gleason score 9 with hormone therapy in one week

VascodaGama said:

Many, many years ahead to enjoy. Consider the QoL in decisions

At 64, your life expectancy is quite long. The cancer may or may not limit the time you live. It all depends on the extent of the metastases and your other overall health issues.

Hormonal treatment and chemo are typically recommended to patients with bone metastases. These are palliative but manage to hold long periods of control. Can you share more details about your diagnosis, PSA, treatment protocol (drugs taken) and any other existing illness?

Is there any symptom? What is the extent of the metastases?

Gleason score 9 is aggressive but one manages to get a grip on the bandit if the cancer is hormone dependent.

Best wishes and luck in this journey.

VG

My psa was 39.7 and the gleason score waas 4+5=9.  bone scan had multiple metastatic bone lesions, sclerotic lesion of L4, .. ct scan also said Rule out  metastatic disease recommend correlation with ct pet imaging

VascodaGama said:

Sclerotic lesion of L4 is worrisome if caused by cancer

Skip,

The PSA of 39.7 ng/ml is high but not all that serum belongs to the cancer. I wonder if you have benign hyperplasia that is typical in us older males. Do you have details of your biopsy? Can you reproduce here a copy of the report?

What lead you to check the conditions of the prostate? Did you have any symptom (pain, urination issues, etc)?

The lesion at the L4 could be a rheumatic disease but it is worrisome if such is a cause of the cancer. Apart from pain, any contraction at the joint could lead to paralysis. The hormonal treatment (HT, ADT) should start with antiandrogens pills (like bicalutamide) taken at least during two weeks before any agonist shot (like Lupron). Agonists cause flare which can lead to a short-term increase of the tumour causing contraction of the joint. If your treatment protocol is Firmagon then the issue is minimal. What is the ADT protocol?

Another aspect you need to investigate is about bone health. Metastases deteriorate bone and ADT administered in long periods attack bone severely. Such requires many guys to add a bisphosphanate to their treatment to avoid further deterioration. I would recommend you to get a DEXA scan and a Testosterone blood test for future hormonal control.

I think you should get the PET/CT exam recommended by your doctor. A 68Ga PSMA PET/CT is specific to prostate cancer (PCa) which would provide data on the location of the cancer in the whole body (not just bone) and it would verify if it is infesting the L 4. Other recommendable PET/CT exams are those using choline.

Many survivors in this forum can help you with ideas if you share the details of your story.

Best wishes,

VGama

 

 

I have went to another cancer hospital and they did put me on bicalutamide with a shot of Lupron.. bringing my psa in one month  from 68 to 2.5... I am continuing on bicalutamide for a total of 90 days along with chemo.  I'm at moffitt at Tampa.. thank you for the advise.