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Met with oncologist today
Well finally 7 months later had my consultation with the oncologist at OSHU, very personable and informative, I have 2 out of 12 biopsy cores that were 3+4 taken from a .8cm lesion, he said there's no hurry on my decision because of the low volume, he recommends 5 treatments of radiation every other day for a 90% success rate, with adt 95%, but probably would settle for 90% without adt, now if the decipher score which I'm waiting for comes back above .6 or so than definitely would do adt, he said with my active life style and my weight being around 140 lbs, might not be that much of a problem I asked can I do the pill form instead of the injections. I still have a Urology surgeon appointment on 9/28, so I will hear him out also and will make my decision soon after.
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Sounds like 5 SBRT sessions, That is pretty standard and works quite well for the level of PC you have.
ADT is not called for by the NCCN with your low Gleason score. Yes, it does give a small edge to not have the cancer come back.
A six month stint of ADT will actually give you about 1.5 years of ADT unless you get the pill. With the pill, you’ll only have it for about nine or 10 months. That’s because your testosterone does not come back quickly if you have the injection, It will take nine months to a year before most of the side effects are completely gone. With the pill half the people return to a good testosterone level within three months.
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1 ReactionI asked for the pill but he said sometimes Insurance won't cover it but I'm kind of waiting for the decipher test to see if I need Adt or not but for now I'm leaning towards that treatment.
Thanks for getting back to me
@ginger38314 If you decide to do RT with ADT tell the RO you will wait for your insurance to turn you down and then appeal. Should be able to get Orgovyx. The timeframes Jeff mentioned are real.
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2 ReactionsWill see what my decipher test says and go from there, if it comes in low then will just do the radiation because it's only a 5% effecting reoccurance.
Thanks for the update.
Like I mentioned before, I believe we’re on the same road.
I imagine there’s some comfort in feeling a sense of direction for you
What type of radiation did he suggest and was there any talk of Focal therapy?
I bought the focal therapy up but he said it's not as effective in my case
srbt radiation 5 sessions every other day. 90% cure rate with that alone or
95% with adt so I will omit that , but if decipher test comes in high then
almost certainly would do adt. So probably will opt for sbrt if decipher
comes in low-inermediat. If high then do the nerve sparing surgery.
So much to consider
You’re probably already up to speed on this stuff but there’s a pretty good article I just read from Mayo 12/2025 talking about Sbrt, Imrt and Sbrt using proton therapy.
https://www.mayoclinic.org/diseases-conditions/prostate-cancer/in-depth/sbrt-for-prostate-cancer/art-20592262
That's pretty much what I was seriously considering it's well suited for
low volume 3+4 and only 2 1/2 weeks 90% cure rate and 95% if you want adt,
which probably would opt out for the 5%, I have an appointment with the
surgeon on September 28th, and will make a decision soon after, I guess for
the sort you have to have a mold made of your torso and some type of
directional probe procedure done one the prostate so they can deliver
precise radiation each time, also supposed to have less side effects than
the lower 25-45 doses over 2 or 3 months. He said once I decide they can
start treatment in about 6 weeks after the pre radiation procedures so
probably could be done by years end. Take care
@jeffmarc
Don't they have drugs that bring back the testosterone quickly? Maybe that is a bad idea to bring it back quick, just wondered?