85 year old due for biopsy

Writeblock, the best way to fight fatigue is through strength. Sounds like you have a great headstart.

Writeblock, the first thing is to get a second read on the slides, Epstein's group at Johns Hopkins is the best at it. All you need to do is to ask your Uro to have the slides sent there. Especially with the 3+5 read--which is uncommon to have that big a spread on a single core--a second read is vital. Understand that the "20%" is the percentage of the CORE, not of the gland. It's like you had a strawberry milkshake and you hit a big enough piece of strawberry with a straw to plug the straw. It doesn't say anything about how big all the pieces are.

As far as which treatment is recommended--talk to the specialists who actually do those procedures. They can give you real information based on their experience and protocols, if you want to look at SBRT, then talk to an SBRT specialist.

Thanks for sharing your journey. Your decision to have a biopsy was well informed and important. Now you will get treated and hopefully live a comfortable life. Wishing you peace during your treatments. Denis

Some people express very strongly that a 85 year old man shouldn't have a biopsy because he may not live long enough to die from prostate cancer. Suppose the man has a very aggressive prostate cancer. Do we want him to die a very painful death from prostate cancer?

Seven years ago, at the age of 70 I was diagnosed with Gleason 3 + 3 prostate with a very low volume of about 10% of 2 out of 12 cores. I went for brachytherapy and was very confident that my prostate caner will not resurface during the rest of my life. Two years back a second biopsy detected cancer in a extraprostatic mass. I had cyberknife for that. Now with my PSA rising after being undetectable for about a year, there is possibility that I have metastatic cancer. Should I surrender to prostate cancer because I may not have many years to live?

I support the decision taken by Writeblock in question.

Going for brachy, I read your post too hastily. I noticed your psa was undetectable in January and assumed the sbrt treatment was successful. I reread your post and realize you're still in the woods. How are you proceeding?

Andrew, I'm now using a different username, changed from writeblock to Praepositus. Praepositus had been my password--go figure. In any case, I'm still 85 yrs. old and still on adt (firmagon). What has changed--besides my username--is that Dr. Epstein has upgraded my one core bx from G3+5 to 4+5. I switch to a 4-month shot of Lupron on 9/13. So far the firmagon has cut my psa in half to 3.9 (actually double that because I'm still on finasteride.). My second month on adt is due to be measured soon--hopefully cutting it down even more. Then it's up to the Lupron.

I've tolerated the firmagon well so I hope I do as well with the Lupron. In fact I actually feel more energized lately, which is odd. No weight gain, no cognitive fog, no depression. Just hot flashes which come and go and which I mostly ignore. I remain optimistic and begin rt (45 sessions) on 9/19 at a facility I trust (NROC) with a doctor I have faith in (Christopher Peters, its director, a ro with a good deal of pc experience.). So far so good. I hope the JH upgrade doesn't diminish my chances for a cure. My one core showed 20% involvement and subsequent ct and bone scans were negative.

Thanks, Allen. I'll do as you suggest.

Fairwind said...
...Had Writeblock's cancer gone undetected, his overall survival would have probably been shortened considerably..

There certainly is no evidence to support that. The generally available evidence supports otherwise. Nonetheless, it “may be” correct in some individual cases. All we have so far is an aggressive treatment started for a 75 yo with an apparently slow growing tumor.

Post Edited (Normal59) : 9/3/2018 1:51:23 PM (GMT-6)

Fairwind, I agree. My pc is very high risk, but apparently still in the organ, though I realize ct and bone scans don't always tell the whole story. Nevertheless they were negative. In addition my general health is fine, considering my age. I have no discernible cardiac or diabetic issues. I consider my recent dx fortuitous inasmuch as I might otherwise have missed a chance for a cure. Moreover the cost in terms of quality of life has been negligible so far. I'm tolerating the ht well and hoping for an uneventful experience with radiation as well.