Announcement

Collapse
No announcement yet.

prostatectomy or radiation therapy

Collapse
X
 
  • Filter
  • Time
  • Show
Clear All
new posts

  • prostatectomy or radiation therapy

    Thank you for the opportunity to post a topic. I was recently diagnosed with intermediate risk prostate cancer. I've met with a Urologist and Radiation Oncologist, and am committing to a treatment but unsure which to do. I'm leaning toward radiation brachytherapy, due to the complications profile compared to radical prostatectomy, and I'm generally surgery averse. My father had brachytherapy, but he was in his 70s, and passed away in his 90s from different issues. I'm super active, with children, etc. don't want to slow down (kids keep me busy) and understand both treatments have different complications.

    I'd appreciate any feedback on either treatment procedure, also, with radiation treatment, what are my options if the cancer returns post treatment? How are complications associated with radical prostatectomy? This is a tough decision, thank you for your comments and advice.

    -------------------------------------
    Age: 53
    PSA = 5.3 ng/ml
    Decipher score: 0.52 (Intermediate risk)
    Biopsy Results:
    Prostate, left mid medial, core biopsy:
    Prostate adenocarcinoma, Grade group 2 (Gleason score 3+4=7)

    Prostate, left base lateral, core biopsy:
    Prostate adenocarcinoma, Grade group 1 (Gleason score 3+3=6)

    Prostate, left base medial, core biopsy:
    Prostate adenocarcinoma, Grade group 1 (Gleason score 3+3=6)

    Prostate, lesion 1, left mid and atypical, core biopsy:
    Prostate adenocarcinoma, Grade group 2 (Gleason score 3+4=7) and focal
    high grade prostate intraepithelial neoplasia

  • #2
    I see this post has been here a week with no replies so thought I'd bump it to the head of the class. Since I haven't been treated I can't recommend any particular treatment unfortunately, but if I were in your shoes I would not want to go through a prostatectomy. I hope other more knowledgeable members will chime in.

    Good luck.
    David
    Born 1953. All care at Kaiser in LA.

    10/11/18: 2+ low volume (5-20%) G6 cores out of 12. Prostate vol 33g. Confirmed by Dr. Epstein. Ensuing MRIs and bxs similar.
    On AS.
    Urolift for BPH 10/21/19: no help.

    PSA
    8/2/18: 1.2
    3/26/19: 1.8
    6/14/19: 2.2
    10/18/19: 2.0
    5/2021: 1.6
    3/2021: 1.7
    10/2021: 1.9
    3/2022: 1.9

    Head and neck cancer 2009: Surgery and 31 days IMRT. NED for 13 years and counting.

    Comment


    • #3
      Our apologies we missed this. Given the choice of beam or surgery at age 53 I would opt for surgery because surgical options post radiation are limited, but radiation options post surgery are not.
      Last edited by Duck2; 06-23-2022, 09:20 PM.
      YOB 1957

      DX 12/18, GS 8, 4+4 6/12 cores, LL Apex 100%, LM Apex 60%, LL Mid 50%, LMM 40%, LL Base 5%, LM <5%, Right side negative.

      3/6/19. Post surgery Pathology Report - Grade Group 4 Intraductal Carcinoma
      T3aNO, <1 mm non focal EPE, GS8, 21 mm uni-focal tumor involved 10% of prostate.
      7 Nodes, SV, SM, PNI, and BNI were negative.
      LVI and Cribriform pattern present.
      Decipher .86 High Risk.

      Post Surgery PSA
      3/25/19 .03. (25 days)
      4/25/19 <.03. (2 months)
      5/25/19 <.02 (3 months)
      9/10/2019. <.02 (7 months)
      11/27/2019. <.02. T < 3 (9 months)
      5/19/2020. <.02 (15 months)
      11/2/2020. <.02 (21 months)
      5/11/2021. <.02 T <3 (27 months)
      8/25/2021. <.02 T <3 (30 months)
      12/6/2021. <.02 T <3 (33 months)
      6/14/2022. <.02 T <3 (39 months) T=37

      3 Part Modality Treatment Completed

      2/25/19 Robotic Laparoendoscopic Single Site Surgery outpatient Cleveland Clinic, Dr. Kaouk, surgery #41 in US.
      ART - 7/25/-9/25 2019 (78 Gy, yes, I glow in the dark).
      ADT - 5/19- 5/21 Eligard and Casodex.



