Well, here I am....

BB - sounds like you have this under control. Just do your diligence with the various doctors taking the necessary time, make some decisions and get on with it. You will feel a lot better once you make a decision and have a plan. The best I felt after diagnosis were the weeks before surgery and the same for my ART decision some months later. Something about the uncertainty of what to do racks the brain as you try to figure a way out of this mess. Once you do, everything settles down and life has purpose again.

UPDATE:
Visit w RO today. Ordered a Decipher genetic test and a Bone Scan
Will develop a plan for RT when those results are back.
Also drew blood to check Testosterone level and a PSA test (last results in September).

Stay tuned....

Post Edited (BBinSC) : 3/2/2022 2:16:11 PM (GMT-7)

DjinTonic said...

BBinSC said...
UPDATE:
Visit w RO today. Ordered a Decipher genetic test and a Bone Scan
Will develop a plan for RT when those results are back.
Also drew blood to check Testosterone level and a PSA test (last results in September).
Stay tuned....

The very first validation study for the Decipher test for intermediate Gleason Group Grades, (3+4) and (4+3), was just published in an ASCO meeting abstract (lead author Daniel Spratt, one of the leading research radiologists specializing in PCa). This is very good news, and confirms Decipher validation beyond the previously validated group of high-risk men (G8-10).

Validation of the performance of the Decipher biopsy genomic classifier in intermediate-risk prostate cancer on the phase III randomized trial NRG Oncology/RTOG 0126. (2022)

"Conclusions: This study represents the first validation of any biopsy-based gene expression classifier in intermediate-risk prostate cancer. Decipher is independently prognostic and can identify patients that have low rates of metastatic events despite not receiving concurrent hormone therapy, and can be used to help personalize therapy in this setting. Clinical trial information: NCT00033631."

Perhaps this will change the current recommendation, which is, I believe, that ADT accompany RT for (4+3) but not (3+4).

Djin

Good info, thanks for sharing.
-B

UPDATE:

PSA was 11.6 yesterday.
Testosterone 388

Asking about going ahead with Lupron.

Terry's Cellar said...
For unfavorable intermediate risk guys at least a short course of ADT seems appropriate especially for a younger guy. From friends who have been on ADT it’s very doable especially if you increase your physical activity. The imaging techniques get better every year; however, I believe going into treatment with the assumption that the PCa maybe out of the capsule is the safest bet. Terry

RO wants to wait until the Decipher results are in to decide on ADT. Bone scan is Tuesday, so should have results from that about the same time. So for now we wait.

**Update**
Bone scan showed a few places on some ribs and degenerative areas on my spine. RO called and asked had I had a previous injury / trauma in that area. Oh yeah that's a long story from 2 fractured vertebrae and spinal fusion surgery almost 40 years ago. She said she was very confident that the indications on my scan we're remnants of that and were in no way indicative of the presence of cancer. I trust her.

We're awaiting Decipher results. Should be in this week. Hoping to stay off Lupron, but will do whatever it takes.

Decipher score is back - .8

RO recommends IMRT of 28 treatments and Lupron right away.

Here we go......

BBinSC said...
Decipher score is back - .8

RO recommends IMRT of 28 treatments and Lupron right away.

Here we go......

there you go! getting treatment started. good luck man!

mattam said...
BB,
You'll get your RT routine down and you'll be ringing the bell before you know it.

Good luck!

Thanks, yeah not worried so much about the routine for RT. My company is being very flexible and understanding, and the Cancer Center is not far away.

The ADT is the gut punch. I'm a single, active, fairly masculine 58 year old guy. At least I was.

how long does the doc want you on lupron?

BB, Although I have no personal experience with ADT, I can tell you I have a friend I see daily at the YMCA has just finished up 12 months of ADT. My friend says it’s a small price to pay considering the alternative. His biggest complaint seemed to be the ‘hot flashes’ that would remind him to get a more active.

FWIW…My friend and I were diagnosed within 3 months of one another. I selected aggressive treatment while he went with the VA’s recommendation of AS. In my opinion the VA was slow to react even when his PSA exceeded 10. A followup biopsy was significantly worse than his first two and his urologist recommended surgery. The pathology turned out poorly and he went on ADT and radiation. He never regained bladder control and recently had an AUS installed which has helped considerably. My take away is early detection and early treatment. If you select AS be positive that you’re on solid program.

Stay active and I expect the next six months will go quickly.

Hey BB - Also in the Greenville area and have gone through PCa treatment locally about 4 years ago. I would strongly suggest a consult with Dr. Daniel Fried, Radiation Oncologist at Spartanburg Regional. Extremely knowledgeable and generous with his time. Regardless of what path you choose, you'll learn a lot from talking to him. Best wishes on the journey.

So I have a question for the group here and the guys on ADT. How soon after a 6 month injection of Lupron does the libido etc disappear? I get mine Friday.