Newly Diagnosed - What to expect?

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New Member

Date Joined Mar 2018
Total Posts : 2
   Posted 3/7/2018 1:40 PM (GMT -6)   
My husband is newly diagnosed with advanced prostate cancer as follows:
53 years old
PSA 9.5
Gleason 2 cores 8 (4+4), 4 cores 7(4+3), 1 core 6(3+3)
3-Tesla MRI shows extracapsular extension and neurovascular bundle involvement
clinical stage T3b

Planned Treatment
2 years - Lupron Therapy - 1st shot to be 3/8/18
25 treatments - EBRT - begin May 2018
HDR Brachytherapy at end of EBRT

Any feedback/thoughts especially on side effects are appreciated.

Veteran Member

Date Joined Sep 2012
Total Posts : 3057
   Posted 3/7/2018 2:03 PM (GMT -6)   
Sorry to hear about your husband's diagnosis. It's essentially the same diagnosis as mine at the same age (51 in my case) and he's having the same treatment that I did.

Regarding cure, there are several of us in his situation that are doing quite well. In my case my PSA has remained low and stable four years after finishing my ADT. For high-risk diagnoses, this combo treatment (often referred to as the Triple Play around here) has a good record.

Regarding SEs, the most come from the ADT, which is not particularly fun. Hot flashes, loss of libido and general creakiness were my main ones. That said, it's doable and those SEs do go away when you're finished. BTW, there is debate about the optimal length of ADT, with most having between 18 months and three years. I did 18 months.

The only other SE I have now is that I don't urinate as well as I used to. I take a Rapaflo 1-2X week and that does the trick. Everything else is fine.

The HDR brachy and EBRT (I presume he's having IMRT for that) were not particularly difficult for me. Some short-term burning after the brachy and I was a little leaky for a while, but that was it. Where is your husband having his brachy and EBRT done?

Good luck to the two of you!
Age 57, Diagnosed at 51
PSA 9.6, Gleason: 9 (5+4), three 7s (3+4)
Chose triple play of HDR brachy, IMRT and HT (Casodex, Lupron and Zytiga)
Completed HT (18 months) in April 2014
9/17: PSA = 0.1

Forum Moderator

Date Joined Sep 2008
Total Posts : 4271
   Posted 3/7/2018 2:04 PM (GMT -6)   
Hello Spouse and welcome. So sorry for your husband's diagnosis. The good news is that many men are treated with his stats (and worse) and live full and long lives in spite of it. One of our really smart guys, Tall Allen, has often posted about the merits of "brachy boost therapy" . Feel free to use our search function and input that phrase -- you will see multiple discussions like this one: /

So it appears that your husband's treatment is indeed appropriate for his condition. Perhaps Allen or others will also weigh in here with additional thoughts.

Good luck. Please feel free to ask any and all questions and keep us posted.

Forum Moderator-Prostate Cancer. Age 62 (71 now), G 3 + 4 = 7, T1C, PSA 4.2, 2/16 cancerous, 27cc. Brachytherapy 12/9/08. 73 Iodine-125 seeds. Everything continues to function normally. PSA: 6 mo: 1.4, 1 yr: 1.0, 2 yr: .8, 3 yr: .5, 4/5 yr: .2, 6-9 yr: 1. My docs are "delighted"! My journey:

Veteran Member

Date Joined Dec 2010
Total Posts : 3880
   Posted 3/7/2018 3:29 PM (GMT -6)   
I too was high risk and used the same treatment protocol more than seven years ago.

My PSA continues to be undetectable and I have no negative side effects. I applaud your choice and am sure you will do very well. Please let me know how I can help.

PSA 59 on 8-26-2010 age 60. Biopsy 9-8-2010 12/12 positive, 20-80% involved, PNI in 3 cores, G 3+3,3+4,and 4+3=G7, T2b.
Eligard and Jalyn started on 10-7-2010. IMRT to prostate and lymph nodes started on 11-8-2010, HDR Brachytherapy December 6 and 13, 2010.
PSA < .1 since February 2011. Located in Cumming Georgia north of Atlanta

New Member

Date Joined Mar 2018
Total Posts : 2
   Posted 3/7/2018 5:59 PM (GMT -6)   
I'm already learning more and feeling better hearing from so many folks.

