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Posted 5/29/2014 4:17 PM (GMT 0)
Hello.
Thanks to all the participants in this forum for their help.
In Mars 2012 my PSA was 2,5 in the age of 58 years, in Mars 2014 PSA 4,18. In the first April, 2014 PSA 4,52 and PSA free 0,72. A biopsy was made on April 03rd, 2014. Result of the biopsy: 2 of 20 positive carrots (gl 3+4) 8 millimeters all in all + Adénocarcinome confined inside the prostate. MRI seven weeks later, result : Cancer very probably affected the capsule of the prostate. Lymphatic Gonglions and seminal vesicles not affected. Likely class T2C N0 Mx. The urologist opted at once for the hormonotherapy followed by the radiotherapy. I I shall have preferred the surgery then a radiotherapy adjuvante. Of what think of it you the guys? PSA of May 24th, 2014 is 7,89. The urolog says that the value of the PSA 7,89 is due to the biopsy (make two months ago). (Excuse my English, I am French-speaking). Not sintigraphy made. Thank you.
Posted 5/29/2014 6:23 PM (GMT 0)
Welcome and sorry to hear that your biopsy was positive. With only 2/20 cores positive and Gleason 3+4, and Stage T2 and PSA 4.5, you are considered to be "favorable intermediate risk." That means you have several curative options.

Hormone therapy has never shown to be a benefit with Gleason 3+4.

I understand why they are not recommending surgery if they know already that the cancer has invaded the capsule. Depending on where that is, they might not be able to spare the nerves. That increases your chances of erectile dysfunction and lasting incontinence. Surgery followed by radiation increases the side effects of treatment.

There are a couple of different kinds of radiation therapies that you might want to look into. The first is called SBRT, sometimes known as CyberKnife. Five short treatments and you're done. The other is called brachytherapy - the place the radiation inside of the prostate. With one kind, called LDR brachytherapy or seeds, they leave the radioactive seeds inside to slowly decay. The other kind is called HDR brachytherapy. With HDR, they temporarily place and then remove the radioactive pellets so nothing is left inside. With all of these, you have to find specialists in your country who perform these procedures.

Good luck!
Posted 5/29/2014 8:04 PM (GMT 0)
Think you Tall Allen
Posted 5/29/2014 8:28 PM (GMT 0)
I am looking at Cyberknife therapy. Go to the cyberknife.com site and there is a list of places. And then start making phone calls. Some of the Rad Onc will want to have hormone therapy along with the SBRT and some dont think it is necessary. If you can figure out how to access the site look at NCCN.org. Most of the Rad Onc follow the guidelines. The other question will be insurance coverage. I am waiting on a decision from BC/BS of TX for Cyberknife therapy and most likely I will go to Oklahoma City for the treatment. Good luck if I can help let me know however there are others on this and other blogs with a lot more knowledge and experience than me.
Posted 5/29/2014 10:08 PM (GMT 0)
Given your MRi radiation would be a better option than surgery. the worst option would be to have both due to the side effects. Adding Hormone treatment is a 50-50. It could shrink the prostate and make radiation more effective, but radiation alone would be OK too. As long as the Hormone therapy is short term, around 6 months, it shouldn't be a problem. No reason to go on long term HT.
Posted 5/30/2014 2:28 AM (GMT 0)
Welcome to HW, sorry you need to be talking to us.

Your numbers sound like mine. In my case there was some concern about the cancer being near the prostate capsule so that was one of the reasons I picked radiation treatments. In my case they widened the beam to cover the prostate and a little bit beyond to get anything on the edges.

Two years out and it seems to have worked.

Andrew
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