51 yrs old, PSA 4.1, Gleason 7 what treatment?

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51 yrs old, PSA 4.1, Gleason 7 what treatment?

by Anne63 on Wed Jun 17, 2009 12:00 AM

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My husband is only 51 and has prostate cancer.  His PSA is 4.1 his Gleason is a 7 (3+4).  He does not want to be impotent or incontinent.  What should he do?  I have not seen anything on this site about Proton therapy any reason for that?

 

 

RE: 51 yrs old, PSA 4.1, Gleason 7 what treatment?

by Johnt on Wed Jun 17, 2009 12:00 AM

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Proton radiation is one treatment, but it is expensive and has a long waiting list and there are only a few proton machines in the US. The Prostate Cancer Research Institute website has a good guide for all treatment options. A Gleason 7 is an intermediate risk PC and needs treatment. Surgery, Seeds with IMRT, HUIF, or IMRT are all good options along with Proton radiation. All have different side affects so be sure to research all options.

JohnT

RE: 51 yrs old, PSA 4.1, Gleason 7 what treatment?

by jcr65566 on Wed Jun 17, 2009 12:00 AM

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Hi Anne63 Sorry to hear about your husband I my self think all treatment are no better then the watch and waiting The reason I say this is I'm on holistically alterative treatment it working quite well for me my psa coming down and I feel better my frand say Ive lost that gray look we get when we have cancer .

but in 2007 for me it was a deferant story I had a psa of 4 an gleasion score of 7 and I was trying to get treatment I realy think three months  after the biopsy thing got realy worst I realy think the biopsy spread cancer though out my body three months after the biopsy I found not only did  I use up all my money seeing doctors I ended up with it in my lower back and my ribs then the same doctors told me there was not much  they caold do for me I was in a lot of pain I ened up seeing a naterpath she advise me to go on  a cause of liquad cellular Zeolitte 15 drops 4 times a day high dos vitamin C and Zinc  the pain stoped and my urine retenion started to disapper wint in a week or so.  A bone scan a year later found it was gone. from my bones but I still had cancer in my  prostate I found  over the last two years the main thing with prostate cancer is antioxidante and stoping the sugar intake see this link

http://www.mnwelldir.org/docs/nutrition/sugar.htm

and as far as Potion therapy go's a lot of these can cost up to $200,000.00 and can be quite exhausting one cc member Scydan said the Potion radiation treatment he had after treatment his cancer still come back with a psa of 28 he on what I'm on now holistically therapy is now doing well but he was so let down for what the exspeced from his treament he wrote a book called Advanced Prostate cancer and me the reasion Im telling you about the book is, it has a grate deal of information on treatment opion and posible out comes But for me Im happy to just stay on watchand wating and remaind on my Holically therapy if you want to know about this let me know below is only a few more opions from the Radiolagyinfo site all the best Ray

http://www.radiologyinfo.org/en/info.cfm?pg=pros_cancer

There are many treatment options for prostate cancer that is confined to the prostate gland. Each option should be considered carefully, balancing the advantages against the disadvantages as they relate to the individual man's age, overall health and personal preferences.

Historical standard options include:

Surgery (radical prostatectomy): An incision is made in the lower abdomen or through the perineum (between the anus and the scrotum), and the prostate is removed. Incomplete surgery, in which the entire tumor cannot be removed, may be followed by radiation therapy. Possible side effects of surgery can include incontinence (inability to control urination) and impotence (inability to achieve erection). More recently, several centers are using three small incisions to do robot assisted prostatectomy that results in shorter hospitalization and faster recuperation.

External beam therapy (EBT): a method for delivering a beam of high-energy x-rays to the location of the tumor. The beam is generated outside the patient (usually by a linear accelerator) and is targeted at the tumor site. These x-rays can destroy the cancer cells and careful treatment planning allows the surrounding normal tissues to be spared. No radioactive sources are placed inside the patient's body. See the External Beam Therapy page for more information.

Watchful waiting: No treatment, with careful observation and medical monitoring.

Newer, advanced options have been developed in the past 10 to 15 years. These newer options avoid or minimize some of the unpleasant side effects sometimes associated with the standard therapies. These options include:

Nerve-sparing radical prostatectomy: Surgical procedure in which the prostate gland is removed without severing the critical nearby nerves that send signals between the brain and penis to allow normal sexual functioning. A skilled and experienced surgeon may be able to preserve sexual function in 50 percent to 90 percent of patients by successfully using this procedure.

