In order to find the best treatment you need to know your risk type. The following from the Prostate Cancer Research Institute outlines the criteria and the approptiate treatment. Combination therapy for high risk PC means a combination of any of the two or three treatment options, surgery, radiation and HT. Also not the recommendation for low risk is"No Treatment.
Find Out Your Risk Level — “Your Type”
Before selecting treatment the first thing to learn is your personal “Risk Level”.
The chart below shows the way doctors measure Risk Level. You can compare your own test results to this chart to understand your Risk Level.
- To be “Low-Risk”, all your results must meet the Low-Risk standards in the green row in the table below. Even one result outside the green means you are either Intermediate-Risk (Yellow) High-Risk (Red)
- Not all experts agree on the exact line between Intermediate-Risk and High-Risk.
- Some say that having two or more scores in the Intermediate range raises the risk to High.
- Others believe that you are not High-Risk until you have one or more tests that are clearly in the High-Risk range.
64 years old.
PSA rising for 10 years to 40, free psa 10-15. Had 5 urologists, 12 biopsies and MRIS all neg. Doctors DXed BPH and continue to get biopsies yearly. 13th biopsy positive in 10-08, 2 cores of 25, G6 less than 5%. Scheduled for surgery as recommended by Urological Oncologist.
2nd Opinion from Dr Sholtz, a Prostate Oncologist, said DX wrong, pathology shows indolant cancer, but psa history indicates large cancer or metastasis. Futher tests and Color Doppler confirmed large transition zone tumor that 13 biopsies and MRIS missed. G7, 4+3, approx 16mmX18mm.
Combidex MRI in Holland eliminated lymphnode mets. Casodex and Proscar reduced psa to 0.6 and prostate from 60mm to 32mm. Changed diet, no meat and dairy. All staging tests indicate that tumor is local and non agressive. (PAP, PCA3, MRIS, Color Doppler, Combidex, tumor reaction to diet and Casodex, and tumor location in transition zone). Surgery a poor option because tumor is located next to the urethea and positive margin is very likely; permanent incontenance is also high probability with surgery.
Seed implants on 5-19-09, 3 hours door to door, no pain, minor side affects are frequency and urgency; very controlable with Flowmax and lasted 4 weeks. Daily activities resumed day after implants with no restrictions. Gold markers implanted with seeds to guide IMRT.
25 treatments of IMRT 6 weeks after seed implants. No side affects at all.
PSA at end of treatment 0.02 mostly the result of Casodex. When I stop Casodex next week expect PSA to rise. Next PSA in November. Treatments and side affects have greatly exceeded my expectations. Glad to have this 11 year journey finally conclude.