Earliest I've been here too. My MRI has just recently shown an 8mm lesion in the left anterior portion of my prostate but looks like it's confined to the capsule with nothing else seen in the pelvic area. PSA was 5.56 but dropped off to 4.3 after getting MRI and retested. Pirads 4 biopsy is recommended but hasn't been scheduled yet. I was diagnosed 15 years ago with a "calcification" in the prostate via a full body CT scan because of an accident, but was never advised to follow up. I'm hoping that's what they're seeing now. I have been seeing a urologist for years with regular blood work, due to BPH, and to check PSA levels. After recent rise in numbers, I was offered an MRI, which I had about a month ago. I have some hope that the biopsy will not show anything aggressive and praying for a Gleason 6 or something better. I'm going to take this doctor's advice and truly weigh my options. I'm 72, not married or currently seeing anyone, but I would like to keep my sexual health because right now I'm fully "capable". I binge watch this show regularly and it has given me the best hope yet. Wish me luck and prayers are appreciated.
Will Pray for good news for you Terry. My story is similar to yours. 70 years old, PSA went from 4.5 to 9.2 in the last year. MRI shows a 17mm lesion. Left side only like you, still just in the capsule too. Just had trans-perennial MRI ultrasound guided biopsy last week. Waiting for results. Trying to do as much research now, while I wait the 2 to 3 weeks for results. My prostate measures 58cc. MRI came back Pirads 5, and my PHI came back 60, both the worst case scenario.
All the best Terry. My situation is very much like years. I will have to have the MRI fusion guided biopsy shortly. I do have a caution that I would like to share with my fellow warriors as we all navigate this journey. I have been battling the odds for many years now, because of a strong family history of prostrate cancer. I have been seeing urologists for more than 20 plus years, and doing all the various test and monitoring. Within the last two to three years I have been taking T3, MpMRI scans w/wo contrast. Less than a year ago, 2 of those scans showed only Pi rad 2 lesions. My PSA kept rising and my previous urologists wanted to just do a Trus random sampling. I saw no point because there was no lesion to aim at and thought it made no sense. In retrospect maybe he was right because I put a lot of faith in the scans. My current urologist sent me to a different facility for the same type of scan except they used a pelvic camera. Also, the sounds etc, coming from this T3 scanner were totally different from the previous scans. Anyway, they found 2 pi-rad 4, lesions. I am really confused as to how quickly the diagnosis changed from one facility to the next, and the fact that one used the pelvic camera with the same test, but completely different results. Make of it what you will. However, it may be wise to really research where you get your scans, and what type. All the best to everyone as we all move through this journey.
Hope this helps... My annual PSA test went from a 3 to an 8 over 7 years. The biopsy confirmed cancer and the doctors at TUCC in Denver recommended 43 radiation treatments at 5 sessions a week or a 1 day surgery for removal. I chose the radiation and my PSA dropped to a 2 and is expected to go lower. The 12 core biopsy was done at the center and they made it almost painless. "Don't be bashful because we're not. We do this everyday." was mentioned several times. They also tattooed 3 dots on my midsection to line up the radiation machine and each session took about 6 minutes. They provided filtered water to help keep your bladder full and they had cookies on Friday. Oh yeah, request a sample pack of Flomax around your second week of treatments in case flow starts to slow/hurt. Everything was back to normal about 2 months after the treatments were completed. All the best!
@@troyelam8978 sexual function improved, possibly because of the flomax (Tamsulosin 0.4 mg). No incontinence and no pain of any kind. Looks like the total cost is going to come in around 19K which was covered by Medicare part A and B plus a separate G plan. Surgery would have also been covered for around 30K.
@@skyking228 hi so glad you are doing fine. Two questions please. Did you have cyberknife as an option and did they give your hormone therapy as well. Thank you.
