prostate cancer treatment choices

Posted by Ronoir @ronoir, Jul 29, 2016

Hello everyone, new member looking for some experiences/advise on post radical prostatectomy treatment. my stats: Gleason 9, lymph nodes, seminal vesicle, margins, fat tissue cap all positive for cancer. 5 of 41 lymph nodes removed were positive also seminal vesicle was removed. p.s.a. 3 mos. post op .08, .10 .12 @.15 presently. Prostatectomy was part of protocol for immunotherapy vaccine clinical trial. Would appreciate any input you may have on radiation and/or hormone therapies. Thanks

Welcome back, @donnelson,

I can imagine you must be quite worried, but we’re so glad to hear from you again. Thank you for reaching out to the Connect community.
I’d like to introduce you to @BuckyFestoon @giddyup1 @robertjohn @hamhock, in this Connect discussion, “Prostate Cancer,” http://mayocl.in/2nYLGbQ, with the hope they will return with some insight for you.

From my research, it seems that bicalutamide (Casodex), is part of hormone therapy, and one of the medications known as anti-androgens, which prevent testosterone from reaching your cancer cells; you can read more, here: http://mayocl.in/2oXbG8j
And, here is more information about a team of researchers from Mayo Clinic whose findings may have important implications for men who have a rising prostate-specific antigen (PSA) test: http://mayocl.in/2pjhKrn

@donnelson, what does your doctor say about the PSA level rising again?

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@donnelson

I have corresponded with this bog before. My prostate cancer received 43 days of radiation several years ago. About 2 years ago the PSA started to rise and I was given a bone scan which showed no problems. The PSA continued to rise and I had more tests with no real answer. The doctor suggested Lupron but after research and talking with some folks here I became reluctant to embark on this form of chemical “castration” if you will. A one month trial was suggested by my medical oncologist but that was not available here with Lupron, only by another medicine with a name that started with “a”. More tests followed, another bone scan, a CT scan, etc and there was still no spread of the cancer from the prostate. The PSA which now was 20.. Now the suggestion is Bicalcutamide monotheraohy. Has anyone had this therapy? if so, how did it go?

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Dear @donnelson,

This is @BuckyFestoon. I have a few questions for you.
1. Have you had your prostate removed? Prior to or following the radiation?
2. Are you now or have you ever been treated at Mayo Clinic Rochester?
3. Have you ever heard of the C-11 Choline PET Scan? Currently only offered at the Mayo Clinic in Rochester.
4. What is your age?

A bit of background on me. I am 4 years cancer free and doing GREAT, following: a PSA of over 25,000 in 2011!!! Late Stage IV prostate cancer, almost complete kidney and liver failure, Lupron therapy, bicalutamide therapy, Taxotere chemotherapy, 2 major surgeries including: a prostatectomy, an orchiectomy and removal of about a dozen cancerous lymph nodes (ranging in size from a golf ball to a nerf football). In short I’ve seen and done it all when it comes to the diagnosis and treatment of prostate cancer.

I can report my thoughts and reactions to any or all of these therapies but before I do it would be helpful to know the answers to the above questions.

All my best,

Bucky Festoon.

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I was diagnosed with prostate cancer last month. My Gleason score was a 7 which puts me at the intermediate stage. My urologist gave me 2 options – surgery or radiation therapy. I opted for radiation. I then was referred and consulted with a radiologist /oncologist last week. Knowing I chose radiation therapy , he offered me 2 types of treatment. 1) Hormone Therapy coupled with Radiation Therapy. He explained that Hormone therapy was taking a shot of hormones from my urologist first which would last 6 months. He went on to say that it would be like taking gasoline out of a car meaning I would loose my testosterone and my libido would be affected. He said my PSA level would go down from this shot from my current reading of 4.7 to .8 or lower. Then he explained after 2 months I then would be treated with radiation therapy. 2) My second option was 28 treatments of radiation therapy which would be 5 days a week for 5.3 weeks.
I chose Radiation Therapy only because the cure rate for both treatments were 75% and in addition I have cardiovascular issues. I start my 28 treatments in June.

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This is Dglass reporting from Fla mayo country
I had proton beam therapy in Jax after I had a liver transplant . Liver transplant 2011 , proton beam summer
2013 . Subsequently my PSA shot up January 2016
Then I had cryo surgery in summer of 2016 a salvage
Job at mayo Rochester ……. subsequently my PSA
Went down and now has gone back up to 6.8 although
Down from 7.7 in February of 2017 .
My opinion is that radiation / radical surgery / hormone
Therapy …… all leaves you with a ratio of 75 to 98%
Of no cancer … but… it still leaves a very large percentage of us with additional surgery ,radiation,chemo
Or hormone therapy !!!! Best of luck keep plugging away at it