Conformal external beam radiation therapy: Uses advanced technology to tailor the radiation therapy to an individual's body structures. Relying on computerized three-dimensional images of the prostate, bladder and rectum, the x-ray radiation beam is aimed precisely ("conformed") to affect the diseased area. In this way, less radiation reaches the surrounding normal tissues. Today there are two levels of conformal radiation therapy: 3-D conformal radiation therapy and intensity modulated radiation therapy (IMRT). Both allow for increased doses to the tumor while protecting the normal surrounding organs. IMRT is considered the more conformal of the two but is not necessary or appropriate for all patients. For more detailed information see the Intensity-Modulated Radiation Therapy page.

Image-guided radiation therapy: for either 3-D conformal or IMRT, daily image guidance is increasingly used. Typically three gold fiducial markers, or tiny pieces of metal, are placed in the prostate before the simulation and treatment. X-rays are taken either with the same beam as that of the treatment or an add-on low energy x-ray beam aligned to the linear accelerator. The metallic markers will be visible on the x-rays. This is done to check the position of the prostate on a daily basis just before the treatment and appropriate adjustment and alignment of prostate to high-dose external beam radiation therapy.

Proton beam therapy: a type of conformal therapy that bombards the diseased tissue with protons instead of x-rays. See the Proton Therapy page for more information.

Cryotherapy: A procedure that uses extremely low temperatures (-190°C) to freeze and destroy cancer cells. Some experienced physicians have had good results with low complication rates using cryotherapy; however, others have not. This should be considered experimental at this time as upfront treatment for prostate cancer, until there is longer follow-up for patients treated with this modality. This technique was developed as an alternative to surgery for patients who have recurrent cancer in the prostate after radiation treatments. For more detailed information, see the Cryotherapy page.

Brachytherapy: the temporary placement of radioactive materials within the body, usually employed to give an extra dose—or boost—of radiation to the area of the excision site. See the Brachytherapy page for more information. Brachytherapy is used on rare occasions.

LDR (Low Dose Rate) Brachytherapy: The temporary placement of radioactive materials within the body, usually employed to give an extra dose—or boost—of radiation to the area of the excision site. See the Brachytherapy page for more information. With seed implant treatment, radiation hits the prostate first, and only then strikes normal tissues. While the implant technique has been around for decades, recent advances in imaging technology have made it more effective. Using ultrasound to see the prostate gland better, physicians can place each seed in the prostate more carefully and better control the effect on surrounding tissues. Long-term results are available for up to 10—12 years at some institutions. These results show that ultrasound-guided radioactive implantation is highly effective in controlling prostate cancer and has essentially the same result as surgery or external radiation for appropriately selected low-risk prostate cancer patients.

High Dose Rate (HDR) Brachytherapy: This technique was developed to supplement the dose of radiation given as external beam therapy for patients with high risk prostate cancer. In skilled hands, this is an effective regimen to treat such cancers. Patients receive several weeks of standard external beam radiation therapy, followed by one to three HDR sessions. These sessions require anesthesia and placement of several needles into the prostate. The patient is then hooked up to the HDR machine, where a radioactive source moves up and down each needle, delivering radiation. This type of brachytherapy leaves no permanent radiation in the patient.

Use of this technique by itself (i.e., without the external beam treatments) for low-risk patients is still in the experimental stages.

a patient who undergoes conventional radiation therapy is exposed to X-rays. As they pass through both healthy and diseased tissue, X-rays leave a track of damage - much like a bullet. This damage can help destroy tumors, but may cause significant harm to surrounding areas.

Protons is supose to cause less damage to healthy tissue as they enter the body, and deposit the majority of their destructive energy at the tumor site. As a result, normal, healthy tissue receives less exposure to radiation, resulting in fewer treatment complications

I read so menny patient say they have damage to there bowl Ive read damage is dome to the DNA of the cell around the prostrate exspely as the the bowl rest closs to it this can lead to bowl problems later on also the

My husband is only 51 and has prostate cancer. His PSA is 4.1 his Gleason is a 7 (3+4). He does not want to be impotent or incontinent. What should he do? I have not seen anything on this site about Proton therapy any reason for that

RE: 51 yrs old, PSA 4.1, Gleason 7 what treatment?

by Johnw100 on Thu Jun 18, 2009 12:00 AM

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Biopsy readings are subjective: first thing to do is to obtain a 2nd reading of your biopsy slides by an espert pathologist if you have not already done so.

After that you can more logically consider your treatment options.

