Surgery or radiation/hormone treatment with a PSA of 6.7 and a Gleason of 8.

One more thing to add-- my father is located in South Florida, but I live in MN-- if better surgeons and/or treatments are available at Mayo, or anywhere else in MN (I live just outside of Minneapolis), he's willing to travel here for treatment.

I'm new here, and was just diagnosed with PC today, but someone posted this link and I found it answered some questions for me. Especially read the part about men in their 70s and why NOT to do either surgery or radiation ... and just live it out. A prostate cancer survivor wrote the piece for Men's Health Magazine.

Link: www.nbcnews.com/id/35874966/ns/health-mens_health/t/surgery-regrets-i-want-my-prostate-back/#.VydxKfkrKUl

Post Edited (WadeB) : 5/3/2016 1:35:43 AM (GMT-6)

Hi ellysbelly, I was diagnose with PC on March7,2016 left base gleason 4+4=8 psa 7.1. My urologist want to do robotic surgery w/nerve sparring on the other side, and my radiology want EBRT and Hormone theraphy. I was told I will not qualify for seed implant because my prostate measures 60.1. I will see another urology for a Proton theraphy consultation this May 9, 2016. from I read, Proton theraphy has been used for cancer patience since 1950 where they have initially done in Physics laboratories. There are only 15 Proton Facility in the country as of today and one of them are in Jacksonville, Florida (University of Florida Proton Theraphy Institute. From what I read, the side effect are minimal. By the way I just turned 70 this april like your dad. I consider my self fairly healthy even with a controlled diabetes, on the gym every other day. Please tell your dad to take his time, because it is a life changing decision then move forward.

Thanks, @InTheShop-- really appreciate the warm welcome, wish none of us had to be here, but very glad that this forum exists. I think that you're right, there's no definitive answer as to which is better in each individual case. The good news is that he should, hopefully, be fine either way-- so it will boil down to which option he's most comfortable with. Thanks again!

@WadeB: If my dad were older and/or his Gleason score were lower, I would absolutely encourage him to consider AS-- with his Gleason score-- paired with the fact that we lost my mom (his wife) to an absolutely brutal battle with (an obviously different) cancer 16 years ago, makes the thought of 'doing nothing' (in his mind and words, not mine) an absolute non-starter. Perhaps he might regret losing his prostate or having radiation in the future (when the side effects kick in), but right now, logical or not, he wants treatment NOW so he can 'eliminate the threat' Whether that's rational or necessary, I can't say-- but even if his PSA were a 6.7 and his Gleason were a 6, he's told me that he'd still opt for treatment. He just wants to be around for us and his grandkids-- and treatment gives him peace of mind that he's more likely to be here than doing nothing would. I did share the article with him, as I want him to make a fully informed decision-- I'm only here to gather and synthesize info, the choice as to what to do will still be his and his alone.

@Howard: Glad that you're here-- thanks for sharing!

@Junbug: Your numbers are remarkably similar to my dad's-- he's calling the surgeon today to schedule a consult. I did a cursory search on Proton therapy and it seems that the side effects (in the long term) are similar to other types of radiation (but it was from a very small and self reported study, so it could be inaccurate)-- but I'll definitely look into it further and share that info with my dad, too. I'm wishing you nothing but good health, please do let us know what you decide. Thanks again for responding!

Hi Elly and I'm very sorry to hear about your Dad. That said, I'm glad you're advocating for him.

As you probably know by know, Gleason 8 would be considered an aggressive cancer, but it's also very treatable. With the clean scans, your Dad has an excellent chance of doing well. The first thing I'd recommend is getting a second opinion on his biopsy slides from either Bostwick or Epstein. The newly diagnosed sticky tells how to do this--it's easy and is one of the few no-brainers (in my book) as you navigate his options. It would be really good to know if he's a G8. (For the record, I was a G8 at diagnosis, but on an expert second opinion was reclassified G9. But it could also go the other way or stay the same.)

I'm as big a fan of AS as anyone here, but I certainly wouldn't recommend it for an otherwise healthy 80-year old. Rather, you'd be looking at radiation (either SBRT, brachy or IMRT with a brachy boost) or surgery. He's at the upper age range for surgery and sometimes with an aggressive cancer like G8, there's a good chance you also need to radiation as a back-up, so keep that in mind. Although I'm younger, I went straight to radiation since I wanted to avoid the SEs of both surgery AND radiation.

