Recently diagnosed with G9 PCa.
PSA 39.4 02/07,
PSA 37.1 02/14,
PSA 28.0 02/22
12 cores of 14 scored G9 70%-100%, mostly 90% and 100%.
CT Scan = Negative.
Bone Scan = Negative.
MRI = There is evidence of spread of the cancer locally into the seminal vesicles (stage 3B) - there is no evidence of others areas of breech or spread, the lymph nodes look normal.
GA68PSMA PET = will be doing tomorrow to find possibly microscopic spread.
The first Kaiser team of Uro, RO and MO recommendation is HT (Lupron) for two years, Radiation 30 sessions of IMRT/IGRT six weeks into HT and followed by 6 Chemo (Taxotere) sessions 2 months after the radiation completion. I asked the RO about
Brachythreapy and he feels that I will have double side effects getting the same result as IMRT alone. They also suggested Chemo based on G9 and high PSA. I understand the G9 part but I believe my PSA was elevated not only because PCa. I have Ankylosing Spondylitis which is in internal inflammation causing PSA fluctuation.
I spoke to another Kaiser Uro and his recommendation is "With aggressive prostate cancer, without evidence of distant spread, my recommendation would be robotic prostatectomy with extended pelvic lymph node removal with a high probability of needing additional radiation and hormone therapy. Taxotere chemotherapy could be considered given your high risk status although this would be similar to clinical trial approach with limited data on its benefit and some risk of side effects/complications/morbidity"
I will also see Dr. Litwin from UCLA. It would be interesting to see what he thinks.
So far, based on what I have read on this forum It look like the best treatment for high risk PCa is the combination of HT, Brachythreapy and IMRT.
I think at this point I need to talk to another RO.
What do you guys think about
this treatment plan?
What's best for G9 in my situation based on your own experience, someone you know or research/studies?
Any recommendation on RO in LA/OC area in or outside Kaiser?
D.O.B March, 1972
DX Feb, 2017
5+4=9 2 cores 90%, 70%
5+4=9 3 cores 100%, D.I 100%, D.I 90%
4+5=9 1 cores 90%
4+5=9 2 cores 100%, 100% PERINEURAL INVASION IDENTIFIED IN THIS CASE.
4+5=9 2 cores 100%, 90%
4+5=9 2 cores 100%, 100%
PSA 39.4 02/07
PSA 37.1 02/14
PSA 28.0 02/22
Post Edited (SteveJ2017) : 3/16/2017 2:35:03 PM (GMT-6)