Thank you so much for the responses especially Michael_T. I have been following your posts for a little while, and also felt you were a similar case. I was so hoping you would reply.

We are from Missouri, so his treatment will be at the Siteman Cancer Center located a Barnes Hospital/Washington University in St. Louis.

Veteran Member

Date Joined Jan 2012
Total Posts : 9369
   Posted 3/7/2018 7:32 PM (GMT -6)   
Welcome to HW.

Sounds like a solid treatment plan to me. Get it done.

We're here if you have questions,
I'll be in the shop.
Age 58, 52 at DX
4.2 10/11, 1.9 6/12, 1.2 12/12, 1.0 5/13, .6 11/13,
.7 5/14, .5 10/14, .5 4/15, .3 10/15, .3 4/16, .4 10/16, .4 5/17, .3 10/17
G 3+4
Stage T1C
2 out of 14 cores positive
Treatment IGRT - 2/2012
My latest blog post

Tall Allen
Elite Member

Date Joined Jul 2012
Total Posts : 10645
   Posted 3/7/2018 8:18 PM (GMT -6)   
Welcome pcspouse 53-

I think that is a great plan for your husband's diagnosis. The only thing you might want to discuss further with your RO (who is your RO, btw?) is whether that much adjuvant ADT (i.e., Lupron) is really necessary with it. I'm not saying yes or no, just that it's worth discussing further before deciding. Here's an article that discusses this issue:


You should have a full understanding of potential side effects of this treatment.

Also, it may make sense with a T3b and GS8 to have an advanced PET scan that is now available at NIH. It can help rule out distant mets before starting RT.
Allen - not an MD
•PSA=7.3, prostate volume=55cc, 8/17 cores G6 5-35% involvement
SBRT 9 yr onc. resultsSBRT 7 yr QOL results
•treated 10/2010 at age 57 at UCLA,PSA now: 0.1,no lasting urinary, rectal or sexual SEs
my PC blog

Regular Member

Date Joined Dec 2012
Total Posts : 392
   Posted 3/7/2018 9:41 PM (GMT -6)   
I had a similar treatment plan with one year less on the ADT and LDR, not HDR. also had an additional 10 days of "boost radiation" at the end of it all

Everyone reacts differently to ADT, my symptoms were manageable and never got too bad. I was on an estrogen patch and some other meds to mute the effects of ADT. I Also continued to exercise through it all, not easy to do but it helps immensely. There are also meds to reduce and/or prevent breast enlargement which can be a side effect of the ADT

As for the external beam, it was relaxing and painless, minor fatigue and urinary urgency, but the treatment sessions were a non event

The LDR brachy was also not bad. Like any other procedure where you are sedated, wake up it's over with little memory of the procedure. Recovered quickly, urinary frequency, some burning while urinating lasted for a few weeks, maybe more, all seems like it never happened

Sounds like a good plan for the diagnosis you have, and you can slog through it with a good chance of a complete cure, good luck
56 yrs old @Dx, on 11/12 Staged T3A
PSA-2007-2.7, 2011-5, 2012-5.6 up to 5.9. 1st 12 core biopsy-8 of 12 cores positive, both lobes W/Tumors in Apex,PNI,extra capsular ext. Gleason 3/3 & 4/3, 2nd opinion Oppenheimer labs, to 3/4. Range 5-40% in core involvement.
Started short term HT 1/5/2013, Dart 1/31- 30 sessions. Brachy 5/08/13, Boost radiation 8/2
After treatment has remained steady @ .1

Veteran Member

Date Joined Sep 2012
Total Posts : 3057
   Posted 3/7/2018 11:27 PM (GMT -6)   
Fauntleroy said...
you can slog through it with a good chance of a complete cure

I'm highlighting Fauntleroy's words here since I think this sums it up very succinctly. "Slog" is the operative verb and "cure" is the essential noun.
Age 57, Diagnosed at 51
PSA 9.6, Gleason: 9 (5+4), three 7s (3+4)
Chose triple play of HDR brachy, IMRT and HT (Casodex, Lupron and Zytiga)
Completed HT (18 months) in April 2014
9/17: PSA = 0.1
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