Recently diagnosed: Treatment options for early stage prostate cancer?

I am a completely unique case. I was planning not to take them because the studies I read said that androgen deprivation did not make any difference in overall biochemical reoccurrence or survival in men over the age of 70 and I was almost 74 when I had the radiation. That said, I have been on testosterone replacement since 2008 and when I stop applying my Androgel I go castrate in less than 60 hours. My radiation oncologist wanted to jab me so bad he could taste it and tried to jab me on my first visit. He said my observations were not good enough and tested me twice and both times my testosterone levels were under 12 ng/dl which is lower than a Lupron shot says it will get you to. I am seeing a urologist at Mayo who will give me my testosterone and monitor my PSA levels closely. I recently started back on my Androgel exactly 8 months to the day since I stopped, and my latest T level was still less than 12 ng/dl even though all my pituitary hormones were normal. It is sending the signals, but the boys are not answering even after 8 months. Why did I stop after the studies say it made no difference? Just hedging my bets because I don't trust almost anything that the medical profession or our government tells me. Remember the covid lie? If you get the jab, you won't get covid, spread covid, get hospitalized from covid or die from covid and you won't kill grandma? I do. My oncologist also wanted to give me 28 radiation treatments until I told him I was looking at doing CyberKnife with its 5 treatments and all of a sudden, he said "Oh we can do 5 too". Guess who is a co-author of a six-month Lupron jab and 28 proton radiation treatments and your first guess does not count. Be your own advocate and there is a ton of studies on the internet. My PSA had been between 2.9 and 2.3 for over five years.

Hope you find the information in this presentation to be helpful. I sure wish I had it two years ago when I was diagnosed with Stage 4 Prostate Cancer.

I took cyber knife, only 5 radiation sessions. Doing good

JDH697, It is a personal decision you have to make on being told to actively monitor or treat.

I did a lot of research and then got two different consultation and opinions.

Mine was 3+4=7 and listed as intermediate risk so the radiation treatment would normally include hormone treatment as well. However my Mayo oncologist/radiologist recommended Decipher test. The Decipher test showed that I was low risk not intermediate and thus hormone treatments not needed.

It was good that your urologist mentioned the second opinion on biopsy. But the Decipher test is a genetic test to determine risk levels and can really make a difference in treatments. Also the PSMA and bone scans are important as they determine if cancer is inside prostrate or has spread.

With your PSA number and Gleason score I would definitely explore the second opinion on the option you were given to actively monitor. This options with my Gleason score of 3+4=7 was never given as is intermediate risk.

I personally did not want the stress of active cancer in my prostrate and would have chosen radiation treatment (proton) even if given option of actively monitoring. I am glad that neither oncologist/radiologist, and urologist listed it as an option.

I also had PSMA and bone scan all negative. I had 30 rounds of proton pencil radiation and finished in July 2023. I am now in the PSA monitoring and first one dropped from prior to treatment 3.75 to 1.2. I was told it may take 1-2 years for PSA go reach it's lowest base. The main objective if is rises during the monitoring every 3 months. My next one is in December. Had little side affects and none now.

I was 56 when I was diagnosed last year (GS of 7-->4/3). I did a lot of research on options and decided to go with a robotic assisted radical prostatectomy at a center of excellence (Mayo-Rochester). For myself, it was an obvious choice - I was relatively "young", healthy, and wanted another 30+ years of PC free life. To go with a less aggressive treatment plan did not make sense to me. I wanted to remove the known cancer from my body, be able to understand the cancer progression with a post RP pathology, and leave as many options open if the cancer came back. Less invasive treatment plans either watch the cancer grow (and potentially metastasize) or use imperfect scanning devices to target therapy. As you know, cancer is very tricky - No matter the treatment plan, you never know 100% if you are cancer free. Thus, I wanted to eliminate the known limitations related to technology. I went with a center of excellence and the best surgeon I could find. One year later, doing great, pretty much back to normal with undetectable PSA.

Good luck with your decision and I pray all goes well for you.

Jim

Welcome, @red3000gt6. How long ago did you finish treatment? How are you doing?

Obviously, the choice is yours… 52yo was diagnosed 2/23 with Gleason 4 after PSA of 10, 12 and 17 and biopsies. Asked for an MRI, found adenocarcinoma on exterior of prostate. More biopsies determined my Gleason 4+4 and was offered RP (DaVinci) or radiation with “chemical castration”. That term did it for me. I chose the radical prostatectomy (10/26/23) and at almost 4 weeks post op, doing great. Averaging 4+ mi/day, weight is down, very little incontinence and some ED. On Cialis and starting back at the gym.

In the end, I’m glad I chose RP. Glad I went for TWO other second opinions and joined many communities online.

Best of luck and lots of love and support!!!

I have been diagnosed with prostate cancer recently but I also have ulcerative colitis. I am told they won't do radiation that close to my colon. Will the proton therapy work for me? I have just started looking for different methods but not much discussion with my problems.

Softail2000: as a layman and as I understand ulcerative colitis, it involves the rectum so if you do get a narrow margin radiation machine, proton or photon, you might want to consider spaceoar which gives a 1/2 inch separation between the prostate and the rectum. Margins will be a key factor for how much any radiation will impact healthy tissue outside the prostate. If it were me with ulcerative colitis , I would be asking a bunch of radiation type of machine questions and the margins used as you already have rectum issues.

bens1, you may be one of the last of the lucky ones to experience
viewray meridian https://www.oncologysystems.com/blog/the-collapse-of-viewray#:~:text=Effective%20October%2025%2C%202023%20all,treat%
20cancer%20patients%20with%20it.