Husband newly diagnosed, insecure about best option

Seed radiation/ brachytherapy has a decent profile for side effects. The effectiveness is rated high.
I read that proton is no more effective than other radiation therapies and is much more expensive.
If radiation is the choice, seed radiation is an effective 1 shot treatment. Good luck with the decision and treatment.

Hi and sorry for the bad news. Hopefully it will not be all bad though. I have been watching the posts for about a year now and after seeing yours, I felt compelled to go ahead and join and share with you my experience in hope that it may be of some help. Last year at age 47, I did some blood work and the PSA came back at 3.5. Whats funny( or is that the right word?) is at the same time I just had a colonoscopy and the guy said,"Your prostate looks good". Wrong!! I did the biopsy and it was in 8 out 12 cores, called it a T2C, meaning contained but on both sides. All scans were clean. Gleason 7 (3+3 and 3+4), intermediate. Everybody was saying that if it was caught early and still contained it was curable. Luckily I talked to a Dr that had prostate cancer years ago and he said it can still be curable even it is not contained. I did the radical prostatectomy a few months later because the seed implants wasn't an option. All the time now I'm educating myself and knew that a T2C was just one away from T3a, meaning it was no longer contained. So after a week when I went back to get the catheter out, they gave me the pathology report. The Dr said," Everything looks good. It didn't get into your lymph nodes or seminal vessles and your margins are negative". I was going "Great!!" The he said," It did get out a little". And I just melted. I was T3A ! Plus my Gleason changed to 3+4 and 4+3. He said," But its ok, your PSA was low, gleason is a 7, negative margins, seminal vessles and lymph nodes". He said," Some Dr's would want to go ahead and radiate but chances are with your stats, I would be radiating you for nothing". He said we'll keep an eye on the PSA and if it ever starts to rise, that means there could be some left in the prostate bed and then we would radiate that area and that would be it". I guess if my Gleason would have been above a 7 or positive margins, he would have probably done the radiation. So... I have gone a whole year with undetectable PSA. I check it every 6 months now, January is next. also worth mentioning, he cut a wider angle, probably suspecting during surgery there could be a chance it had gotten out and got into the surgical margin. It didn't get into the margin but less than something like .001 millimeter from it. So did he really have to cut the wider margin? I dont know. In doing so, he had to remove about 15% of one bundle of nerves. So far, not alot of luck with erections, except with a pump and Cialis helps some, but hopefully that will get better. Keep in mind as far as "getting out" and not being contained, the Walsh book says it can get out and still be curable, as long as it doesn't metasasize. As he says in the book, "think of it like a gift in a box, if it stays in the box, its contained. It can get out of the box but not get through the wrapping paper". I guess that's where I was. Well good luck and hope my story helps in some way!

Thank you all so very much. I have so much to learn. Your comments are a great start for me. Several things you mentioned gave me definite questions i need to ask the doctors. Hopefully, my husband and I will make the best decision:) Oh, and Geaux Tigers is right bertb. We are looking forward to a great game and even more so watching Bama fall in the Valley. Great weekend to all!

I have to agree with JohnT. If there is a likelihood that his PCa has spread outside the prostate then surgery would likely involve some side effects while leaving some cancer cells behind. Brachytherapy is a good choice and the effectiveness of it is greatly increased when used in conjunction with IMRT. There is tons of information out there so take some time and sort through all your options. Talk to the experts and the guys who have been through it. Then decide what treatment is the best for you.

Marie, I thought I would chime in here as well, although you can see my husband and I are new to this as well. My husband was also diagnosed with a G7 (3+4) with a heavy biopsy load. Our NUMBER ONE priority was finding a very experienced and on-top-of-it doctor regardless of what treatment my husband chose. It took us 4 interviews with different radiation oncologists and surgeons before he made a final decision to go with IMRT and hormone treatment. We did our research and read everything we could find, but in the end, it's really all about the doc and his or her experience and attitude and your comfort level and trust with that doctor. For us that meant traveling some 3 hours away to Duke to find the very best in treatment and care. My husband just finished his 8 weeks of radiation. He did not experience fatigue. He did (and continues) to experience an occasional weak urine stream and slight burning. He also experiences hot flashes from the hormone treatment and has gained some weight (he's really battling that back right now). We chose radiation over surgery because we were told, we read, and we believed that there was a 50% chance or better that the PC had escaped the prostate. We didn't want to go through surgery and then turn around and go back at it with radiation. Our research indicated that the treatment we chose was likely to be every bit as effective as surgery. Best of luck.

Welcome, sorry you have to be here.  My DH and I started this journey on 9/11 when he was diagnosed.   We read Surviving Prostate Cancer by Patrick Walsh which was very helpful in describing all the different treatments as well as side effects. 

We read through a lot of the threads on this site and also went to yananow.org to read survivor stories for various treatment options.

We felt like we were on prostate cancer overload by the time we met with his URO, but it really helped to put everything in perspective.

Best wishes as you start through this journey.

MarleH,

You mentioned the possibility of proton therapy in your post. I am someone who has actually undergone proton therapy treatment (Indiana University Health at Bloomington) and I would encourage you to explore this option. Not sure where you are but you mentioned New Orleans. M. D. Anderson and University of Florida would probably be your closest proton centers. MDA would be especially good to obtain an opinion from, as they do all types of prostate treatment there, and will tell you the pros and cons of each, and what in their opinion is best for your husband.

I am always amazed at the naysayers and discouragers on this board when proton therapy is mentioned, especially since none of them have had it. I am a year out from treatment, have absolutely no side effects at this time, and a steadily dropping psa currently plateaued at 0.4. Go talk to some proton centers and make your own decision. I did, and I am very satisfied with my decision. By the way, at IU Health when I was there, plenty of gleason 7s being treated, some on hormones and some not. Those I have kept up with report similar good results as mine.

Whatever you and your husband decide, let it be your decision and no one else's. Most of all, good luck and best wishes!

I would cross Proton off your list. It may be just fine for a low grade cancer in which the objective is to avoid side effects. For a high grade, high volume cancer Proton just doesn't have the dose and field necessary to get a satisfactory long term remission. The normal Proton dose is 65 to 70 grays. This is sufficient to kill a low volume tumor. Brachy/IMRT combo is 130 to 150 gy, more that twice the dose of proton and this is necessary to kill high grade high volume tumors. The higher the dose the greater the killing power and your husband needs a very high dose based on his tumor volume.

MarleH, welcome to HW, thanks for joining and sharing with us. I see others have been talking, so I'll just say welcome to the gang....

Skeeter,

It has been pointed out to me that you have a website address for the hospital where your treatment was done in your signature. That is not allowed by forum rule 4. Please remove that.

4. No advertising or links to advertising or "Spam" is permitted.

• Advertising or spam is defined as posting a link for the purpose of selling, soliciting or promoting something.
• Links promoting fundraising, advocacy, etc. are not permitted.
• Links to personal blogs/homepages are allowed in member profiles and signatures
• Sharing of links to helpful and relevant web sites and resources is allowed if they are not used for a promotional purpose.

Interesting that I am seen as an opponent of Proton. I've often stated that I investigated it, but could not do it because my insurance refused to pay the costs, not for any perception of it being less effective.

skeeter... thank you so much, i have no clue why anyone would not want me to have a valuable link to a site that i very much need to visit and explore. thank you. and all the haters should just subside.