Newly dx ….. starting down the path to treatment

For people on here to being able to help, you would need to share more info about your biopsy/ disgnosis and treatment plan (ADT for how long, with which drugs, which type of radiation will you get).

@cble
Can I asked some questions before giving you my experience.

What was your Gleason Score? Did you have any other test like PSMA, Decipher?

You posted meeting with R/O. Have you decided on radiation already or are you just getting options?

The side affects are common for both surgery and radiation. However how our bodies react are very different. One person can have significant side affects and another not. This goes for surgery and radiation.

You are already going on ADT. That is hormone treatment and side affects are common with hormone treatmetns. Were you given option of not having it or just had to have it? Were you advised of the side affects? Were you told about why ADT (inhibits growth of prostate cancer cells).

I know a stressful diagnosis. Just know that treatment of prostate cancer have drastically improved over the years and with very successful treatment outcomes.

I think if you can answer the questions us on MCC would be better to pass on our experience.

Many thanx …. Yes Gle 4+4, PSMA … pathology confined to prostate and one tiny external iliac lymph node….nothing more for now
Seems ….ADT is a must and RT will increase overall survival …..

ADT …. 24 months I’ve been told
Surgical options were described as having more risk of side effects…
74, well controlled HBP, well controlled lipids, and pre diabetes BS never higher than 6.5…non-smoker, can’t shoot my age at golf but can score in the mid eighties, fly fish as often as the water temp her in the north east allow

Final note 5’9”, 204 lbs…a bit overweight but not significantly
Non-drinker

pretty much like me: Gleason 8 ( 4 areas of prostate involved 4+3 +7 on 2 ...4+4=8 on 2 smaller areas..other 8 areas of prostate clear..but, like you, 2 lymph iliac nodes )... I am 73 1/2..about same ht/wt..pretty good shape..cycle swim surf..totally f***** shocked when diagnosed...all thru the yrs my PSA was around 1 or under..then May '25 it jumped to 48.

so..what is in store ?? ..ADT ( prob orgovyx and erleada) first month is tough adjusting to side effects.. you will have hot flashes...not feel quite right..maybe sleep issues..everyone is different. I am starting EBRT in a few weeks..will let you know on that front- you will get to do that too..

a hearty welcome to the club...good luck..!!!
the prostate cancer brotherhood !

I’m 6’ 4” And weigh 185 pounds. BMI 21.3 above 24.9 is overweight, so I’m not exactly thin.

According to the BMI calculations, you are obese. 30.1 BMI

It is significant. This is not good for prostate cancer, long-term progression free survival.

I’ve edited this because I put the wrong weight for myself. I weigh 185 not 195.

The fact that the cancer has spread outside, the prostate means that it is in your bloodstream and could come back at any time, Anywhere. That is why you need to be on ADT and even an ARSI (Zytiga or a lutamide) For the best chance of it, not coming back soon.

Doctors have come to the conclusion that staying on ADT alone can cause castrate resistance. if you get on an ARSI it can delay castrate resistance. Median lifespan after reaching castrate resistance is two years.

Speak to your doctor about this and find out if getting on an ARSI is your best chance of long-term survival.

Getting on ADT can cause your A1c to go up. You are prediabetic and it could cause you to become diabetic. My A1c is 5.4 and I keep it there by being very careful about what I eat. You really want to start doing that, Stay away from carbohydrates and red meat, which are not great for prostate cancer. The Mediterranean diet is close to what is recommended to Keep a healthy blood sugar.

When you start ADT one thing that happens is your muscles start to deteriorate. Stomach muscles in particular weaken and you end up getting a belly very quickly. This may not be something you look forward to, but ADT gives you a lot more progression free survival.

Even though I really watch what I’m eating, I did get a little bit of a belly. In order to keep my muscles and bones healthy with ADT I walk on a track twice a day every day at least a mile each time and I go to the gym three times a week and do an hour of weight training. When I go to the gym, I do 60 or 70 situps every time to try to keep my stomach muscles in shape. I am 77 and have had prostate cancer for 15 years, It has reoccurred four times so I’ve been on ADT for nine years. I became castrate resistant six years ago, Beating out the median survival of two years. Leading a healthy lifestyle can really help.

The reason I do this is your bones start to deteriorate under ADT as well as your muscles. Many people on ADT end up with osteoporosis, So you wanna be careful about exercising and keeping your bones healthy?.

A bone specialist who was at a recent conference, said that everybody that is on ADT should be taking bone strengtheners. I was on Fosamax weekly for about six years and I am now on Zometa infusions every three months. Talk to your doctor about this, It is very important.

As for the hormone therapy side-effects, they are greatly minimized by following a rigorous resistance-training program.