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3+3 wants SEEDS

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Posted 3/25/2018 6:34 PM (GMT 0)
I have a friend at work that recently had biopsy that was 3+3. Contained in prostate. His PSA was around 4. He was told his prostate was small the size of a 20 year old. He wants to do SEEDS and not wanting AS. He's afraid G might increase and would be harder to treat. In his early 50's.

I had Robotic surgery 3 years ago with G8.

I don't know anything except when it pertains to Robotic surgery, and I'm no expert.

I'm always amazed at the knowledge of the people on this forum. I would appreciate your opinions and comments on my friends' situation.

Thanks, I look forward to reading your opinions.
Posted 3/25/2018 7:44 PM (GMT 0)
Duke,

Brachytherapy (seeds) is a good treatment option for your friend. With a 3+3, he would be a good candidate for AS--if he's got the mindset for it. It would still be a good recommendation for him to have his slides sent over to Johns Hopkins for a second opinion to give a solid recommendation.

Beyond that, have him get to the nearest major center with an expert radiation oncologist to talk about his options. Beyond that, he could also consider SBRT--which is a combo of seeds plus external beam, which has great outcomes as well.
Posted 3/25/2018 9:29 PM (GMT 0)

halbert said...
Duke,

Brachytherapy (seeds) is a good treatment option for your friend. With a 3+3, he would be a good candidate for AS--if he's got the mindset for it. It would still be a good recommendation for him to have his slides sent over to Johns Hopkins for a second opinion to give a solid recommendation.

Beyond that, have him get to the nearest major center with an expert radiation oncologist to talk about his options. Beyond that, he could also consider SBRT--which is a combo of seeds plus external beam, which has great outcomes as well.

Correction - SBRT is high dosage external beam radiation. There are no seeds involved.
Posted 3/26/2018 12:19 AM (GMT 0)
LDR is a great option and I am definitely biased as my signature will advocate. I share your concern about AS and the wait for a higher G. Yet, there will be those coming on board singing the praises of AS that bares your attention. SBRT and HDR are also excellent choices. Get that second opinion on the slides first and than do the due diligence research. Talk to people who have been through the PC journey. Your chances of cure are very good with any of the RTs suggested. Best wishes and keep us updated.
Posted 3/26/2018 1:58 AM (GMT 0)
Twenty years of AS study at Johns Hopkins has determined that there is NO increase in mortality risk for men in their AS program who later need treatment, versus someone who had immediate treatment. So, there is no risk in him doing AS.

But, he is a generation younger than I, and he needs to do what he feels most comfortable with. Either form of BT, or SBRT, should offer him a cure.
Posted 3/29/2018 4:16 PM (GMT 0)
As someone relatively new to AS, I would recommend it if your diagnosis falls within the strict requirements. For me, AS took some "mind adjustment," as it were, because it's easy to get overwhelmed and try to figure out "too much" (i.e., endless games of "What if x?" "What if X then Y?")

My trick is that I keep telling myself that I'm on AS in six-month intervals -- I'll review my "membership" at specified intervals based on new info and results.

I figure if I can even put off treatment for, say, five years, that would be incredibly beneficial. We don't know what exactly will be on the table as far as options and SEs then, but it can only be better. Look at some of the threads from 2013 -- it's amazing what's been accomplished since then.

One exercise that I've been trying is to relegate the times when I think about prostate cancer -- That is, I set aside specific times of the week to think about it and investigate. I try not to vary from that because then my "mind" can monopolize and diminish my quality of life. I must remember to "enjoy life as it happens" and not let the unknown ruin the beauty of the present.
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