Biopsy Results Back - Not Good - GC5 - Gleason 9 (4+5)

In my case, my RO didn't feel bracytherapy would be helpful, or perhaps some rectal shield. Of course, one wonders if current proctitis might have been avoided. But, the desire to get treatment started definitely has an emotional component.

Urinalysis showed no bladder infections. So, I'm cleared for colonscopy/atgon and await GI scheduling.

Marco, you sound like you're getting great advice from my knothole.

Bill

Hi again,

I wonder the reason for the colonoscopy. Do you have/had any colon issue?

Did you inform the radiologist on the matter?

As oldsalt says above the colonoscopy is recommended to be done firstly for two reasons; To check the colon walls at the area of the prostate (the field of radiation), and To verify if ulcerative colitis exist.

The results could alter the planned radiation protocol. Existing ulcerative colitis is many times an impediment for RT in prostate cancer treatments.

Nowadays (CT) colonography (lesser invasive) is used instead of a colonoscope to check the intestines but in your case I would choose the colonoscope way.

Call your doctor's clinic/hospital and get advices. They can schedule the colonoscopy at other institutions. Do not wait.

Best of luck.

VGama

My PSA was 31 when I was diagnosed in June of 2020. My Gleason was 4+5 (9) with 80 % cancer in the prostrate. I was put on Hormone therapy with in Degarelix injection once a month to bring down the PSA. I had gotten a PET scan that showed no spread outside the prostate area. The seminal vessels however had turned cancerous. We stuck with the decision to do High Dose Radiation (HDR) Brachy Therapy and then go with 25 sessions of External radiation. My Radiologist/Oncologist wanted to get my PSA down to 1 or less before doing the brachytherapy. It took almost 7 months to get down to 1 and do the implant. I came out of the brachytherapy with a 0.25 PSA. At this time I started to take Zytiga (1000mg daily) with prednazone together with the monthly injection. My PSA is now 0.07. It has steadily gone down since the first injection. I am scheduled to take the shots and pills for another year. I have really responded well to the treatments and have done really well with the side effects. I have never been sick and have never had any pain. oh ya.....I pray everyday !

It will be 3 years 4 months when I finish the injections and 2 years with the pills. I went on an exercise and diet regimen this last January and lost 50 lbs . I needed to get my fat, lazy **** in shape in this fight ! I am 63 years old.

I will make a decision on whether I will continue the hormone therapy when that time comes. I am in a situation where my Radiologist/Oncologist in not part of my network insurance coverage. I trust him impeccably and was only able to have him because our network didnt offer the HDR Brachytherapy. He also had the skill during the implant procedure to get everything done that he wanted too. Hanging on until I can get Medicare and it wont matter anymore. Trust in your doctor is everything as far as I am concerned.

Buff,

Congratulations on the downing of the PSA. It's a joy to see it down in the lower limits of detection. The bandit is feeling the pinch.

If I understood it well, you plan to stop the hormonal treatment that you started in June 2020 with Degarelix, adding Zytiga plus Prednisone since January 2021.

I do understand your wishes and I agree with you to do so but you must be careful on the stopping process as the elimination of Prednisone should be tapered out along a period of weeks.

Prednisone acts by "switching off" the immune system so that Zytiga can do its job properly without the impediment of our natural disease-protector, the immune system.

Zytiga is taken to interrupt the "manufactoring" of androgens at 3 sources. The testes, the adrenal glands, and at the intertumoral process (done by the tumor itself). Degarelix does the job at the testes alone but it is friendlier than Zytiga.

Along the period we take these combined drugs, some of our body functions are affected and could lead to "dangerous" occasions, for the lacking of circulating hormones. The blood pressure can become extremely high, one can experience retention of liquids (swelling in your legs or feet) and low blood potassium levels, etc. The liver and the kidneys are the most affected.

Surely the situation is not pretty so that stopping ADT is a good beginning but you should follow the instructions of your doctor.

Without the effects of ADT the PSA tend to rise. That doesn't mean recurrence of the cancer but a recovery to a normal status. It will be then, that you can certify the success of the radiation therapy. This is when the validity of the PSA results are important and used to certify a remission status.

I wonder if you have done the 25 sessions of External radiation, to complete the RT protocol.

Best wishes in this journey.

VGama 

I might have mentioned that 2 years after finishing radiation I was diagnosed with radiation proctitis. So, rectal bleeding. It isn't going away by itself which it often does. My radiation oncologist has suggested Argon Plasma Therapy which has a good record of repairing tissue. She referred me to GI for the procedure. They want a colonoscopy to check for colon issues. They will be done together. So, next Thursday, on 80th birthday, I'm scheduled. Not looking forward to the prep. Oh well. Getting old is not for sissies.

Encouraging news. Thanks for that. I'm not looking forward to that GoLytely stuff.

I did look up the attending GI doctor. Has great reviews.

So, knock on wood.

Bill

Colonoscopy was cancelled. I managed to get a flexible sigmoidoscopy+APC scheduled for last week. It was quite amazing. Yes, I still needed the full bowel cleanse. But, the doctor suggested I needed no sedation. There was a large screen so I could watch the whole deal. The scope is inserted and the sigmoid colon was inspected. Just a couple of diverticula. He inserted the Argon tube into the scope and went along lesion by lesion. His impression was that it should do the trick. The next two mornings I had a small amount of blood which was expected. Since then, zero. My butt is still sore.