      3 Part Modality Treatment Completed

      2/25/19 Robotic Laparoendoscopic Single Site Surgery outpatient Cleveland Clinic, Dr. Kaouk, surgery #41 in US.
      ART - 7/25/-9/25 2019 (78 Gy, yes, I glow in the dark).
      ADT - 5/19- 5/21 Eligard and Casodex.

      Comment


      • #4
        My surgeon told me that it is difficult to have surgery after radiation, not every surgeon will do it.

        ​​​​
        BD: 1959 PSA 4.9 11/2012 (no symptoms)
        Biopsy 12/2012 Negative
        PSA 5.9 05/2013 (still no symptoms)
        Biopsy 6/2013 3+4 (thank goodness for PSA tests)
        1 core positive (upper left), 1 suspicious (lower left) out of 12
        DRE: bump right side T1c; PCA-III = 20 (normala)

        Da Vinci 7/18/2013:
        Total prostatectomy with seminal vesicles (S13-6085, 1-29, 7/18/13, 29 H&E and 1 paraffin block)
        Invasive carcinoma involves left lobe of prostate only, extends from left apex to posterior mid region of left lobe Gleason 7/10 (4+3); G4 tumor comprises 75% of invasive carcinoma present
        Estimated total volume of carcinoma in entire prostate gland: 10%
        TNM: T2b NX MX (Stage IIA)

        PSA History:
        8/13 11/13 2/14 8/14 2/15 8/15 3/16, 8/16, 3/17,9/17,4/18, 9/18 PSA "undetectable" (PSA <.1)

        March '19 = 0.1
        April '19 = 0.10 <-- switched to uPSA tests
        June '19 = 0.10
        Sept '19 = 0.10
        Dec '19 = 0.09
        Jan '20 = 0.13
        May '20 = 0.2 <- standard test by mistake
        Jun '20 = 0.11 <- back to uPSA test
        Aug '20 = 0.16
        Jan '21 = 0.23
        Feb '21 =0.20
        Mar '21 - started ADT/HT, radiation scheduled
        Jun '21 Eight Weeks Radiation @MSKCC
        Jul '21 <.05 (T-Level 0)
        Feb '22 <.05 (T-Level back to normal)

        Comment


        • #5
          Very few surgeons will do surgery after radiology.

          One surgeon described it as separating a grilled cheese sandwich.
          Age Dx'd 57
          PCa History: Father, Grandfathers
          Oct16 Bx: Gleason 4+3 Grade Group 3 w/PNI
          LB: 4+3 (60% pattern 4),
          RA: 3+3, RLM: 3+3, RLA: 3+3

          Jan 2017 RALP - Dr. Grant Taylor - Pathology = pT3a; Gleason 4+3; Weight: 42g

          Jun 2019 AMS800 installed, Jul 2019 activated - Dr. David Rapp
          PSA_TESTS
          Apr16-5.10
          Jul16-4.70
          Aug16-5.13

          ---Surgery---
          Mar17<0.01
          Jul17<0.01
          Oct17<0.01
          Jan18<0.01
          May18<0.01
          Nov18<0.01
          Jan19<0.01
          Jun19<0.02
          Nov20<0.10
          May21<0.10
          Apr22<0.10

          Comment


          • #6
            The subject is one that often goes unanswered as there are men with strong feelings one way or the other, generally bias against surgery for fear of ED and incontinence. But there are advantages and disadvantages to both. Surgery is favorable for healthy young men because there is little risk with the surgery itself. The SE's are immediate and usually get better during the first year post-op. The surgeon can see everything that's going on inside and your prostate is evaluated for stage and grade by a pathologist. Incontinence is a major concern though.

            Many men choose radiation as they believe it will not affect their sexual prowess or continence, but the side effects develop over the years following treatment. Stage and grade are "guessed" based on external scans. Radiation can lead to secondary cancers down the road, and those who refute that base their claims on "recent" improvements in radiation delivery systems... mostly within the past decade. But if you are young as you are you can expect to live another 20-30 years and who knows what will happen. But for older men who are obese, have diabetes or CODP or other health issues the risk is less than that of surgery. Also for men who already have BPH or difficulty urinating radiation can even make that worse.

