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User

Posted 25 May 2018 at 11:00

I was diagnosed Prostate cancer a month ago --the initial opinion based on the biopsy was that this was localised . Gleason score 7.

However the scan indicated that it was starting to get into the left seminal vessel ( but not the lymph nodes or bones)

So the re diagnosis is locally advanced and the oncologist is throwing the book at it --Chemotherapy. Radiation and brachytherapy.

I am told there is an 85% chance of success.

I would love to get in contact with others in the same category --and get any advice going.

User

Posted 25 May 2018 at 12:04

Yes Hormone therapy as well!

ist chemo was 8 days ago.

User

Posted 26 May 2018 at 14:41

Hi Lisa

the Gleason score was 4 plus 3 in core A. And 3 plus 4 in both cores of B and C

All the carcinoma was in the left side. None in cores D E and F

what seems to have moved me from low risk to high risk is the fact that the scan showed some invasion of the left seminal vessel.

the first oncologist told me I was on watchful waiting then it changed to a 4 treatment approach.

i forgot to mention to the oncologist that I had a vasectomy about 20 years ago.

regards.

Roger

User

Posted 26 May 2018 at 17:55

I did read somewhere that it might increase the risk of prostate cancer but no sure what studies have been done.

if it was really relevant they would ask the question?

Could it show up in the scan?

roger

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User

Posted 25 May 2018 at 12:04

Yes Hormone therapy as well!

ist chemo was 8 days ago.

User

Posted 25 May 2018 at 12:54

I was diagnosed Gleason 4:5 localised mid April. I had bone scan, which after a targeted MRI of an area of concern my vertebrae was declared clear. I had a CT scan that was clear, 2 weeks ago I had an targeted MRI of my left pelvic area, as I still have area of concern, so am still awaiting final diagnosis today since my Template Biopsy on the 1st March. I am hoping the pelvic issue is not a Metastasis but am waiting for a call.

User

Posted 25 May 2018 at 13:02

So. You are getting four separate treatments at the same stage? Radiotherapy, brachytherapy, hormone therapy, and chemotherapy?

User

Posted 25 May 2018 at 13:29

Originally Posted by: Online Community Member

So. You are getting four separate treatments at the same stage? Radiotherapy, brachytherapy, hormone therapy, and chemotherapy?

Would they do RT and Brachy at the same time?

User

Posted 25 May 2018 at 14:53

There does seem to be an increasing tendency to hit the PCa with multiple treatment early in some cases and some oncologists treat more aggressively but this case seems rather unusual. External Beam RT often supplements Brachytherapy - was it low dose (seeds) or high dose (temporary insertion of radioactive needles)?

Barry

User

Posted 25 May 2018 at 16:19

Hi Roger, I'll follow this post with interest. My dad was recently diagnosed with PCa - Gleason 4 + 3, all 12 cores taken were cancerous with up to 100% involvement. He was started on HT on the day he received the news - degarelix (which I've since learned is a drug for advanced cancer). He gets his bone and MRI scan results this next Wednesday and has been told his Gleason score may be subject to change. I'll let you know what his treatment plan is once we know more. Good luck to you x

User

Posted 25 May 2018 at 16:40

I understand that the Brachytherapy will be after the radiotherapy.

anyone else having 4 treatments?

the recommendation is for a high dose rate brachyboost after the radiation.

my oncologist says that a recent study suggests that the addiction of upfront chemotherapy is beneficial.

i am seeing him on 4 June. Any questions I should ask?

User

Posted 25 May 2018 at 19:12

I can’t get into your profile but am guessing you are not in the UK? I have only read of this kind of approach in countries where patients or insurance companies pay ie there may be a profit to be made from lots of treatment. I think we had a member in India who was offered chemo alongside curative treatments but this would not be normal in the UK

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 25 May 2018 at 21:49

Hi.

I live in St Albans. HERTS and I am 75(quite fit!)

still I am more than impressed at the time and money being expended by the NHS.

if I come through all this I am hoping to do some charity bike rides.

User

Posted 25 May 2018 at 22:04

Wow! Very unusual situation then - I can only think of one other member on here that has had chemo with curative treatment and I don't think he is active.

