Confused! Recently diagnosed with prostate cancer

My doctor at Cleveland Clinic ordered a PSMA Pet Scan to determine if the cancer had spread outside the prostate. If it hadn't spread, they would go ahead with radiation treatment. You are injected with a radioactive tracer that (to my understanding) attaches to prostate cancer wherever it is in the body and shows up on the scan.

When I received the results it said the cancer had spread to the prostate bed. When I questioned the radiation oncologist who ordered the scan he said it had NOT spread. Apparently the technician that read the scan results thought I had already had my prostate removed (I didn't). The oncologist said what the tech was seeing was the cancer IN the prostate. Obviously I was disappointed with this mistake because so much was riding on the results.

The radiation oncologist OK's me for radiation treatment along with ADT (androgen deprivation therapy). I completed the radiation at the end of June 2023 and am due for the third 6 month ADT (Lupron) injection in early April 2024

Good luck with your decision making process - It is a stressful time. I hesitated for a few months before my urologist simply said - "You have to do something."

Im stilling waiting for treatment after 7 minths with an aggressive form of pc ..im getting pissed think that I am a money maker for them. Why would I need a PSMA scan And then another chest ct scan to wee id the rib lesion was benign and then an MRI why i ask an mri thought the new a PSMA scan is so good and it showed no spread outside the prostrate and then another scan to see if the little land then a biopsy,why a biopsy you know the catcher back you know it’s at least 34 wanted to see if it was gonna be 33 and I even said that’s not gonna happen and it didn’t now it’s 4 4 and then a meeting with a radiologist and then a meeting with a cryotherapy dr and then a meeting with urologist to help me decide what treatment would be best. Radiation surgery or cryotherapy. Now trying to get an appointment with dr who do the cryotherapy who now I think is backed up two or three months because he’s old and he only does him on Wednesdays so I’m not waiting another two or three months that’ll be almost 10 months after I was diagnosed borderline. Unbelievable and unacceptable.

Hey man I know exactly what you are going through. Bottom line I opted for surgery. My cancer was stage 2, which means it was localized to the prostate. My Gleason was 8 (4+4). So my cancer was primarily on the right side and at the base of the prostate. That region was about 88% occupied. So my PSA was above 4 for about a year. The doctor suggested we monitor it for another 6 months. I wasn't comfortable with that so I asked to have the next test, whatever it was. It was an MRI. The MRI showed a spot of concern with a PRAD rating of 4. 4 or 5 is likely cancer. Next step was biopsy. He took extra samples based on MRI. All 6 of those samples came back positive for cancer. Next step was PET scan to check for spreading. My cancer was local and there was no signs of spread outside the prostate. So I only had 2 options for treatment 1) surgery or 2) radiation. For my type of cancer, the probabilty of recurance was about the same. The probability of side effects were also about the same except surgery add a side effect with damage to your pooping function. Ultimately what drove my decision for surgery was Plan B. Since my recurrance rate was high I wanted to know what plan B was. For surgery there is a legit plan B - radiation. With radiaiton there is no real plan B. I asked my surgeon if he had ever done a post radiation prostatectomy. He said yes - ONE. He said he would never do another. Yeah, they are super complex and loaded with side effects. Cryo is also a weak plan B and also loaded with side effects. So there really isn't a legit plan B with radiation. I looked at ultrasound which is the newest thing however they don't have more than 5 years of success data on those procedures. They are also very selective with patients because they don't want to treat cases that will negatively impact there success data. These procedures are also not covered by insurance yet. So, I suggest not only looking at your primary treatment option, but look at plan B. If you have a high rate of recurrance like me then plan B becomes a significant part of the decision process. I am 7 days post surgery. Catheture comes out next week. Hoping my biospy results match my PET scan results and that cancer is a distant memory. Good luck my brother and hope this info helps!

I was surprised to read that TULSA (trans-urethral ultrasound ablation) is used for salvage therapy post-radiation, and potentially on the whole gland. Would not have thought that.

Anything is possible if you are willig to deal with the side effects.