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gleason score 9 with hormone therapy in one week

skipperben
Posts: 6
Joined: Apr 2018

Just received the news from my nurologist that I have a gleason score of 9 with bone metastatic bone lesions.  I guess what I would like to get from this site is some indication of how long do I have to live.  I'm 64, and want to hear from all of you, just how long can a person live with this cancer.  Of course  using all the modern medical treatments available.  And if you have had success, please tell me what hormones were used or what type of treatment was used.

VascodaGama's picture
VascodaGama
Posts: 3050
Joined: Nov 2010

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

skipperben
Posts: 6
Joined: Apr 2018

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

Old Salt
Posts: 720
Joined: Aug 2014

Vasco gave you good advice.

It's not up to us to estimate how long you will live. And only a stupid MD would give you a definitive answer to a question like that because there are just too many variables. But what I can say is to contact the beste Medical Oncologist you can find ASAP and go from there. Starting with hormone treatmen (Androgen Depression Therapy) is common for a sitation like yours.  Your urologist is not qualified to guide you at this point of your disease, but keep him/her in the loop.

The diagnosis must have come as a big shock, but hang in there; we wish you the best on your journey. 

VascodaGama's picture
VascodaGama
Posts: 3050
Joined: Nov 2010

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

 

 

skipperben
Posts: 6
Joined: Apr 2018

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.

VascodaGama's picture
VascodaGama
Posts: 3050
Joined: Nov 2010

Great news on the lower PSA. Things seem now in your favor. I hope you have gained confident and that the treatment gives you control on the bandit.

The cancer is hormonal dependent so that you can return to it later once chemo wares off, on intermittent administration.

Congratulations.

VG 

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