Posted 6/27/2014 1:06 PM (GMT -6)
I posted my biopsy results recently which were the following:
1 core of 24 positive; 1 mm out of 16mm core; Gleason 7 (3+4); PSA 9.4; free PSA 14.4, PCA-3 ,<4; prostate 61.4 grams. I sent the sample to JH's for 2nd opinion. Many of you responded that this was not a particularly bad report and I had several options for treatment, including AS.
I have been researching, reading, and thinking of little else since my diagnosis. At his point I am leaning toward Proton Therapy at UF, but some articles and comments from some of the men I talked with that had the treatment there have caused me some distress. It seems that men with large prostates and/or potentially advanced cancer may have to either have ADT meds for several months before proton treatment, or have the ADT meds and additional radiation after proton. The SE of ADT seem pretty awful (and potentially permanent). One of the main reasons I like proton therapy is because of fewer SE.
I called UF and asked about ADT for large prostate. I was told the prostate had to be 100 grams before ADT would be recommended to shrink it before treatment. I felt better after that. She asked me what my Gleason was and I told her 3+4. She said this was intermediate and would note require ADT either.
What happens if JH's comes back with 4+4? That puts me in high risk category. Would I likely have to have ADT first, or some IMRT and ADT after proton? Which pathology does one accept as definitive?