            As mentioned previously, with surgery you have a backup plan, and many of us with higher grade cancers have had surgery and later required adjuvant or salvage radiation later on. And my Uro told me that men who have had the so called MAX-RP (RP+HT+RT) have the lowest rate of recurrence.
            Late 2012: PSA 4, age 62 all DRE's 'normal'
            Early 2014: PSA 9.5, TRUS biopsy (false) negative
            2015: PSA's 12 & 20, lots of Cipro ... Mar '16: PSA 25, changed Urologist

            Jun'16: MRI fusion biopsy, RT base, 2ea 15-40-100% G8(4+4)
            Aug'16:DVRP, "broad cut" 11 LN-, neg margins, gland 53g, 25% involved
            multifocal EPE, PNI, BNI, bilateral SVI, pT3b N0
            Dec 2016: Mrs: Dx stage 4 NHL/DLBCL, Primary Bone Lymphoma
            spinal RT boost+6X R-CHOP21+6X IT MTX via LP.
            Remission ended 2020, Follicular NHL. Currently active surveilance.

            Mar 2020: older adult son, T-cell acute lymphoblastic leukemia (TALL)
            Hyper-CVAD + pegaspargase, RBC transfusions in NYC amid COVID-19

            Bone marrow transplant Oct 2020, currently in Remission
            Jan'17: began Lupron ADT, uPSA's ~.03
            May'17: AMS800 implanted, revised 6/17
            Aug'17: 39 tx (70 Gy) RapidArc IGIMRT
            Jan 2018-Jan 2022: PSA's <0.008, T=50
            Apr'18: Dx radiation colitis, Oct'18: Tx sclerosing mesenteritis
            June 2020: younger adult son, small bowel resection
            adenocarcinoma of lower ileum (SBA) w/+lymph node, stage T3a-N1
            Adjuvant chemo: 12x FOLFOX, currently in Remission

            "Everyone you meet is fighting a battle you cannot see"

            Comment


            • #7
              Actually Rob the studies I have read indicate the RT max (Brachy, IMRT, and ADT) have a few points higher cure rates that RP max (RALP, ART, ADT), but few men get RT or RP max because neither are not one treatment and both require at least 18 months of ADT.

              I did email Michigan man last week and 4 years out he is still <0.01.
              Last edited by Duck2; 06-27-2022, 09:00 PM.
              YOB 1957

              DX 12/18, GS 8, 4+4 6/12 cores, LL Apex 100%, LM Apex 60%, LL Mid 50%, LMM 40%, LL Base 5%, LM &lt;5%, Right side negative.

              3/6/19. Post surgery Pathology Report - Grade Group 4 Intraductal Carcinoma
              T3aNO, <1 mm non focal EPE, GS8, 21 mm uni-focal tumor involved 10% of prostate.
              7 Nodes, SV, SM, PNI, and BNI were negative.
              LVI and Cribriform pattern present.
              Decipher .86 High Risk.

              Post Surgery PSA
              3/25/19 .03. (25 days)
              4/25/19 <.03. (2 months)
              5/25/19 <.02 (3 months)
              9/10/2019. <.02 (7 months)
              11/27/2019. <.02. T < 3 (9 months)
              5/19/2020. <.02 (15 months)
              11/2/2020. <.02 (21 months)
              5/11/2021. <.02 T <3 (27 months)
              8/25/2021. <.02 T <3 (30 months)
              12/6/2021. <.02 T <3 (33 months)
              6/14/2022. <.02 T <3 (39 months) T=37

              3 Part Modality Treatment Completed

              2/25/19 Robotic Laparoendoscopic Single Site Surgery outpatient Cleveland Clinic, Dr. Kaouk, surgery #41 in US.
              ART - 7/25/-9/25 2019 (78 Gy, yes, I glow in the dark).
              ADT - 5/19- 5/21 Eligard and Casodex.



              3 Part Modality Treatment Completed

              2/25/19 Robotic Laparoendoscopic Single Site Surgery outpatient Cleveland Clinic, Dr. Kaouk, surgery #41 in US.
              ART - 7/25/-9/25 2019 (78 Gy, yes, I glow in the dark).
              ADT - 5/19- 5/21 Eligard and Casodex.

