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Recently diagnosed: Treatment options for early stage prostate cancer?
Im 57 and was diagnosed with prostate cancer on 4/21/23. Following a 3t mri which revealed a pirads 5 leasion I had a targeted mri fusion guided biopsy. The pathology report revealed adenocarcinoma in 2 of 14 cores. Gleason 7 (3+4), grade group 2, 30% involved. Chronic inflammation was noted as well in areas around the cancer. My PSA started in 2109 at 1.8 and went to 2.1, 3.57, 5.91 and 6.7 a couple of months after the 5.91 and before the biopsy. My PSA density is 0.15. My urologist recommended surgery and a consult with a radiation oncologist obviously suggested radiation therapy but states active surveillance might be appropriate if the second opinion on my slides didn’t change. Any thoughts?
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I went from a 2.3 to a 2.9 over 5 years. Lesion was 7mm and I did the 5 treatment proton at Mayo Phoenix. I had two cores that were 4-3 and three that were 3-4 out of 30 cores and the 5 were all from the area where the MRI showed the lesion. I still wonder if I should have waited but the oncologist was worried about the 4-3. Only problem is that a study showed that after a prostatectomy that 51% of the 4-3 stayed a 4-3 and 49% were actually 3-4. You can get that accuracy flipping a coin. Do the people that examining these samples even know what they are looking at? Remember these hospitals don't make money unless they do something to you. The week after I finished radiation the study from England came out that every group had the same overall survival weather, they did nothing, had a prostatectomy, or underwent radiation. Does not make one feel all warm and fuzzy about making a decision.
Radiation treatment and ADT are no picnic. I am 71 and what I care about is enjoying my hobbies, cabin visits, grandkids and my 51 year relationship with my wife and just plain being alive! No sex drive, a little less body strength and stamina, hot flashes, some bathroon issues after radiation, but damn...all worth it to continue to enjoy my retirement years. Sometimes attitude is all its about. Happy to be recovering....
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1 ReactionIs that document available online anywhere? I would be interested in reading it as my first telegraph visit with Mayo was leaning toward AS. (Gleason of 3-3)
Yes it is..that is where I got it.
Blue Heron Health News
blueheronhealthguides.com
Called: Prostate Protocol
Any questions feel free to email me back...
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1 ReactionI'm sending you the contents...
I just now read your post, as I have only recently joined this discussion group. Your case sounds similar to mine. I had a genetic/genomic test done, in my case the Prolaris test. It came back showing I was a candidate for AS, so that’s what my urologist and I decided on. Most would rather do AS than actual treatment if it is medically appropriate.
Was your radiation treatment fully covered by Medicare or is it considered a drug under Part D? Thanks.
In general:
Radiation is a covered treatment, subject to any applicable deductible, copay or coinsurance.
ADT hormone therapy can be covered by Part B (injectables) or Part D drug (Orgovyx).
It was covered by Medicare, and anything was not covered was paid by my secondary insurance. I did not get any androgen deprivation drugs.
Just curious, did you decide to not take them or did the docs not recommend them?