My Prostate Cancer Journey...

[bmcgonig]

I think that’s a great approach.

 

[Dtail]

Good thought process. Would be the same concept for me.

 

[GaryInCO]

I got diagnosed in 2019 at age 63 with Gleason 3+4. Decided on brachytherapy, and it was a breeze. The surgery was no big deal, though I did have some impressive bruising. Colon wasn't entirely happy for a few months -- I basically had a mild sunburn where the sun don't shine -- but nothing terrible. Within 4-6 months everything was back to normal. Except for ED, but that was starting before I got PC, so I'm not sure the brachytherapy made it any worse. 5 years later my PSA is below 0.1 and I feel completely normal.

FWIW my brother was diagnosed just before I was. His case was worse -- Gleason 4+5 I think -- and he opted for surgery. And now his PSA is edging up and approaching the definition of relapse (PSA > 0.2). Roughly 25% of men relapse after surgery, and about 10% of those develop metastases, but even those had a 10 year survival. https://ascopubs.org/doi/10.1200/JCO.2022.40.16_suppl.5090

 

[Car-Guy]

A good friend of mine had PC with a Gleason 9 score and even had a couple of spots outside the prostate. After nine weeks of radiation treatment, 3 years of hormone treatments and several negative PET scans, he's done with medical intervention (at least for now) and is now moving into the active surveillance stage. He stopped by today to celebrate with a couple of beers and sure seems like a happy camper.

 

[Midpack]

I finally had my consult with a surgical oncologist, medical oncologist and radiation oncologist at Duke (University) Cancer Center. We learned a lot and we got our questions answered, many without having to ask (they anticipated them). I’m glad I traveled there, the level of state of the art skill and experience is orders of magnitude higher than any local urologist practice.

After meeting with them, I’ve decided SBRT seems to be the best option for my situation. I also considered surgery, brachytherapy, IMRT primarily, but I heard or read about cryo, HIFU, proton beam, hormone therapy and others.

It will take 2-3 months to get on the schedule, but it’s a relief to have a decision made for a path forward. There will be short term challenges and some risks, but hopefully the long term outcome will improve as a result.

Some essential quotes that led me to seek out a center of excellence:

“Your decision about who will manage your prostate cancer is one of the most critically important decisions you will ever make.”

“Men with Intermediate-Risk prostate cancers lie at a tipping point between innocuous and consequential and face particularly hard choices. They must weigh the risk of immediate side effects from treatment against the small possibility of future metastasis and mortality.”

 

[Car-Guy]

Best of luck to you. Probably no bad treatment solutions but maybe some better than others, depending in the "case". My friend (that I mentioned in post 29) will be coming over later today for a few more beers and to watch the first Sunday football games of the season. I'm sure I'll get an update on his progress.

Actually, I see him about once or twice a month when he wants to borrow or return some tool(s) but we don't spend a lot of time to really talk a lot.

 

[disneysteve]

I haven't posted about it yet but I'm in the midst of the workup for prostate cancer myself. On my annual labs in April, my PSA was 5.1, up from 3.33 a year earlier. I went to urology and they did a free and total PSA. My free was 23.5% (normal over 25%) so I went for an MRI which showed a 3mm lesion in the apex. That was followed by a transperineal biopsy. All 15 biopsy specimens came back negative. No cancer identified. There was some discussion of the lesion and labs possibly being subsequent to a bout of COVID a few months earlier. We discussed the options and decided to recheck in 3 months. My repeat PSA a couple of weeks ago went up to 6.3 and my free dropped to 17.9% so clearly something is wrong. I'm seeing the oncologic urologist (who did my biopsy) on Tuesday to see what he feels the next steps are.

Good luck to all who are dealing with this.

 

[Midpack]

^^^ All the best to you, I know it's not fun, but PC seems to be a far less aggressive cancer - and common as men age. And the various treatment options are only getting better over time.

 

[disneysteve]

^^^ All the best to you, I know it's not fun, but PC seems to be a far less aggressive cancer - and common as men age. And the various treatment options are only getting better over time.

Definitely. The frustrating part is all of the waiting. It’s now been 5 months since my abnormal PSA. Everyone says how it’s slow growing and all but all of the time doing nothing just seems like it can’t possibly be a good idea. It’s hard to accept that. I’ll see what he says on Tuesday and if I don’t feel confident with his plan I may get a second opinion.

 

[rodi]

My husband is 7 weeks into the hormone therapy and starts EBRT in two weeks. The hormone blocker has an unexpected bonus for him. It must have already shrunk his prostate some since he no longer needs to pee in the middle of the night and, in his words, press like he's a 40 year old again.

I keep seeing the standard of 9 weeks for EBRT.... His doctors have him doing 28 treatments which is 5.5 weeks on a M-F schedule. Midway through that he gets his second 3 month hormone blocker.

I'm looking forward to this being behind us. And behind the rest of you on this journey.

 

[Midpack]

Definitely. The frustrating part is all of the waiting. It’s now been 5 months since my abnormal PSA. Everyone says how it’s slow growing and all but all of the time doing nothing just seems like it can’t possibly be a good idea. It’s hard to accept that. I’ll see what he says on Tuesday and if I don’t feel confident with his plan I may get a second opinion.

It's taken a long time for me as well. There were other appts in between but...

• PSA Feb
• Free PSA Mar
• MRI Apr
• Biopsy Jun
• Bone Scan Jul
• Genomic test Jul
• Meeting with oncologists Sept
• SBRT w IGRT & SpaceOAR - tbd, but first available Nov-Dec, which I may push to Jan.