              Comment


              • #8
                A recent study found that brachy boost with IMRT showed no benefit over IMRT for very high risk, G9-10, men as it did for unfavorable intermediate and high risk (G7 4+3 and G8).
                69 yr at diagnosis, BPH x 20 yr, 9 (!) negative biopsies, PCA3-
                7-05-13 TURP for BPH (90→30 g) path negative for PCa, then 6-mo. checks
                6-06-17 Nodule on right + PSA rise on finasteride: 3.6→4.3
                6-28-17 Bx #10: 2/14 cores: G10 (5+5) 50% RB, G9 (4+5) 3% RLM
                Nodule was negative for PCa
                Bone scan, CTs, X-rays: neg.
                8-7-17 Open RP, negative frozen sections, Duke Regional Hosp.
                SM EPE BNI LVI SVI LNI(5L, 11R): negative, PNI+, nerves spared
                pT2c pN0 pMX, G9 (4+5) acinar adenocarcinoma
                5% of prostate (4.5 x 5 x 4 cm, 64 g) involved
                Dry; ED OK with sildenafil
                11-10-17 Decipher score: 0.37, Low Risk:
                5-yr met risk: 2.4%, 10-yr PCa-specific mortality: 3.3%
                9-16-17 (5 wk) PSA <0.1
                LabCorp uPSA:
                11-28-17 (3 m ) 0.010
                02-26-18 (6 m ) 0.009
                05-30-18 (9 m ) 0.007 (nadir)
                08-27-18 (1 yr.) 0.018 (huh?)
                09-26-18 (13 m) 0.013 (retest)
                11-26-18 (15 m) 0.012
                02-25-19 (18 m) 0.015
                05-22-19 (21 m) 0.015
                08-28-19 (2 yr. ) 0.016
                12-18-19 (28 m) 0.015
                06-30-20 (34 m) <0.014
                12-30-20 (40 m) 0.037 (?)
                03-31-21 (43 m) 0.020
                07-13-21(46 m) 0.018
                01-25-22(52 m) 0.023

                Comment


                • #9
                  I don’t know if anything is better for G10 men.
                  YOB 1957

                  DX 12/18, GS 8, 4+4 6/12 cores, LL Apex 100%, LM Apex 60%, LL Mid 50%, LMM 40%, LL Base 5%, LM &lt;5%, Right side negative.

                  3/6/19. Post surgery Pathology Report - Grade Group 4 Intraductal Carcinoma
                  T3aNO, <1 mm non focal EPE, GS8, 21 mm uni-focal tumor involved 10% of prostate.
                  7 Nodes, SV, SM, PNI, and BNI were negative.
                  LVI and Cribriform pattern present.
                  Decipher .86 High Risk.

                  Post Surgery PSA
                  3/25/19 .03. (25 days)
                  4/25/19 <.03. (2 months)
                  5/25/19 <.02 (3 months)
                  9/10/2019. <.02 (7 months)
                  11/27/2019. <.02. T < 3 (9 months)
                  5/19/2020. <.02 (15 months)
                  11/2/2020. <.02 (21 months)
                  5/11/2021. <.02 T <3 (27 months)
                  8/25/2021. <.02 T <3 (30 months)
                  12/6/2021. <.02 T <3 (33 months)
                  6/14/2022. <.02 T <3 (39 months) T=37

                  3 Part Modality Treatment Completed

                  2/25/19 Robotic Laparoendoscopic Single Site Surgery outpatient Cleveland Clinic, Dr. Kaouk, surgery #41 in US.
                  ART - 7/25/-9/25 2019 (78 Gy, yes, I glow in the dark).
                  ADT - 5/19- 5/21 Eligard and Casodex.



                  3 Part Modality Treatment Completed

                  2/25/19 Robotic Laparoendoscopic Single Site Surgery outpatient Cleveland Clinic, Dr. Kaouk, surgery #41 in US.
                  ART - 7/25/-9/25 2019 (78 Gy, yes, I glow in the dark).
                  ADT - 5/19- 5/21 Eligard and Casodex.

                  Comment


                  • #10
                    I was diagnosed as a G10 and, for various reasons, thought I had a decent chance of a good outcome from surgery, possibly, avoiding RT and ADT (so far so good). If I had know I would have needed adjuvant RT+ADT after my RP, I still would have chosen maxRP over maxRT (primary IMRT + boost + 2 years ADT). I think MaxPR would have given me my best chances. I don't like the idea of the prostate with G9 or 10 cancer sitting around while the RT takes its time to work.