There's a question for when you see the onco - why? The research undoubtedly showed that early chemo given to men with advanced cancer is shown to have good results and prolong the amount of time that hormone treatment will work, but it would be interesting to know what research he has seen that suggested it was appropriate for men that are not advanced.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 25 May 2018 at 22:12

Thanks.

my cancer is described as locally advanced.

sounds like I am being treated exceptionally and I will ask the question.

the next 6 months will be tough I am sure!

User

Posted 26 May 2018 at 02:14

this is so unusual - you didn't have your treatment within a trial by any chance?

Barry

User

Posted 26 May 2018 at 05:20

Barry

No formal trial.

i will check the extent of the circulation of the data.

Roger

User

Posted 26 May 2018 at 07:53

maybe your consultant has been reading articles like this:
https://www.medpagetoday.com/clinical-context/prostatecancer/61476

Argues that for certain locally advanced stages adjuvant chemo is beneficial

User

Posted 26 May 2018 at 08:37

That is really useful thanks.

i am coming to terms with the fact that my cancer is very high risk.

my urologist gave me an 85% survival rate as long as action was taken immediately.

not sure precisely what that means and in the article I don’t understand the expression “failure free”

plenty of questions!

Roger

User

Posted 26 May 2018 at 10:43

No, this makes no sense. Based on the information you have given, your cancer is low to moderate risk so putting your body under this amount of toxicity is very strange. Were you diagnosed with one of the rare types of cancer rather than the more common adenocarcinoma? Was your PSA exceptionally high? Does your onco suspect micro mets?

The trial results quoted are from 2016 summaries of 2015 data - mostly Stampede. But these were almost all high grade, aggressive cancers or ones that do not usually respond to normal treatments.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 26 May 2018 at 10:58

I guess treatment protocols change subtly all the time but chemo at this stage does, as others have said, seem very unusual. Just thinking of my older brother who actually went private (he is in BUPA) but his treatment, at the Christie in Manchester was in line with NHS guidelines. His PSA at the outset was 14 and he was Gleason 9 but still local (bone scans etc all clear). He opted for high dose brachytherapy where they insert needles temporarily into the prostate as opposed to the seeds. After that he had 15 sessions of EBRT and he was on bicalutamide for 18 months before, during and after the main treatment.

Anyway - all the very best and keep us informed.

User

Posted 26 May 2018 at 11:22

Many thanks

I have checked. My cancer is the standard one.

no mention of micro Mets.

however my PSA was 27.

i am on a steep learning curve here.

User

Posted 26 May 2018 at 11:48

Hi Roger,

Thank you for this thread. I will be following it with interest.

I love SA!

Good luck with the treatment

Clare

User

Posted 26 May 2018 at 12:38

Hi Roger, could I ask what the breakdown of your overall Gleason score of 7 was?.... 3+4, 4+3??? How may biopsy cores tested positive and at what level of involvement? TIA

User

Posted 26 May 2018 at 14:41

Hi Lisa

the Gleason score was 4 plus 3 in core A. And 3 plus 4 in both cores of B and C

All the carcinoma was in the left side. None in cores D E and F

what seems to have moved me from low risk to high risk is the fact that the scan showed some invasion of the left seminal vessel.

the first oncologist told me I was on watchful waiting then it changed to a 4 treatment approach.

i forgot to mention to the oncologist that I had a vasectomy about 20 years ago.

regards.

Roger

User

Posted 26 May 2018 at 17:45

Hi just wondered what relevance a vasectomy makes as I had one years ago and have not mentioned it

User

Posted 26 May 2018 at 17:55

I did read somewhere that it might increase the risk of prostate cancer but no sure what studies have been done.

if it was really relevant they would ask the question?

Could it show up in the scan?

roger

User

Posted 30 Jul 2018 at 07:18

An Update.

i am into the 4th cycle of chemo ( out of 6)

a minor crisis on Thursday last week as I visited my GP with a chesty cough.

blood test showed a neutrofil level below 1 ( .85)

so admission to Watford A+E on Friday afternoon and two nights there.

i was told that the neutrofil level was down to about 4 on Friday night.

anyway I am now back home and all under control .

Anyone with similar experiences-I assume that low white cell readings are relatively normal. It was only a week since the chemo.

User

Posted 30 Jul 2018 at 09:20

Not normal but very common - glad to see all is well now.

Re vasectomy; there are those who believe that it causes prostate cancer but like all the other supposed causes there is no data to prove it.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

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