I think this is an important question nicely presented. I can not contribute anything but hope others can....
I opted for ADT along with SRT. It seemed like a coin toss to me. The ADT has not been too hard. No interest in sex. About a 10% loss of strength. I have used weights for 40 years so I can calibrate...
I am not sure I agree with the study’s chosen end point. Shouldn’t the end point be different for the two treatment groups? ADT has been shown to be effective, at least for a while, in most men....
Thanks Allen. They are an interesting group of papers suggesting Gleason 3-4 is a different beast. I would feel more comfortable if the cancer was scored by genetics rather this histology but that is...
Rigby I was in a similar position to you. One year after radical prostatectomy I faced a low but rising PSA: .10, .11, .12 and a Gleason score of 3-4. The differences are I was continent, did not see...
There are a couple is ways of interpreting the statement "you have a 20% chance of a curable cancer". The interpretation that best fits the data is: you have a 20% chance of cancer, and if you do...
Thank you all for the information. It is exactly what I was looking for. Yes the RO’s numbers are more optimistic than the Memorial Sloan Kettering nomogram (50% radiation alone for me, 20% boost...
Unfortunately it looks like it might be time for salvage radiation. Briefly, I had a radical prostatectomy about a year ago with Gleason 3+4, extraprostatic extension and a positive margin. My psa...
No doubt training, experience, and money play a role in the procedures recommended. I do not believe these are the sole motivators. In general, I am most concerned about these factors distorting the...
Brachytherapy seems to be equal or superior in cancer control and side effects are lower. Why have the large teaching hospitals not picked up on it? Recent papers seem to be the most definitive so...
It appears results are better the lower the PSA when radiation is begun. However, beginning salvage at some preset level, say .4, appears to only have a small negative effect. The advantage is up to...
Are there published numbers showing the percentage use of each treatment?...
Tewari and colleagues published an article on continence in Nature Reviews urology 2012. The article makes the mechanism sound very complex. Among other surprises, he cites articles suggesting the...
I talked to surgeons at 3 large hospitals. Each had their lab look at my slides. The pathology reports were identical. As an aside, I can't really picture Dr's Bostwick and Epstein examining every...
The Gleason score is based on the histology (microscopic appearance)of the cancer cells. My primitive understanding is that big cells (Gleason 4, 5) are linked to big genetic mutations. However I do...
This has been fairly widely documented. I have not read of the reason. To me it does make biological sense, since the pelvic floor muscles were downstream of the prostrate, they should be relaxed...
Your math is correct and the amount seems realistic. You are also likely to improve greatly over the next few months. I was leaking freely when I walked at 4weeks out. It remains a mystery what...
Yes it is a very interesting story. The group has published in nature-genetics. The paper is excellent, showing how complex the genetics of prostate cancer are and how great the new mouse tools are....
Is there any consensus about when to biopsy based on psa, age, and family history? If MD's can't agree how do the labs decide on the label high out of range?...