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  • BCR of My Protate Cancer - Advice Please

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    Old 05-04-2021, 06:38 AM   #16
    IADT3since2000
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    Re: BCR of My Protate Cancer - Advice Please

    My understanding is the same as what Djin is saying: true Gleason 6 tumors do not metastasize except in extremely rare instances, and even then there may be other factors operating, such as nearness to a higher grade tumor.

    I am not a medical professional and have never been enrolled in a medical course, but I have been following research on prostate cancer for years, and that is how I have come to my belief. Dr. Laurence Klotz, MD, the eminent urologist (and all around genius) in Toronto who is arguably the world's leading expert in active surveillance, has carefully researched this issue for his very large group of active surveillance patients, with initial enrollment in 1995.

    His conclusion has been that true G6 tumors lack metastatic potential except in extremely rare instances. I just searched www.pubmed.gov for - klotz l [au] AND prostate cancer - and got a list of 384 publications of which he was the author or a co-author, an extraordinary, incredible body of work. Revising the search to - klotz l [au] AND prostate cancer AND Gleason 6 - reduced the list to 51 papers, still amazing. Adding "AND metastatic potential", so - klotz l [au] AND prostate cancer AND Gleason 6 AND metastatic potential - yielded two papers, one from 2003 and one from 2017. In the abstract of the 2017 paper, at https://pubmed.ncbi.nlm.nih.gov/28267056/ , he writes the following about not just low-risk prostate cancer but also low, in other words "favorable", intermediate-risk disease: "... Low risk and many cases of low-intermediate risk prostate cancer are indolent, have little or no metastatic potential, and do not pose a threat to the patient in his lifetime...."

    .Jim

    - - - - - - - - - - - - - - - - - - - - - - - -
    21 years as a survivor. Doing well. Diagnosis Dec 1999 PSA 113.6 (first ever), age 56
    Gleason 4+3=7 (J. Epstein, JHU), all cores +, most 100%; "rock hard" prostate with ECE - stage 3, PNI, PSADT determined later 3-4 months; technetium bone scan and CT scan negative; prognosis 5 years.
    Later ProstaScint scan negative except for one suspicious small area in an unlikely location. ADT Lupron as first therapy, in Dec 1999, then + Casodex in March 2000, then + Proscar and Fosamax in Sep 2000. Rejected for surgery January 2000; offered radiation but told success odds were low; switched to ADT only vice radiation in May 2000, betting on holding the fort for improved technology; PSA gradual decline to <0.01 May 2002. Commenced intermittent ADT3 (IADT3) with first vacation from Lupron & Casodex. Negative advanced scans in 2011 (NaF18 PET/CT for bone) and 2012 (Feraheme USPIO for nodes and soft tissue). With improved technology, tried TomoTherapy RT, 39 sessions, in early 2013, plus ADT 3 in support for 18 months (fourth round of IADT3), ended April 2014. Continuing with Avodart as anti-recurrence shield. Current PSA remarkably low and stable at <0.01; apparently cured (Current PSA as of 12/2/2020). (Current T 93 12/2/2020.) Supportive diet/nutrition, exercise, supportive medications during this journey, as well as switches in antiandrogen, 5-ARI, and bone drugs. Barely noticeable side effects from radiation; continuing low T, likely do to long use of ADT, but good energy and adequate strength. I have a lot of School of Hard Knocks knowledge, and have followed research, which has made me an empowered and savvy patient, but I have had no enrolled medical education. What I experienced is not a guarantee for all but shows what is possible.

     
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