Recently diagnosed

Welcome and sorry you had to join our little group. I am assuming that you are having a PSMA PET scan tomorrow. I think your doctors are being tight-lipped until they see the results of the scan and that's why little info is forthcoming from them. Once the results of the scan are in, you'll have a few different treatment paths to choose from. It makes a difference if disease is contained in the prostate or has migrated outside of the capsule and how much so. That's what the PSMA PET scan will determine. No sense in speculating until results are in. Best wishes!

At your biopsy levels the PSMA PET usually comes back clean (if not your treatment will change drastically). Get a Decipher test on your biopsy (if not already ordered) to see how aggressive the cancer is. With a clean PSMA you will have the option of Active Surveillance (especially with a low Decipher). If all tumors are on the same side may have the option of a focal treatment.

Definitely ask for your biopsy tissue be sent for decipher testing. With your biopsy results and if decipher low you could be good candidate for Active Surveillance which i imagine your Doctor will discuss with you . As it was mentioned he is just wanting the PET results too before going into more detail with you.

With such a low level of cancer, you could probably go on active surveillance. I love you have sad getting a decipher score or an arteraAI score Could give you a good idea about how aggressive this is.

Here are some videos from experts discussing this?

Here is a video with Dr. Laurence Klotz, one of the experts on active surveillance. He can give you answers as to why you would or would not be a good candidate for active surveillance.

Active Surveillance for Intermediate Risk Prostate Cancer w/ Dr. Claire de la Calle | Ep. 288

Yeah. Apparently they don’t have the decipher technology in Australia so samples get sent to the US and the cost is $3-5k. I know the cost for your life etc. but will wait and see what the pet says.

Welcome to the Brotherhood.

@jonb1760

I had similar numbers to you except I did have a PSA that was 10.2. I had a low decipher score. I felt that nobody was going to be able to accurately predict the growth of my cancer over a given period of time so I decided to have it taken care of right away.

I chose a specific built in, single unit, Mri guided Radiation machine called the Mridian. The only other comparable machine on the market is the Elekta Unity. What they see they can treat in real time. Also, the margins or the amount of healthy tissue that is exposed to radiation, is significantly less with this type of machine, so my side effects were less, as I wanted to protect quality of life issues.

I had done my comparisons between removal, Proton Therapy and other types of Radiation and was happy with my final decision. I spoke with five Radiation oncologists, all of whom were either trained, or working at, centers of excellence. I was diagnosed in September 2022 and treated with five radiation treatments in January/February 2023. I did have spaceoar put in which helped to create some space between my rectum and my prostate which I believe did help impact possible side effects. I had no adt before or after my treatment.

@jeffmarc Dr. de la Calle sounds like a first choice for anyone thinking about their prospects on active surveillance.

@climateguy
I did find her talk very interesting. It’s much wider ranging than the other doctors. Maybe I’ll move it up to First in my list that I copy from.

@mjp0512 yeah I know. Just easier said than done. But trying to focus on what I know not what I don’t. Have an appointment with the Aust cancer federation nurse tomorrow. Might be able to get some answers then.