                    Djin
                    Last edited by DjinTonic; 06-28-2022, 04:34 AM.
                    69 yr at diagnosis, BPH x 20 yr, 9 (!) negative biopsies, PCA3-
                    7-05-13 TURP for BPH (90→30 g) path negative for PCa, then 6-mo. checks
                    6-06-17 Nodule on right + PSA rise on finasteride: 3.6→4.3
                    6-28-17 Bx #10: 2/14 cores: G10 (5+5) 50% RB, G9 (4+5) 3% RLM
                    Nodule was negative for PCa
                    Bone scan, CTs, X-rays: neg.
                    8-7-17 Open RP, negative frozen sections, Duke Regional Hosp.
                    SM EPE BNI LVI SVI LNI(5L, 11R): negative, PNI+, nerves spared
                    pT2c pN0 pMX, G9 (4+5) acinar adenocarcinoma
                    5% of prostate (4.5 x 5 x 4 cm, 64 g) involved
                    Dry; ED OK with sildenafil
                    11-10-17 Decipher score: 0.37, Low Risk:
                    5-yr met risk: 2.4%, 10-yr PCa-specific mortality: 3.3%
                    9-16-17 (5 wk) PSA <0.1
                    LabCorp uPSA:
                    11-28-17 (3 m ) 0.010
                    02-26-18 (6 m ) 0.009
                    05-30-18 (9 m ) 0.007 (nadir)
                    08-27-18 (1 yr.) 0.018 (huh?)
                    09-26-18 (13 m) 0.013 (retest)
                    11-26-18 (15 m) 0.012
                    02-25-19 (18 m) 0.015
                    05-22-19 (21 m) 0.015
                    08-28-19 (2 yr. ) 0.016
                    12-18-19 (28 m) 0.015
                    06-30-20 (34 m) <0.014
                    12-30-20 (40 m) 0.037 (?)
                    03-31-21 (43 m) 0.020
                    07-13-21(46 m) 0.018
                    01-25-22(52 m) 0.023

                    Comment


                    • #11
                      Originally posted by DjinTonic View Post
                      I was diagnosed as a G10 and, for various reasons, thought I had a decent chance of a good outcome from surgery, possibly, avoiding RT and ADT (so far so good). If I had know I would have needed adjuvant RT+ADT after my RP, I still would have chosen maxRP over maxRT (primary IMRT + boost + 2 years ADT). I think MaxPR would have given me my best chances. I don't like the idea of the prostate with G9 or 10 cancer sitting around while the RT takes its time to work.

                      Djin
                      You are a statistical oddity.
                      YOB 1957

                      DX 12/18, GS 8, 4+4 6/12 cores, LL Apex 100%, LM Apex 60%, LL Mid 50%, LMM 40%, LL Base 5%, LM &lt;5%, Right side negative.

                      3/6/19. Post surgery Pathology Report - Grade Group 4 Intraductal Carcinoma
                      T3aNO, <1 mm non focal EPE, GS8, 21 mm uni-focal tumor involved 10% of prostate.
                      7 Nodes, SV, SM, PNI, and BNI were negative.
                      LVI and Cribriform pattern present.
                      Decipher .86 High Risk.

                      Post Surgery PSA
                      3/25/19 .03. (25 days)
                      4/25/19 <.03. (2 months)
                      5/25/19 <.02 (3 months)
                      9/10/2019. <.02 (7 months)
                      11/27/2019. <.02. T < 3 (9 months)
                      5/19/2020. <.02 (15 months)
                      11/2/2020. <.02 (21 months)
                      5/11/2021. <.02 T <3 (27 months)
                      8/25/2021. <.02 T <3 (30 months)
                      12/6/2021. <.02 T <3 (33 months)
                      6/14/2022. <.02 T <3 (39 months) T=37

                      3 Part Modality Treatment Completed

                      2/25/19 Robotic Laparoendoscopic Single Site Surgery outpatient Cleveland Clinic, Dr. Kaouk, surgery #41 in US.
                      ART - 7/25/-9/25 2019 (78 Gy, yes, I glow in the dark).
                      ADT - 5/19- 5/21 Eligard and Casodex.



