Prolaris Score?

I was just trying to compose my response (basically, 'forget about this Prolaris test because your neighbor is way too sick'). But Hopeful was ahead of me, and expressed my view in a nicer way. 

...simply look for positive moments to enjoy.....do things that you enjoy.......hang out with positive people

Hello Finishing Grace,

I'm new to this forum.  I was diagnosed with PC on May 8, 2017.  I'm 53 years old, in otherwise excellent health.  I had not a physical for a few years and never had a PSA test, so my doc strongly advised that I take it - so I did.  My first result came back as 5.89, then took it again (after a round of antibiotics) and this time it was even higher - 7.09.  Then did a prostate biopsy, and got the sobering news that they found cancer in 7 of 12 cores, and a Gleason score of 7 (4+3).  The pathology report labed my results as "intermediate risk", but the 4+3 score tilted that risk as more aggressive.  So far no signs of extracapsular extension - which is good news as it seems to be contianed to my prostate so far.

I am leaning toward proton therapy, and as part of my consultation with the radiation oncologist at the Chicago Proton Center he suggested that before firming up our plan of attack we should either 1) get a second opinion on my biopsy tissue - and do that at John Hopkins medical center, OR 2) see if my insurance would cover the cost of a Prolaris test - which offers a more definitive look at the biopsy tissue... the findings of which - in combination with a 3T MRI - would enable us to develop the most appropriate treatment plan.

Given the results of my initial pathology report, I was not shocked when my Prolaris test score came back as high... it was 4.3, and labeled "more aggressive".  As a result, my doc is recommending that I do a short term hormone therapy (approx 4 months), and start the proton therapy after I'm about a month and a half into the hormone therapy.

After everything I've read about hormone therapy I really don't want to do it.  I prefer to dive right into the proton therapy and take my chances, as to me, the quality of my life is just as important as the quantity of my life.  I will be talking to my doc tomorrow to see if that's an option.

The Prolaris test is expensive, but apparently my insurance covered it.  If you have the option to do it, you probably should.  It does take about two weeks from the time your doc requests it until you get your results back, FYI.

If you have additional questions, please don't hesistate to ask.

FinishingGrace said:

Thank you

It is unlikely that my neighbor, who is on full disability at this point and medicaid, will be able to get the test covered. I do plan to ask. Either way he's already started chemo and HT. 

A close friend was an oncology nurse at a proton center where I live. Her opinion is that proton therapy is by far the best and most successful weapon against prostate cancer.

Proton beam therapy certainly seems to have the biggest and most focal fan club, for what that's worth.  I've been very impressed by protonBOB/brotherhood of the balloon website, as well as Bob Marckini and his book, "You Can Beat Prostate Cancer... and you don't need surgery to do it."  All of the survivor stories on that site, plus his book, have really shaped my thinking in terms of the treatment path I plan to take.

hopeful and optimistic said:

3T MrI

Cubfan, I wonder, did you in fact have a 3T MRI? This test can be an indicator of extracapsular extension.

Haven't had an MRI yet.  For proton therapy, they first insert 3-4 gold fidicual markers in the prostate, along with the hydrogel spacer (that is inserted in the space beween the prostate and rectal wall... it dissolves within 4-6 months).  They then do the 3T MRI to both confirm exact placement of the markers and spacer, and to get high definition images of the prostate (with and without contrast).  However, the doc said that if i do the neoadjuvant hormone therapy, they would get that started first (ASAP I suppose), and then do the marker/spacer placement and MRI about six weeks later... and immideately initiate the proton therapy.  Sounds like my treatment length for protons would be 28 sessions spread over 5 1/2 weeks.

hopeful and optimistic said:

3t MRI

I was referring to this image test as a diagnostic tool, so you can make the best decision on your choice of therapy(s), to be done before any treatment, not part of a treatment. VG also mentioned having another image test as well.......selecting a PET SCAN such as a gallium 68 pet scan prostate, the combination of the two type image tests provides "best" knowledge available about the location of the cancer.

 

 

I was initially supposed to have a 3T MRI after my consultation with a radiation oncologist at the hospital where I had my biopsy (met with him on referral from my urologist)... and for the exact reason you state above - to confirm whether or not there's any extra capusular extension, etc., so we could confirm my treatment plan.  The doctor at the proton center will use it to do the same... but it does seem like their desire to combine that with confirmining placement of the fiducial markers and hyrdogel does put the cart before the horse, so to speak.  Their logic is that I likely can only have one MRI covered by my insurance, so might as well do all of that at once.

I need to ask about that PET scan to see if i might be eligible to have it done...