What treatment help

Boki01

My father 74 age 3+4=7,grade 2,psa 8,8,biopsy 4 of 12 positiv all left and left centar 1 and 2 (6%-10%) 3 and 4 (11%-20%)

Surgery or radiation

ASAdvocate

In my fourteen years of researching possible treatments (I am a Gleason 6 on active surveillance), I have never read any large scale, peer-reviewed, multi-institutional study that showed another treatment matching the non-recurrence results of SBRT/Cyberknife radiation.  Not even close.

Just my opinion, based on my research.

lighterwood67

Probably one of the toughest questions to resolve when dealing with Prostate Cancer. You need to make yourself very knowledgeable on types of treatments. My recommendation would be to pay particular attention to the folks who have actually had SBRT/Cyberknife radiation. And the ones who have had a Radical Prostatectomy. Be sure and get both sides of the treatments (mainly side effects, recurrence rates, and cure rates), from an experienced Doctor. Good luck on your journey.

Old Salt

I second both prior posts.

The choice may not be straightforward, but you and your Dad do have time for further study. Please be aware that a typical urologist knows little about radiation therapies. At the same time, there are specialties even within radiation oncology. Therefore, you may want to consult with an SBRT specialist and a brachytherapy specialist.

Also note that to make a decision, the specialist will need to know how close the cancerous area was to the edge of the prostate.

Finally, there used to be a 'rule' not to perform surgery on guys over 70. However, if the patient is in good health (no significant comorbidities) exceptions can be made.

Clevelandguy

Hi,

Your choice on surgery or some form of radiation treatment. If going the radiation route I would look into Proton radiation which had a fixed length beam that does not go past the cancer(less collateral damage). Proton radiation might not be available everywhere but is very similar to Cyberknife. Cyberkife shoots a beam through your whole body so other organs might need to be protected with injectables gels so the radiation does not injure your bladder or rectum.

Dave 3+4

Boki01

Thanks, his psa 1.11.2022 is 8.8 and 31.1.23 is 7.9 its good or no.

Old Salt

To properly respond, we need more info:

Bone and CT scans to see if the cancer is contained within the prostate or not.

It does seem like those PSA values are higher than 'normal' for his age. Is he really stage II?

Boki01

Biopsy result says 3+4=7 grade group 2.Ct and other scan not yet done.

Boki01

Urologist suggested rt or rp but not yet seen dr for radiation therapy.

jrindlaub

Make sure your dad also considers a combination of IMRT and IGRT forms of radiation. They are lower dose than SBRT, but require either 28 or 45 treatments, for about a ten minutes (1 hour total). but lower side effects, same efficacy from what I have seen. Stand for Intensity Modulated Radiation Therapy and Image Guided Radiation Therapy

Tico14

Boki. I was a couple years younger than your father when I had the RALP. Four of twelve positive, two suspicious. EPE and positive Margin on right side. Percentage, I think, was 33%. Surgery went fine. Incontinence big time still (5 years later). All PSA's since were "virtually undetectable". Mr. Johnson still "at ease".

hunter49

at that age and his cancer seems lower grade I would go with radiation. Do an MRI see where tumors are

VascodaGama

Hi,

It seems to me that his doctor is only suggesting a preliminary clinical stage based on the biopsy report. Probably he has judged the situation as localized so he mention on the possibility of a radical treatment of RP (surgery) or RT(one form of radiation).

Your dad should do a MRI before making a decision.

Best

VG

Boki01

Thanks, he do MRI and choose

Ht+rt(sayberknife)