Steel Guy (and others), thanks very much for your post(s). I am scheduled to get a PSMA scan in May at UCLA for BCR prostate cancer. For those who have already had the PSMA scan: Did you work with...
Thanks for the posts! Very helpful....
Not sure if this topic has already been addressed, but what are the best, most powerful MRI machines now available in the United States for scans of the prostate? I have had a 3T mpMRI, but that was...
Thank you so much for taking the time to keep us informed. You and your husband are in our thoughts and prayers....
Bohemond, I am a Vietnam Vet, too. Can you direct me to the site where I can begin the VA application process for disability? I found an application for disability that is a prostate cancer...
+1...
JNF, I'm afraid we're just talking past each other. I get it that he was talking about cryo in the context of your case, of your treatment options. But the criticisms he made of cryo are exactly the...
Robert, I see from your profile that you took Metformin. How long did you take it, and do you think it helped? I am have just started taking it. Thanks. B...
I did check your signature. I'm sorry if my reply didn't make it clear enough that I was referring solely to what your urologist said about cryo, and not to the specifics of your case. The comments...
Sounds as if your urologist was referring to whole gland cryoablation, not focal cryoablation. Tall Allen was careful to make the distinction. And that distinction is important. I have had focal...
Coincidentally enough, I, too, have been diagnosed as a Gleason 10 with the signet ring cell variant. In July 2016. I am sorry that your husband has been similarly diagnosed, but that is not meant to...
Boone, I was in a situation similar to yours. I was on AS as a G(3+4), monitoring with MRI guided biopsies. I made the decision to go with SBRT as a monotherapy and actually scheduled an appointment...
Redwing, thanks for adding me to the G9 thread. As you note, there aren't many G10's on the forum. While the G10's might be an "exclusive" group, I do not find that exclusivity at all reassuring! But...
Sorry you have to deal with a G9 grading. Others who have responded to you have given you excellent advice. I will add mine: -- Make sure you are properly diagnosed before choosing a treatment. I...
69; Dx 4/21/16; Tx part 1: 8/16/16: focal cryo+mmunotherapy -- baseline PSA: 5.6 -- GL 6 to 10 (w/signet ring-cell pattern); -- 3T mpMRI 4/16: GL 7; ECE-; SVI-; LN- -- mapping biopsy on 7/21/16;...
Robot, I'm curious. Why do you -- and others -- assume the downgrade is the correct reading? Why is JH necessarily correct and the first pathologist not? What possibly unwarranted assumptions are...
It's confusing, but there is SBRT (Stereotactic Body Radiotherapy) and there is SBPT (Stereotactic Body Proton Therapy). They are different....
It's confusing, but there is SBRT (Stereotactic Body Radiotherapy) and there is SBPT (Stereotactic Body Proton Therapy. They are different....
TA, your presumption, quite understandable, was wrong. He is doing primarily IRE right now, not surgery, at least according to the poster on Inspire....
56 or 72. The reads by two radiologists varied. The 85 cores were taken under anesthesia. I experienced no pain, no urinary retention whatsoever, no need for a catherter at any point, no sexual side...
Thanks, TA, for tracking down the study you referenced. Very useful. I was surprised that the mean number of cores taken for the "saturation" biopsy was ~22 cores -- and ~ 15 cores for the...
Indeed. Could not agree more....
TA, an interesting hypothetical. Clearly, the treatment statistics would improve if all men had a saturation biopsy, since the very small yet very aggressive tumors would more likely be found. If...
TA, I'm sure you are right about the limit to diagnostic accuracy. As I understand it, the gold standard for biopsies -- short of RP removal and subsequent examination of the gland, which I further...
TA wrote: "So there are uncertainties in true Gleason score, uncertainties in staging, and cancer volume. That is something we all live with. All we have to guide us are population statistics, which...
Guess I was in that 20% minority, then. I don't think I would like even 80% odds that it was the right treatment since the consequences of missing a tumor can be so dire. But it's an individual...
Thanks to all who answered. Although I wasn't asked, I think the implication of a preponderance (80%-90%) of multi-foci cancer in post-prostatectomy glands is this: that the patient better make...
From a 1998 Oxford Journals article: -- "In men with prostate cancer, the gland usually contains two or more widely separate tumors. A critical issue of prostatic carcinogenesis is whether these...
Interesting Aeon essay on the problem with p-values. The rule of thumb is to discard experimental results which have more than a 5% likelihood of occurring purely by chance. But “If you observe a...
Did you all see this relatively recent NYT article: http://www.nytimes.com/2016/05/02/health/biggest-loser-weight-loss.html?_r=0 [Paywall] Contestants lost hundreds of pounds during Season 8, but...
TrailGuy: Thanks so much for your brutally honest reporting. Enormously helpful....
You're not out to lunch, but it will be very difficult to have both surgeries performed during one lengthy operation at the high level of surgical skill you'll want. There are relatively few doctors...
I was hoping Tall Allen would weigh in. Thank you....
I had focal cryotherapy under general anesthesia about three weeks ago, so I am not the best person to ask since side effects and complications could possibly still emerge. That said, I have...
I believe Johns Hopkins is running a trial that couples cryoablation and immunotherapy. Cryoablation, whether whole or focal, apparently enhances the beneficial effects of immunotherapy. I cannot...
island time: an extraordinary post, filled with great insight and wonderful advice, infused with a personal history that provides a compelling context for your observations. Thanks for your candor...
Extraordinary well-informed and useful. Such a valuable resource. Thanks to Tall Allen for the enormous amount of time he spends helping the rest of us. Here's the link, but you can find it in his...
Great thread. Agree with the posts that point to the power of the mind-body connection. My thought, however, is this: what a tremendous responsibility to place on patients for the course of their...
LAPilot, I agree with you. I've opted for focal cryoablation and immunotherapy, but that was only after getting an 85-core transparineal 5-mm template 3D mapping biopsy of the entire prostate. (I've...
My 3T MRI showed the main lesion but missed smaller, higher Gleason tumors, which were not found and biopsied until much later. Those smaller but much more aggressive tumors were discovered only...
Emar, given your husband's history, I suggest your husband consider a transperineal mapping biopsy, which can take up to 90 cores (probably more) for analysis by a pathologist. That will...
A minor clarification: the PD-1 protein is found on the surface of T cells, not cancer cells. Cancer cells have the PD-L1 protein on their surface. Clinical testing of PD-1/PD-L1 checkpoint...
Thanks, Allen, for posting this important analysis. I look forward to any f/u analysis that reports the toxicities and SE's from EBRT + BT boost, especially since I will probably opt for this...
Al, it is you who needs to take another look, and to be more careful when you quote studies to prove a treatment point, especially when you're not a doctor. The 146 "high risk" patients included only...
Actually, gynecomastia is not that hard to get rid of. Plastic surgeons have been doing it for years, principally through liposuction. B...
Hey, Al, you should take another look at the study you cited so approvingly: "High-Dose-Rate Interstitial Brachytherapy as Monotherapy for Clinically Localized Prostate Cancer: Treatment Evolution...
Thanks, Tony. As I understand it, Dr. Onik has continued through the years to refine his use of cryoablation, so a great deal has changed in the last 15 years in terms of Onik's treatment protocols....
Good point about not kidnapping Doug's thread. (Sorry, Doug!) And, Allen, thanks for your useful thoughts in your posts. Will start up new thread as needed! Best to all, Boon...
Allen, the study was indeed published in 2012. As I mentioned, I had skimmed the study (in my haste to get to a 4th of July event), and I had focused on data collection dates, not data publication...
Thanks for the explanation. I note that it is an old study. Later studies do not appear to have replicated the results....