Prostate Cancer: Which Treatment to Choose?

I am 76 and at Gleason 9 and I was placed on lupron and Erleada for a year and I am now 8 months with no meds. My PSA turned undetectable and testosterone dropped to about 10. The side effects were manageable. I also had surgery Good luck, there are treatments available for you to continue living a good and happy quality of life.

ADT's are used to slow and/or stop the cancer rate of development. Once that is accomplished the cancer can be dealt with. There are many treatments available. For my Gleason 10 I chose Proton Beam. Proton Beam can very precisely target what needs to be dealt with. The treatment itself is absolutely painless and a piece-of-cake. No anesthesia at all is necessary. My testosterone is now undetectable. But I am dealing with the after effects of Lupron. You being active and strong should minimize the Lupron after effects. I wish you best of luck realizing that luck has little to do with this.

I am 70 years old and had a PSA of 10.2 last year. In January and February I had my treatment with the MRIdian linac radiation machine. I had 5 radiation oncologist opinions including Moffitt. I chose Orlando Health who had both the MRIdian and Proton. I had 5 hypo fractional treatments but no hormone therapy.

My brother had a psa of 6.5 and cancer had spread into the lymph nodes. He was treated last year with the same machine as me at Weill Cornell in New York city and they put him on Lupron. He has never been in good shape physically and has had terrible side effects. Anecdotally, there seems to be a connection between physical shape and reactions/side effects to Lupron.

At 85, if it were me, I would be asking multiple doctors, in different cancer centers, how much advantage there is using hormone therapy with radiation vs the potential negative quality of life issues of hormone therapy for the remaining time of my life. Maybe the targeted radiation is enough to give me 10 years of reasonable healthy every day living. Second and third opinions are important.

I would highly suggest getting another opinion from a prostate center of excellence. So many doctors believe that in your 80's you have lived a good/long life, and it is time to just manage your cancer until you die in a few years. I completely disagree with this attitude. I have a good friend that is 87, he is active and lives every day to its fullest. The reason he and his wife are doing so well is they don't act like they are 87, they travel, entertain, do home repairs themselves, boat, garden, etc... Obviously, there is some luck/genes involved, but they are both doing their part, living life to its fullest and fighting every day.

Because the prostate cancer has metastasized, I don't believe you are a candidate for surgery. However, I would recommend meeting with the most qualified oncology team to determine what treatment is best and can give you the best possible life possible.

I was diagnosed last year (56, very active, wanting 30+ years of PC free life, positive attitude) and went with a radical prostatectomy. Thankfully, the cancer was contained and did "not" metastasize. However, cancer is cancer and you really never know. This is why I always recommend the most aggressive treatment possible, that aligns with your life expectations (length, quality, etc.).

Best of luck with your treatment plan and I pray all goes well for you!!

Jim

If you dont mind my asking. How did you locate the cancer after ADT shrunk the tumor?
Dont mind me. I am just another layman trying to understand the whole thing.

I have not begun treatment yet. The procedure that was recommended by Moffitt is to begin with hormone treatment to halt the growth and spread of the tumor. Tiny gold rods are inserted into the tumor area so that the radiation beam can be directed and on target.

Hello wellness100. No I don't mind at all. We who have gone through these procedures are a vital source of information for those after us. I have no info as to whether ADT will or will not shrink the size of the tumor. It may or may not, I have no clue. What my Oncologist told me was that ADT is used to slow and/or arrest it's activity. The logic being that once tumor growth is reduced and/or stopped you now have a stable target to aim at.

So to repeat. I do not believe ADT is shrinking the tumor size. If I said that it would be my error. We're all laymen here relaying our experiences to one another. I hope I've answered your question. If I haven't please post once again. Because if YOU have questions we can be assured that many others will also have those same questions. We're all here to help one another as best we can. Thank you for posting that query.

My UCLA surgeon put me on lupron for 6 months before surgery. He advised me that this will soften the cancer and give a better chance of getting it all or at least more of it.

I had a gleason score 10, following a psa doubling from 2.5 to 4.8 in one year. I was 79 going on 80, opted for ADT and radiation. I got on the new Orgovyx immediately, a pill a day. Within six weeks I began my 45 radiation treatments. At the end of it, my PSA was zero. I am now on the 13th month of a 2 year orgovyx treatment. It is an incredible drug. Really only minor side effects. I continued my very active lifestyle, went to a gym 3 times a week. took care of 9 homes, and two grand kids. My wife really did wonders with diet (no red meat, added protein). I just had another psa, still at zero. The only side effects from the orgovyx has been some hand pain, and a couple of hot flashes a day. No ED issues either.

Thanks for response. I am glad you did.
I have similar treatment recommendations initially. It was ADT then radiation. But in my case, it did such a good job that my doctor no longer recommends radiation. In fact, the PSA is down to the level where the most sensitive technology available today cannot find any tumor, if any exists. Its called cancer free or undetectable, or whatever. So in any case no radiation.
Hoping that applies to you too.