Keep learning all you can and we're here to help guide you. Good luck to your Dad!

i am in Canada. I am now 74 years old.
diagnosed april 2015 and did brachy 3 months later.

i went to see the surgeon who explained everything about my prostate cancer and the results of the biopsy.
6 of 12 positive.
psa level 9.2
scan revealed tumor contained in prostate and small enough to do the brachytherapy

he suggested i speak with another doctor in his office who did brachytherapy ,which I did.

both said based on my numbers, results would be the same, so i selected non-surgery and went with brachy.
first visit my numbers stood at 1.8 from the 9.2 i had before brachy and next week go for second 3 month checkup on the numbers.

why I qualified for brachy I don't know . all what was said was good physical condition etc.
so here I am.
so, it boils down to one sees themselves going through. I didn't like the idea of a slipped scalpel perhaps and radiation I understood very well. how precise they are today is amazing and it was essentially a breeze and even during radiation treatments, I was out playing racquetball.

now there is a newer treatment out there, just raising its head and by an Israeli company that has been approved in many places in the world.
there are no side effects , no surgery, no radiation.

it is for low risk PC candidates.
here it is for all to see.
www.timesofisrael.com/weizman-developed-drug-cure-prostate-cancer-in-90-minutes-studies-show/#.VwzeTnvEp6c.gmail

point is, for all of us, therapies will get improved and better all the time.

you are a good son .

good luck.

4=4 is a bit on the aggressive side, but today they can do so many great things. as long as it didnt spread, it will be o.k.
thats the key.

@racquetball74: I happen to be his daughter, but thank you! :) That's what we're most relieved about, that, though aggressive, it seems to be contained to the prostate-- and that his doctors seem confident that it's curable at this stage (stage IIC) with either treatment.

My biopsy was a Gleason 8 - second read by U of Miami Health was a 7 (4+3)-

I had significant voiding issues and was advise by multiple urologists that radiation would make the voiding much worse. Based upon that, I opted for surgery.

If not for the voiding issues I would have gone with some form of radiation.

Another top clinic in Florida is Dattoli Cancer Center in Sarasota (www.dattoli.com). They are Prostate cancer specialists in radiotherapy methods that do not involve surgery. If I lived in Florida I would definitely meet with them.

@Michael_T: Thanks, I wholeheartedly agree that a 2nd opinion is VERY worthwhile, he's adamant that he's NOT DOING IT. I'm working on him, but he's being childish at the moment. I'm hoping a combination of badgering and guilt will do the trick-- I'm not afraid to unleash my kids on him, if need be-- ha!

I've offered to handle any logistics that would be necessary in getting the 2nd opinion on his biopsy-- making all calls and arrangements-- and he's still saying no. I am frankly annoyed that he's unwilling to do something that most would deem so important (and non invasive and low/no cost). I get that it's not my body nor my choice, but I'm a data junkie (he is normally one, too, when not in full blown panic mode) and realize that the best course of action would best be informed by having an accurate Gleason score-- he seems to think that the course of action is set regardless of his risk factor and I'm not having much luck in getting through to him. I'll indulge his temper tantrum for another day or so and then try again.

He seems to think that he has NO time-- that he must get into treatment NOW and think later. I respectfully disagree and think that, while not getting stuck in analysis paralysis is key, there needs to be some thoughtfulness here and not just a "get it out! get it out!" at all cost mindset.

He's spoken with a RO and he's talking radiation and HT. Not entirely sure which type of radiation (or what type of HT, for that matter!), I only know that the radiation in consideration would be administered 5 days a week for 9 weeks-- the actual session would only be about a minute of radiation. Does that help you identify what type of radiation?

He is in the midst of scheduling a consult with Patel in Orlando, who both his urologist and his RO highly recommend.

5x9 sessions is 45 sessions of most likely a standard form of EBRT.

If he really feels he has to do something NOW, certainly he could start the Hormone Therapy while he is doing his research to compare his surgical options vs radiotherapy.