You might ask his doctor if that treatment is an option yet.

With so many novel treatments being developed almost yearly, what is said to “be on the hormone therapy forever…..” might be a very, very short time. Just take it a day at a time.

It’ll work out well.

Hi, Brian: I am not sure if I answered all your questions the other day. They are using target radiation for the lymph nodes and the cancer in the prostate. They said there is no need for genetic testing because, although his father had prostate cancer, he didn't develop it until perhaps the age of 70. (My husband is 69). The oncologist said it would be different if his father had developed it at 40 or 50. As well, he said there is not an indication of a need for the spacer because he has no bowel issues.... and he would have had to be sent to a city 4 hours away for that process. I will try to look up the Novartis PSMAddition to see if I can learn anything. I really don't feel that he should be on hormone therapy forever. That seems like a life sentence. I am encouraging him to do the weights and he has started doing that every other day. That makes me feel happy (for him and for me). I have found that there is another second generation drug, an option to abariterone which has fewer side effects. When we meet with the doctors this week, I am going to ask about it. I have found a site PCRI.org which specializes in prostate cancer and the doctor Mark Scholz seems so knowledgeable. I watch their videos daily. I am so thankful that there are people out there, like yourself, and others, who are willing to share what they know so that we don't feel as though we are all alone. Our cancer centre is brand new and is supposed to be state of the art but I feel, being a Canadian hospital, it still cannot measure up to what you have in the States.