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Old 11-13-2012, 02:08 PM   #1
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sgodwin HB User
Wondering what to do

Hi everybody. Newbie here.

Five years ago, my PSA was about 2.5. Oddly enough, the doc who ordered the test never got back to me and didn't make any recommendations.

Then last April, it came back at 7, so my new doc referred me to a urologist. We did a biopsy that confirmed prostate cancer. It's stage T1C, with a small percentage of cancer in 5 cores (out of 12). The Gleason score was 6-7. The DRE was normal. I opted for active surveillance. Oh, and I should mention that I'm 56 years old.

A couple weeks ago (about four months after biopsy) I went back and my PSA was at 8 and the doc said he could feel some irregularity on one side during the DRE. He's recommending another biopsy or treatment, and gave me the options of surgery or IMRT.

From what I've read online so far, it seems like I'm still in the low-risk group, but the doc seems to think its more serious. I'm not thrilled about either treatment option, but I don't know what good a second biopsy would do only 5 months after the first one. So I'm looking for a little support and feedback, and would appreciate any thoughts y'all might have. Thanks.

 
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Old 11-13-2012, 02:21 PM   #2
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Re: Wondering what to do

Quote:
Originally Posted by sgodwin View Post
Hi everybody. Newbie here.

Five years ago, my PSA was about 2.5. Oddly enough, the doc who ordered the test never got back to me and didn't make any recommendations.

Then last April, it came back at 7, so my new doc referred me to a urologist. We did a biopsy that confirmed prostate cancer. It's stage T1C, with a small percentage of cancer in 5 cores (out of 12). The Gleason score was 6-7. The DRE was normal. I opted for active surveillance. Oh, and I should mention that I'm 56 years old.

A couple weeks ago (about four months after biopsy) I went back and my PSA was at 8 and the doc said he could feel some irregularity on one side during the DRE. He's recommending another biopsy or treatment, and gave me the options of surgery or IMRT.

From what I've read online so far, it seems like I'm still in the low-risk group, but the doc seems to think its more serious. I'm not thrilled about either treatment option, but I don't know what good a second biopsy would do only 5 months after the first one. So I'm looking for a little support and feedback, and would appreciate any thoughts y'all might have. Thanks.
You need to get treated. You're too young. Now your problem is what treatment. But get treated before that stuff gets out. Seriously!!!

 
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Old 11-13-2012, 04:34 PM   #3
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Tall Allen HB UserTall Allen HB UserTall Allen HB UserTall Allen HB UserTall Allen HB UserTall Allen HB UserTall Allen HB UserTall Allen HB UserTall Allen HB UserTall Allen HB UserTall Allen HB User
Re: Wondering what to do

Dr. Klotz recommends coming off AS when any core's Gleason score hits 4+3 or when the PSA doubling time is less than 3 years.

For intermediate risk PC like yours, the best combination of cure rate and potency preservation I've seen, and I've looked, is CyberKnife. Dr. Robert Meier presented the results of a multi-institutional study a couple of weeks ago at the annual ASTRO conference. Three years after treatment, 99% had no evidence of cancer recurrence. This is far better than surgery, IMRT or protons. Potency preservation was also the highest among all those treatments. Urinary and rectal side effects are generally mild and transient. The only other treatment I've looked at that comes close is HDR brachytherapy (temporary implants, not seeds). Specialists who do HDR brachy monotherapy may be hard to find.

- Allen

 
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Old 11-13-2012, 04:44 PM   #4
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sgodwin HB User
Re: Wondering what to do

Thanks - I haven't heard about CyberKnife, so I'll check that out.

 
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Old 11-13-2012, 07:06 PM   #5
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Re: Wondering what to do

sgodwin,
Check out Proton Therapy. Loma Linda and MD Anderson are good places to start and both have informative user groups. Highest cure rates, lowest side effects rate - you will hear lot's of claims so you need to do your due diligence. If continued sexual function, urinary function, and bowel health are important to you as well a cure you need to consider Proton.
Bob

Last edited by harpman; 11-13-2012 at 07:07 PM.

 
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Old 11-14-2012, 05:49 AM   #6
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Billy6 HB User
Re: Wondering what to do

sgodwin,
I would be concerned regarding the fact that 5 samples showed cancer cells indicating that it is spread out through the organ, not localized. This does not seem, to an amateur like me at least, to be an ideal situation for any sort of radiation therapy. My inclination is that a Gleason 7, wide-spread tumor needs to be removed. I wouldn't characterize your cancer as low risk.

Bill
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Old 03-14-2013, 12:02 AM   #7
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zekec HB User
Re: Wondering what to do

I don't think you need a 2nd biopsy either because you need treatment. A Gleason 7 at age 56? Well if you are satisfied with living just another 10 years do nothing. If you'd rather live longer get treatment.

 
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Old 03-14-2013, 05:10 AM   #8
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Billy6 HB User
Re: Wondering what to do

What was the outcome of your treatment? Did you opt for radiation or surgery?
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