I was diagnosed at 51. MRI pirad 3, PSA 3.9, Gleason 3+4 with 5 percent of one core being 4. Decipher score .37. History of PC in family therefore I watched my PSA. Decided with HDR BRACHYTHERAPY monotherapy at Barnes in St. Louis. PSA dropped to 1.1 after 3 months. Nadir at .6. Bouncing now but it is expected at my age. Sexual function preserved however lower amount of ejaculate fluid, as was expected. I’m hoping my PSA to drop after this bounce within 2 years of therapy. I hope this helps, thus channel was immensely helpful and comforting. God bless
My dad was diagnosed with CA prostate stage 4 with bone metastatic in Dec 2022, He had a turp surgery since then he is into various treatments chemotherapy, radiation and now into Harmone therapy Apalutamide.. his condition has not improved however I feel the psa levels plays a great role.. praying for his wellness and hope!
I have just been diagnosed of localised prostrate cancer. I am 56yrs and test results as follows: psa 4.7, gleason score 7(3+4), T2, M0. I cancer is localised inside the left lobe of the prostate only. Not spread to lymph nodes. Dr scholz kindly sdvice best treatment option. Urinary incontinence and or bowel issues are critical for me.
June 2024 had my prostate removed and the lymph nodes vis robotic surgery. Prostate was 80% cancer but all contained. Zero % in the lymph nodes. No radiation as we wanted to monitor the PSA through blood work. Negative zero on my last three blood tests and we just skipped a month and next month we will test again. On TRT shot (once a week) as the gel really didn't do much. So far so good and I'm thankful to this video producers and all of you. We will keep moving forward but one thing is for sure, some of the various videos people create on YT might need a little more explaining or steps and some experience in there but it really wasn't that bad. Removing the 20" drain tube was an experience I don't want to go through again! Again, Thank you all!
For those new to his videos, he hardly ever recommend surgery anymore because of the potential morbidity issues watch all his videos with the advancement in radiation and focal treatments especially one who has a great deal of experience. She's post surgery way down the line yet men rush out, like he mentions, and get surgery and live with the aftermath. Even the best surgeons who are highly skilled nerve and facia sparing know that the highest incontinent and ED rates come from what they do. This saves many peoples life's surgery has for many years. It was the only treatment option that was truly life-saving. Now with more information studies like the Oxford study, which show 15 your rate, mortalities the same no matter what treatment option you took why do the most invasive treatment first unless absolutely necessary
All great advice here from Dr. Scholz. Knowing the basics of prostate cancer helped immensly. Gleason 4+3 Psa 8.7. Pirads 3. I had two readings of my biopsy by pathologist localy and Johns Hopkins Consult. Any major city will have experienced urologists, clinics, hospitals and options for treatment. I personaly have a major practice outside of Chicago close to me where I am receiving care. Thank you PCRI !
60 years old, BPH and Prostatitis for years, 90cc prostate (that's large), PSA 3.5 to 5.5 over the last 4 years, up and down. MRI 4 years ago, PIRADs 3, but Biopsy negative, but biopsy showed inflammation--prostatitis and calcification. PSA leveled off to 5 last year (2023), but my prostate density is low because of the size of my prostate. I had a follow up MRI last year (2023), showed a 6mm nodule, PIRADs 4. But my PSA went down to 4.5. Then had another MRI (without contrast) 3 months ago, 6mm nodule did not grow and radiologist thought it might just be a BPH nodule. I'm going to do a PSA every 6 months and an MRI once a year--sort of Active Surveillance without ever having a positive biopsy. Being vigilant and watching these videos gives me a lot of confidence if or when the time comes. My mortality becoming focused has actually made me appreciate and love my life, family, and friends each moment and each day.
I have a Pirad FIVE!! Gleason 7 . 3+4=7! (5 out of 12) . I don't mind the Gleason as much as the LESION. I hadJ. Hopkins look and they DIDNT EVEN MENTION THE PIRAD !!! I am so confused, now.
so you had lesions from bph/prostatitis? I also, 62, have had prostatitis for years, bph last few years, and latest MRI found 2 lesions.. i just went through an episode of really bad inflammation for a few months (was given antibioitics vs. anti-inflammatory..finally got the latter and things cleared up). I am hoping the lesions are from something else other than cancer.
@@jpjp3873 unfortunately it turned out that my cancer came back..right outside of my prior treatment zone.. getting ready to do radiation for the two lesions.