                      3 Part Modality Treatment Completed

                      2/25/19 Robotic Laparoendoscopic Single Site Surgery outpatient Cleveland Clinic, Dr. Kaouk, surgery #41 in US.
                      ART - 7/25/-9/25 2019 (78 Gy, yes, I glow in the dark).
                      ADT - 5/19- 5/21 Eligard and Casodex.

                      Comment


                      • #12
                        Originally posted by Duck2 View Post

                        You are a statistical oddity.
                        Nah, just not in the majority. This recent study of oncological outcomes of RP for high- and very high-risk men found that 27.7% of them had pT2 post-op staging. That figure is in line with others studies I've seen that put the figure around 25%.

                        Oncological and Functional Outcomes of High-Risk and Very High-Risk Prostate Cancer Patients after Robot-Assisted Radical Prostatectomy (2022)

                        Djin
                        Last edited by DjinTonic; 06-29-2022, 09:23 PM.
                        69 yr at diagnosis, BPH x 20 yr, 9 (!) negative biopsies, PCA3-
                        7-05-13 TURP for BPH (90→30 g) path negative for PCa, then 6-mo. checks
                        6-06-17 Nodule on right + PSA rise on finasteride: 3.6→4.3
                        6-28-17 Bx #10: 2/14 cores: G10 (5+5) 50% RB, G9 (4+5) 3% RLM
                        Nodule was negative for PCa
                        Bone scan, CTs, X-rays: neg.
                        8-7-17 Open RP, negative frozen sections, Duke Regional Hosp.
                        SM EPE BNI LVI SVI LNI(5L, 11R): negative, PNI+, nerves spared
                        pT2c pN0 pMX, G9 (4+5) acinar adenocarcinoma
                        5% of prostate (4.5 x 5 x 4 cm, 64 g) involved
                        Dry; ED OK with sildenafil
                        11-10-17 Decipher score: 0.37, Low Risk:
                        5-yr met risk: 2.4%, 10-yr PCa-specific mortality: 3.3%
                        9-16-17 (5 wk) PSA <0.1
                        LabCorp uPSA:
                        11-28-17 (3 m ) 0.010
                        02-26-18 (6 m ) 0.009
                        05-30-18 (9 m ) 0.007 (nadir)
                        08-27-18 (1 yr.) 0.018 (huh?)
                        09-26-18 (13 m) 0.013 (retest)
                        11-26-18 (15 m) 0.012
                        02-25-19 (18 m) 0.015
                        05-22-19 (21 m) 0.015
                        08-28-19 (2 yr. ) 0.016
                        12-18-19 (28 m) 0.015
                        06-30-20 (34 m) <0.014
                        12-30-20 (40 m) 0.037 (?)
                        03-31-21 (43 m) 0.020
                        07-13-21(46 m) 0.018
                        01-25-22(52 m) 0.023

                        Comment


                        • #13
                          Many thanks for the feedback. This is a difficult decision; your shared experiences are so helpful and very much appreciated.

                          -------------------------------------
                          Age: 53
                          PSA = 5.3 ng/ml
                          Decipher score: 0.52 (Intermediate risk)
                          Biopsy Results:
                          Prostate, left mid medial, core biopsy:
                          Prostate adenocarcinoma, Grade group 2 (Gleason score 3+4=7)

                          Prostate, left base lateral, core biopsy:
                          Prostate adenocarcinoma, Grade group 1 (Gleason score 3+3=6)

                          Prostate, left base medial, core biopsy:
                          Prostate adenocarcinoma, Grade group 1 (Gleason score 3+3=6)

                          Prostate, lesion 1, left mid and atypical, core biopsy:
                          Prostate adenocarcinoma, Grade group 2 (Gleason score 3+4=7) and focal
                          high grade prostate intraepithelial neoplasia

                          Comment


                          • #14
                            Hi Prostprob....so sorry you are here.

                            You are 53 and have many years ahead of you. I wouldn't do Radiation or Removal RP...No Way.
                            My numbers were worse than yours and I did HIFU...Nov/2020.....Psa is holding between 3-3.5

                            With what I know now, If you have insurance...Look into Proton Beam Therapy. Results are unbelievable. In my opinion, this is the best treatment out there. It uses low radiation targeting bad cells only and/or tumor and destroys it. They do the treatment 30-40 min/day for 40-90 days depending on severity of cancer. If no insurance it can cost 110k USD.