RE: 51 yrs old, PSA 4.1, Gleason 7 what treatment?

by Teb829 on Thu Jun 18, 2009 12:00 AM

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For more information on Proton therapy go to the following website..www.protonbob.com  or go to the Loma Linda University Hospital website. It has less side effects and a great track record in treating prostate cancer. I would also recommend getting a second reading of your biopsy slides by Dr. Jonathan Epstein of Johns Hopkins medical center. You can contact him through Johns Hopkins website.. I was diagnosed with Prostate cancer and sent my slides to him. After he reviewed them,he questioned the original diagnosis and recommended a second biopsy. I had that done at the Cleveland Clinic and they agreed with Dr. Epstein that I was misdiagnosed. It's worth getting a second opinion!!

RE: 51 yrs old, PSA 4.1, Gleason 7 what treatment?

by Dazed__Confused on Thu Jun 18, 2009 12:00 AM

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Sounds very familiar as i was 51 when diagnosed with a 4.1 psa,gleason of 3+3.i have researched all my options & fianally decided on robotic surgery that was performed on 6/1/09.cancer was detected on 2/15/07 & i was on watchful waiting & psa went progressively higher to 5.2 which still was not too bad but on the dre exam a lump on the the prostate was noticed by the dr at that time so i decided it was finally time to get treatment.my original biopsy showed only 2 out of 12 cores had cancer but one of them had 90% whick i beleive is the one that started to grow & the lump finally appeared.it has now been 1 week since the catheter was removed & continence is really not a problem but i have not even tried for an erection because of slight pain still but nothing serious.i started back to work on the 15th 2 weeks after surgery,was released after a one night stay but the first 2-3 days home were not that good.on the 13th of the month i walked about 2-3 miles at our art festival but was a little sore from that.every day a little better,gope to start golfing in 3-4 more weeks.i hope this helps releive your concerns somewhat & goodluck with whatever path you choose!!! pick the best doctor possible for whatever you decide!!!

 

RE: 51 yrs old, PSA 4.1, Gleason 7 what treatment?

by TINA__CAREGIVER on Tue Jun 23, 2009 12:00 AM

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First of all, I would get a second opinion from another pathologist to make sure that both concur.  At a patient of this age (my husband was diagnosed at age 54) I believe I would have the radiation seed inplants and maybe external beam radiation as well.  Get you an appointment with a radiation oncologist as well as a regular oncologist,  Certainly wouldn't take the chemo route for first option. There are lots and lots of strings out there to pull to fight prostate cancer and as a caregiver, I highly suggest that you pull almost everyone of them.  Read a lot about it on the internet.  Your urologist might want to start you on Lupron hormone injections but if you don't want to lose your impotency just yet, then that's not the route to take cause it works the same as castration.  Eventually on down the road that might be another option.  No matter what do not ignore this situation.  To me watchful waiting is what a lot of older men do in these cases.  Good luck and I certainly would like to hear what you decided. 

RE: 51 yrs old, PSA 4.1, Gleason 7 what treatment?

by jcr65566 on Tue Jun 23, 2009 12:00 AM

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Hi TINA CAREGIVER you know it been nearly three years since I was first diagnose, if only I been able to get even an RP done with in the first few months I would be free of cancer right now.Why is it that it took months to see the over worked urologist and by the time I wasted seeing cow boys urologist who put me though a whole pile of useless test to do a robot RP and then told me I weigh to much come back when you lose 80lb it was to late. By then a bone scan by my GP found I developed advanced prostate cancer I had the start of it in my lower back and my ribs, but a naturopath put me on to a treatment protocol that worked. I found out a year later when other bone scan found no prostrate met's cancer in my bones. My naturopath told me, we just got it in time any later it would not have worked, I now just use alterative holistic treatment to treat it and though it worked out well it use to cost me $321.00 a month. I've got it down to $100.00 a month now, at lease I feel better and every test shows my PSA dropping all the best Ray

RE: 51 yrs old, PSA 4.1, Gleason 7 what treatment?

by Billoo on Tue Jun 23, 2009 12:00 AM

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I am 59 and I was diagnosed with PCa in March 2009.  I got the second opinion on the biopsy from the John Hopkins., My urologist suggested the seed implant.  Bone Scan and CT of prostate came OK..  I opted for the seed implant which was done on June 1, 2009.  I took two weeks off just to rest and recoup.  I joined my work duties in the third week.  I sometimes feel some heaviness and pain.  But I can do my work without any difficulty.  I have a support of my wife and whole family,  which, If feel, is equally important as the treatment.  I am waiting for the PSA test after 3 months of the implant and hope this will be OK.

RE: 51 yrs old, PSA 4.1, Gleason 7 what treatment?

by TINA__CAREGIVER on Wed Jun 24, 2009 12:00 AM

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Hi what was your PSA initially?  The seed implants should make a difference.  My best regards to you.   Tina
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