Posted 11/22/2018 2:53 PM (GMT -6)
The combination of EBRT/IMRT and brachytherapy HDR if you can handle it based on your health. plus ADT is often recommended for 4+3 to kill all the cancer. Don't be afraid of hormone treatment. If you want to try 6 months verses a year that is better than nothing. However if 1 year was recommend you need to find why you don't need it. You might consult with Mark Scholz https://www.prostateoncology.com/authors/mark-scholz/ You can do it remotely but it won't be reimbursed. There are many others out there that can provide you objective information-experts who won't be treating you. I was going to fly to LA to meet with an urologist in the Schultz group after the MD Anderson Proton Center came back with a 4+3, however this was not confirmed by my 3 other pathology reviews including John Hopkins and my oncologist at MD Anderson didn't even believe the pathology report. The thing is with surgery you may not get all the cancer. Also no guarantee on no erectile dysfunction following radical prostatectomy. I thought from your first post you were a lot younger. I really believe you need to dig into the google research, read as many good prostate cancer books that you can and get all the testing done especially TPen and perhaps other genetic test. Get as much information as you can before making a decision. I changed my mind many times. Good luck!
69 yrs., marathon runner with knee injury, 41 of 44 3D-CRT/IMRT Radiation delivered via 3D-CRT in 1.8 Gy minimum dose fractions to a total of 79.2 Gy., 10.5.18. PSA .012, 8.12.18, 1.42 June 18, 2018 (Lupron 5.21.18 & 8.15.18), 12.7 May 2018, 13.7 Jan. 2018, 2.1 May 2012. SpaceOar 9.6.18, testosterone <.7, 8.15.18, Tot Mayo 19 ng .17 testosterone Free 6.18.18, Gleason 3+4=7 involving 15% of the right apex and 15% of the right mid, 3+3=6 prostate cancer involving 5% of the left base. Pathology interpretations by John Hopkins, UNM Cancer, and SF Path 3+4=7 or 4+3=7 MD Anderson Proton Center w/o %. T3 MRI w/ contrast 1.8 lesion left side 5P, Neg. Bone Scan. Prolaris test 3.5 consistent with intermediate and a PTEN test negative. Father PC age 78 RT & ADT now 93 yrs. Neurogenic bladder due to lumbar disk disease and recurrent bladder neck contracture with urinary retention man. 20 years doing catheterizations. TURP & scaring 2003, Finasteride 5 milligrams daily since 2002.