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Gleason 8 on HRT

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User
Posted 06 Aug 2024 at 23:00

I had a PSMA test which came up 8.7 and I was recently diagnosed with localised prostate cancer Gleason 8. Whole body bone scan did not show any metastatic. I inquired about the necessity of a PET scan, but the nurse explained that my imaging to date hasn't shown any enlarged lymph nodes of concern. As a result, further imaging wasn't recommended when my case was discussed at the multidisciplinary team meeting. 

During a recent consultation with a prostate cancer nurse, we discussed my treatment options in detail. The standard protocol involves hormone suppression for approximately 3months, followed by 20 sessions of external beam radiotherapy.

After discussions with my healthcare team, I've begun hormone therapy, receiving my first injection about three to four weeks ago, along with a 28-day course of tablets.

On a recent meeting with Oncology he advised against external beam radiotherapy for my stage of cancer. We discussed high dose rate brachytherapy for targeted radiation.

The oncolgist compared external radiation and brachytherapy, highlighting that brachytherapy offers more focused treatment with potentially fewer bowel side effects. We discussed practical aspects such as hospital stay duration and recovery time for each option.

We also discussed an upcoming clinical trial - PACE NODES. This Trial is evaluating 5-day treatment of just the prostate or prostate and lymph node region.

For now, I'm continuing with the hormone therapy while I research and consult further. I've been provided with detailed information on both the clinical trial and brachytherapy to review at home. A follow-up appointment is scheduled to finalise my treatment plan.

Edited by member 08 Aug 2024 at 21:04  | Reason: Clarity

User
Posted 06 Aug 2024 at 23:00

I had a PSMA test which came up 8.7 and I was recently diagnosed with localised prostate cancer Gleason 8. Whole body bone scan did not show any metastatic. I inquired about the necessity of a PET scan, but the nurse explained that my imaging to date hasn't shown any enlarged lymph nodes of concern. As a result, further imaging wasn't recommended when my case was discussed at the multidisciplinary team meeting. 

During a recent consultation with a prostate cancer nurse, we discussed my treatment options in detail. The standard protocol involves hormone suppression for approximately 3months, followed by 20 sessions of external beam radiotherapy.

After discussions with my healthcare team, I've begun hormone therapy, receiving my first injection about three to four weeks ago, along with a 28-day course of tablets.

On a recent meeting with Oncology he advised against external beam radiotherapy for my stage of cancer. We discussed high dose rate brachytherapy for targeted radiation.

The oncolgist compared external radiation and brachytherapy, highlighting that brachytherapy offers more focused treatment with potentially fewer bowel side effects. We discussed practical aspects such as hospital stay duration and recovery time for each option.

We also discussed an upcoming clinical trial - PACE NODES. This Trial is evaluating 5-day treatment of just the prostate or prostate and lymph node region.

For now, I'm continuing with the hormone therapy while I research and consult further. I've been provided with detailed information on both the clinical trial and brachytherapy to review at home. A follow-up appointment is scheduled to finalise my treatment plan.

Edited by member 08 Aug 2024 at 21:04  | Reason: Clarity

User
Posted 07 Aug 2024 at 00:52

U5R, sorry you find yourself on here but there we are a friendly bunch with lots of support for you.

Terminology can be confusing for newbies, you would had had a PSA test to come up with a score of 8.7. The biopsy gives you the Gleason score of 8.

The PSMA pet scan is sometimes used in diagnosis but probably more often used for trying to find the source of a recurrence.

Have you been offered surgery.

You probably had an MRI scan prior to your biopsy and a bone scan after initial diagnosis you may have already had a CT scan following diagnosis.

You may have been given a staging number something like T2a.

Thanks Chris 

User
Posted 07 Aug 2024 at 10:35

Hello U5R,

You haven't given the full details of your diagnosis such as staging, but I think there's some confusion about external beam - that is by far the most common treatment for what I presume your cancer is and it's not a trial, unless there's something unusual about your diagnosis which you haven't mentioned.

Brachytherapy may be suitable too, but accounts for only around 5% of radiotherapy treatments because not many centres do it. Another treatment is a combination of both - half the radiotherapy is given as brachytherapy and the other half as external beam which is call Brachytherapy Boost, and gives you the advantages of both treatments with a relatively low side effect profile.

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User
Posted 07 Aug 2024 at 00:52

U5R, sorry you find yourself on here but there we are a friendly bunch with lots of support for you.

Terminology can be confusing for newbies, you would had had a PSA test to come up with a score of 8.7. The biopsy gives you the Gleason score of 8.

The PSMA pet scan is sometimes used in diagnosis but probably more often used for trying to find the source of a recurrence.

Have you been offered surgery.

You probably had an MRI scan prior to your biopsy and a bone scan after initial diagnosis you may have already had a CT scan following diagnosis.

You may have been given a staging number something like T2a.

Thanks Chris 

User
Posted 07 Aug 2024 at 05:57

Hi U5R.

Welcome to the forum mate.

As Chris said it would be helpful if you could post your cancer staging. 

I was T3a, Gleason 8 (4+4) later upgraded to 9 (4+5). I had surgery. There are people on here who've had R/T and brachytherapy. They will be able to relate their personal experiences of both treatments.

Please keep us updated and best of luck with whatever treatment you choose.

 

User
Posted 07 Aug 2024 at 10:35

Hello U5R,

You haven't given the full details of your diagnosis such as staging, but I think there's some confusion about external beam - that is by far the most common treatment for what I presume your cancer is and it's not a trial, unless there's something unusual about your diagnosis which you haven't mentioned.

Brachytherapy may be suitable too, but accounts for only around 5% of radiotherapy treatments because not many centres do it. Another treatment is a combination of both - half the radiotherapy is given as brachytherapy and the other half as external beam which is call Brachytherapy Boost, and gives you the advantages of both treatments with a relatively low side effect profile.

User
Posted 07 Aug 2024 at 21:07

Initially in meetings with urologists and nurse I   was informed my choice is between radical surgery and hormone therapy + external beam radiotherapy after 3 months. However in subsequent appointment with an Oncologist I was encouraged to consider high dose rate brachytherapy and given a new booklet to read.

 

Diagnosis:

  1. PSA 8.7

  2. MRI scan 43 cc prostate, PI-RADS4 stage T2NO

  3. Transperineal prostate biopsy 8 out of 30 co adenocarcinoma prostate, maximum core length 7 ,

T2NOMO

  1. Otherwise fit and well

Edited by member 08 Aug 2024 at 20:46  | Reason: Not specified

 
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