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@dglass4040

This is Dglass reporting from Fla mayo country
I had proton beam therapy in Jax after I had a liver transplant . Liver transplant 2011 , proton beam summer
2013 . Subsequently my PSA shot up January 2016
Then I had cryo surgery in summer of 2016 a salvage
Job at mayo Rochester ……. subsequently my PSA
Went down and now has gone back up to 6.8 although
Down from 7.7 in February of 2017 .
My opinion is that radiation / radical surgery / hormone
Therapy …… all leaves you with a ratio of 75 to 98%
Of no cancer … but… it still leaves a very large percentage of us with additional surgery ,radiation,chemo
Or hormone therapy !!!! Best of luck keep plugging away at it

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You have been through a lot after your transplant although you sound like you will keep on fighting to eradicate all of the cancer. Great attitude! I came off double bypass open heart surgery 2 years ago and recovered. I am now faced with the challenge of prostate cancer. My Gleason score is 7 and the Urologist gave me a choice of surgery or radiation. I recently met with a Radiologist/Oncologist and he mapped out the treatment options to me. He knows I ruled out surgery so he advised to take hormone therapy coupled with radiation. The hormone shot was to last 6 months and within that time I would under go radiation treatment. The side effect could range from no Libido and no testosterone with the hormone shot. I opted for straight radiation which will consist of 28 treatments over 5.3 weeks. I start June 26th.

All the Best to you!

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Would like to talk with santi in regards to his treatment as I have been through the same.I am experiencing other symtoms from radiation treatment and they want me to go to other treatment but refused. can he email me please. Thanks gord

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I just completed 28 rounds of radiation therapy on 8/21. I have my PSA test sceduled for 9/26. My radiation/onclologist is shooting for a .5 – I was diagnosed last March with a Gleason score of 7 and the cancer is localized to the prostate gland. Previously my PSA was 4.7 …. I am hoping for the best. As a side note I would insist to your treating oncologist to have the SPaceOAR inserted prior to radiation as a added barrier of protection to your rectum. Good Luck!

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Thanks. Your answer is very helpful.
Ray

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It seems most people are opting for radiation therapy. I have recently been diagnosed with Prostate Cancer. Gleason Score 7. After reading a 600 page book on the subject by Dr. Patrick Walsh, I decided I just wanted my prostate removed. I am 63 years old and not overweight. I was fortunate to have a friend who had a similar experience and he put me in touch with Dr. Ferrigni at Mayo Phoenix. I am scheduled to have a robotic surgery procedure on November 22. So many choices and options. I hope I’ve made the right choice.

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Hello @markbenson, and welcome to Connect. I’m sorry to hear about your diagnosis. I encourage you to watch the live Video Q&A with Dr. Mitchell Humphreys about prostate cancer, which will take place tomorrow, Monday Sept. 25th at 5pm. You can participate in the Video Q&A right here on Connect; feel free to post your question before or during the presentation. You can view details and sign-up here:
https://connect.mayoclinic.org/webinar/video-qa-about-prostate-cancer/.
I’d also like to introduce you to some members talking about prostate cancer on Connect. Please meet @donnelson @flor @BuckyFestoon @giddyup1 @morris @rinron @BuckyFestoon @ronoir.
And, you may wish to read this past discussion, https://connect.mayoclinic.org/discussion/prostate-cancer/, where members have also shared their experiences with prostate cancer and removal of prostate.

@markbenson, may I ask if you would share why you chose to have your prostate removed rather than undergo radiation therapy?

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@kanaazpereira

Hello @markbenson, and welcome to Connect. I’m sorry to hear about your diagnosis. I encourage you to watch the live Video Q&A with Dr. Mitchell Humphreys about prostate cancer, which will take place tomorrow, Monday Sept. 25th at 5pm. You can participate in the Video Q&A right here on Connect; feel free to post your question before or during the presentation. You can view details and sign-up here:
https://connect.mayoclinic.org/webinar/video-qa-about-prostate-cancer/.
I’d also like to introduce you to some members talking about prostate cancer on Connect. Please meet @donnelson @flor @BuckyFestoon @giddyup1 @morris @rinron @BuckyFestoon @ronoir.
And, you may wish to read this past discussion, https://connect.mayoclinic.org/discussion/prostate-cancer/, where members have also shared their experiences with prostate cancer and removal of prostate.

@markbenson, may I ask if you would share why you chose to have your prostate removed rather than undergo radiation therapy?

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I decided on surgery because I have seen so many friends and family suffer from radiation therapy and it often was not effective. I would rather have surgery than deal with chemo

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Does anyone know of someone that has had prostrate cancer aggressive one at gleason score 9 that was confined to prostrate that has taken both brachytherapy the seed implants as well as external beam radiation about 6 weeks. I can not find anyone to talk to about this as I can not find anyone that went through both. Does anyone no of someone that I can connect with? Thanks Gordon

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