What to make of the treatment plan suggested for my buddy?

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BobCape
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Date Joined Jun 2010
Total Posts : 416
   Posted 4/24/2011 1:48 PM (GMT -6)   
A good friend of mine was just dx with pca. He's, 52 years old, recent psa result of 18. Biopsy they tell him Gleason 7. He feels comfortable just doing what his drs are telling him, and doesn't want to know all the details. Cat scan, mri, etc all negative.
 
He says they told him the pca is at the edge of the prostate, nut not broken through yet.
 
He tells me they are planning to give him beamed radiation and Hormone Treatment. And theHT will be over a period of years.
 
I am aware of the recent study that showed alot of benefit using HT and RT together, but I though that would be short term HT.
 
And i'm not aware of any test that could show that the pca is still contained?
 
And if they thought it was contained, why not at least consider surgery?
 
This doesn't seem like the typical treatment...Any thoughts?

tatt2man
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Date Joined Jan 2010
Total Posts : 2842
   Posted 4/24/2011 2:26 PM (GMT -6)   
BOB_
- did your buddy have a biopsy done - and the results? -
-sorta sounds like your buddy is playing the doc-is-god routine and feels more comfortable with his head in the sand
-my initial response would have been surgery due to the positive margin

-regardless of what I and other say here - it is his choice for treatment / doctor / hospital - as we all know - "this ain't a do-over"

-wishing him (and his spouse?) all the best.
hugs,
BRONSON
.............
Age:55 -gay with spouse of 14 years, Steve -Peterborough, Ontario, Canada
PSA:10/06/09 3.86
Biopsy:10/16/09- 2 of 12 cancerous, 5% involvement -Gleason 7 (3+4)
Radical Prostatectomy:11/18/09
Pathology:pT3a -Gleason 7 -extraprostatic extension -perineural invasion -prostate weight -34.1 gm
PSA:04/08/10 -0.05 -Zero Club
PSA:09/23/10 -0.05 -Zero Club
PSA:03/24/11 -0.02 -Zero Club
PSA:03/24/12- TBA

F8
Veteran Member


Date Joined Feb 2010
Total Posts : 3803
   Posted 4/24/2011 2:26 PM (GMT -6)   
the treatment plan as well and the gleason and PSA suggest that there is a good chance that the cancer is out of the capsule and possibly systemic.  i know that's not what the doctor is saying.
 
ed
 
 
age: 56
PSA on 12/09: 6.8
gleason 3+4 = 7
HT, BT and IGRT
received 3rd and last lupron shot 9/14/10
2/8/11 PSA <.1, T= 6 ng/dl

compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7205
   Posted 4/24/2011 2:42 PM (GMT -6)   
Very strange.  Something doesn't sound right. Maybe you need more information. I would think surgery would be a reasonable tx.
 
HT???
 
Mel

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 6949
   Posted 4/24/2011 2:54 PM (GMT -6)   
The initial RT scheme proposed for me also included 2-3 years of HT. I went the surgery route because of the fairly low success rate they quoted for the RT.

Herophilus
Veteran Member


Date Joined Sep 2009
Total Posts : 663
   Posted 4/24/2011 3:03 PM (GMT -6)   

Take it out!

Just what I'd do  (just what I did) age 51. 10 of 12 positive. Ended up with 4+3. Would not change a thing

Hero



Age 51 PSA 6.8
Bxy 10 of 12 Cores positive for Gleason 6. up to 75%
Robotic surg 11-02-09
Post op path. 20% neoplasm;4+3=7 Gleason
All nodes (14) and other related tissue negative for cancer
No EPE
Post op PSA x 3, all <0.01
walkbobwithjack.blogspot.com

BobCape
Regular Member


Date Joined Jun 2010
Total Posts : 416
   Posted 4/24/2011 4:48 PM (GMT -6)   
Hi Bronson, ya, his Biopsy came back Gleason 7.. that's the only detail he got. I have a hard time trying to tell him to listen to my advice when he's dealing with some of the best mnds in the world.

Post Edited (BobCape) : 4/24/2011 4:53:39 PM (GMT-6)


zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 4/24/2011 5:29 PM (GMT -6)   
Bob- you mentioned ' He says they told him the pca is at the edge of the prostate, nut not broken through yet.' First of all disregard the word nut? (-:
Let's tell the truth on PCa....'that they cannot ascertain containment'...assumed contained or not contained would be the proper verbage...means slightly different, of course not what people wish to hear, same with clear scans and we got it all...yada...yada. So they are assuming not contained, usually we uro-docs assuming it is contained very often...just an observation perhaps. We have no idea on this end.

Since we cannot predict his outcome, best not for us not to bias the waters. Someone could come on and say Super Samadi is the only salvation (still without a warranty program). Maybe and maybe not. Super Dattoli could get beyond the margins in radiation, too. (I like him alot more, but no bias's) and I'm not saying anything as to whom.
The best thing to say is....get further opinions, learn all you can...maybe go see a top notch oncologist whom has seen every type of scenario, just for his input (not treatment necessarily). When is it dumb to seek further opinions on your possible death scenario??? As always people have choices in PCa, mentioned in books (<: }
Or flip a coin and hope it lands properly.

John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4227
   Posted 4/24/2011 8:08 PM (GMT -6)   
I agree with Ed. Both his stats and treatments indicate a high probability of it already being systemic because of his grade and high psa. He is in a high risk catagory and many doctors and the PCRI recommend a combination treatment that includes HT for all high risk patients. His tumor being at the edge would favor radiation and his high risk status would favor 2 years of HT. This combination will give the best chance for a cure and his doctor's recommendations are spot on.
The other option is surgery, adjuvant RT along with HT for two years. This triple whammie could possibly be better for a younger man, but he would also have to acccept the resulting SEs.
JohnT
66 years old, rising psa for 10 years from 4 to 40; 12 biopsies and MRIS all negative. Oct 2009 DXed with G6 <5%. Color Doppler biopsy found 2.5 cm G4+3. Combidex clear. Seeds and IMRT, 4 weeks of urinary frequency and urgency; no side affects since then. 2 years of psa's all at 0.1.
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