                            Another treatment option would be Cyberknife. It consists of placing gold markers close to prostate. The team then marks out a plan to target bad cancer cells/tumors using high radiation for 5 days only. Team usually requests a Pet Scan prior to treatment. That's basically it. I have talked to 3 different individuals in Seattle. Washington and their psa number is fantastic and continues to drop. All 3 individuals had no complications and no urinary problems, bowel problems, erection problems....none and have sex. One of the three uses Viagra. Insurance will cover this as well. If you have no insurance, cost is approx...36k USD...By the way, the good cells in your prostate are not touched.

                            My understanding is, if you choose Radiation, many men have urinary incontinence...(diapers) and bleeding is common from rectum. Many have erection problems afterwards. I have one friend whom had Brachytherapy and he cannot get an erection. His psa however continues to drop.

                            Radiation of the whole prostate, kills the prostate. Afterwards, they want to give you a hormone injection to kill testosterone.
                            By the way, both Cyberknife and Proton Beam Therapy are FDA approved.

                            My advice, don't panic...do your research, make some inquiries/phone calls.
                            Anyhow, that's my 2-bits

                            Good Luck to you!
                            Danno
                            YOB: 1953

                            Pathology report July28/2020

                            Right apex anterior x4 prostatic adenocarcionoma, gleason score 6/10 (3+3), Grade group 1, 2/4 cores involved, 20% &< than 5%
                            Left mid lateral : prostatic adenocarcinoma, gleason score 7/10 (3+4), grade group 2. 4% pattern : 15%. Tumor involves 40% core.
                            Left mid peripheral zone x4: prostatic adenocarcinoma, gleason score 7/10 (4 + 3), grade group 3. 4% pattern: 85%; cribriform pattern. 2/4 cores involved (fragmented), 75% of overall tissue
                            Left apex: prostatic ad enocarcinoma, gleason score 7/10 (4+3), grade group 3, tumor involves 5%
                            HIFU treatment, Toronto Canada on Nov.22/2020....Volume prostate prior to HIFU 43cc

                            PSA History:


                            Aug/2011 2.42, Oct/2012 3.1, Feb/2016 5.1; Apr/2017 6.0; Sep/2018 6.7
                            Oct/2019.. 8.5; Nov/2020 10.6 HIFU treatment Nov22/2020 Feb/2021 2.9
                            Jul/2021 3.2; Nov/2021 3.0 Next...Feb.23/2022 3.5

                            MRI Aug/2021 & Volume 30cc
                            Ablation defect on left posterior. Low signal extending from left peripheral zone from base to apex. Left peripheral reduced in size. No discrete high signals present on right/left peripheral. No suspicious lesions.

                            Comment


                            • #15
                              Forgot to mention, All 3 men that I referred to whom undertook Cyberknife Treatment at Swedish facility in Seattle were in there 60"s...One was 68

                              Cheers
                              Danno
                              YOB: 1953

                              Pathology report July28/2020

                              Right apex anterior x4 prostatic adenocarcionoma, gleason score 6/10 (3+3), Grade group 1, 2/4 cores involved, 20% &< than 5%
                              Left mid lateral : prostatic adenocarcinoma, gleason score 7/10 (3+4), grade group 2. 4% pattern : 15%. Tumor involves 40% core.
                              Left mid peripheral zone x4: prostatic adenocarcinoma, gleason score 7/10 (4 + 3), grade group 3. 4% pattern: 85%; cribriform pattern. 2/4 cores involved (fragmented), 75% of overall tissue
                              Left apex: prostatic ad enocarcinoma, gleason score 7/10 (4+3), grade group 3, tumor involves 5%
                              HIFU treatment, Toronto Canada on Nov.22/2020....Volume prostate prior to HIFU 43cc

                              PSA History:


                              Aug/2011 2.42, Oct/2012 3.1, Feb/2016 5.1; Apr/2017 6.0; Sep/2018 6.7
                              Oct/2019.. 8.5; Nov/2020 10.6 HIFU treatment Nov22/2020 Feb/2021 2.9
                              Jul/2021 3.2; Nov/2021 3.0 Next...Feb.23/2022 3.5

                              MRI Aug/2021 & Volume 30cc
                              Ablation defect on left posterior. Low signal extending from left peripheral zone from base to apex. Left peripheral reduced in size. No discrete high signals present on right/left peripheral. No suspicious lesions.

                              Comment

                              Working...
                              X