This video series is invaluable. Apparently I chose wisely. Seeing the radiation doc in a week to discuss recent blood tests. PSA went from 4.5 to 0.06
Alex, you are a fantastic example of a truely caring and compassionate health care champion. I love your work and the very good advice given by Doctor Scholz. If I can offer one suggestion though, I love the ties, but please ask the Doctor to not wear the grey suit for the video! I have a 4+5 = 9 of
Dr Scholz and Alex are incredible in reducing the anxiety and raising the hope and awareness for anyone with a prostate cancer diagnosis. It would be nice to see a video about the difference in biopsy procedures(transrectal vs transperineal). I only wish their videos were required viewing for all urologists who often are matter of fact and often not hopeful. Thank you both for your dedication, time and information. It makes a world of difference to every patient. I encourage everyone to donate to PCRI to insure more videos can be forth coming.
In 9/2016 my precious husband at the of 67, was diagnosed with stage 4 prostate cancer. His start PSA was 1140. By the time he saw a doctor it had increased to 1980. Thanks to all the new ways of treatment to bring to today2024,. He is on Pluvicto and happy to say is helping. Last PSA was very low. The main thing he complains about behind his left knee hurts really bad and his quality of sleep at night is minimal. Yes his cancer is all in his bones. I truly appreciate your RUclips videos. Any suggestions for the knee pain and sleep?? Thx
I am 67 with stage 4 cancer diagnosed 3 months ago. Currently receiving Radiation Therapy and Hormone Therapy (Lupron). I don't like taking sleep aids but I was prescribed Hydroxyzine (basically like benedryl) 10mg two tablets and that helps me sleep and isn't habit forming. I use Diclofenac sodium Topical gel for my knee pain and tylenol. Praying for the best.
I’m very interested in learning more about these “centers of excellence” at the 6:50 mark of the video. I have my images from the MRI (PI-RADS 3, 7mm lesion) and I’d love to get a second opinion.
You need to consider location with respect to where you live also. You may be making multiple daily visits for radiation, for example, so reasonable distance should be considered. Centers such as Mayo Rochester NY, Sloan-Kettering in NY, UCSF in California, Cleveland Clinic in Ohio, are such centers, but there are many others that might be more practical locations for you. These centers can often develop treatment plans that are administered by your local providers if you are not near one. The NCI list is a good place to start your search. You can also ask PCRI for a volunteer to call and help you get started.
I would request that you do a video on low-PSA tumors, and and how the treatment options change in that type of situation. For example, I have Gleason 9 cancer, but my PSA never exceeded 2.5, and I'm sure there must be others in similar situations
We're 3 generations of PC mortality.. As I prepare for my biopsy (psa of 3.7,age 58), I am also coping with the devastating and possibly mortal radiation side effects of my elder brother's (age 72) Beam radiation therapy. He developed an anal fissure after one year, , and a horrible recto urethral fistula (urine passes from rectum) and random infected abscesses. He's on a colostomy bag, urostomy bag and at highest pain levels, which even opiods can't stop. Bedridden for the rest of life and howling in pain 24/7. Sadly due to complications of late detection he didn't have the option of Prostectomy. Seeing all this I'm planning to go for a radical prostectomy if it comes to that. Radiation is out - I don't want some thing coming up 3 or 10 yrs later and I die of radiation sideffects instead of PC . Here in India, radical prostectomy is so common, almost universal, and I have yet to meet someone who's had ED or permanent Incontinence. I trust a good doc with a robotic expertise. Also docs here also say That after radiation you lose the option of later prostectomy, whereas after prostectomy, all other options are open lifelong. Please do check out how many people get radiation proctitis before taking the call. It can hit anytime in the future, years after your initial radiation procedure. If I am diagnosed with localised pc I will only do a prostectomy. Better a diaper instead of your bowels and urine hanging out!! I wonder why it is not being discussed that CHRONIC radiation proctitis affects UPTO 30% of patients (from reports available online). PCRI should do an episode only on this and discuss the high probabilities, as the consequences of this side effect are infinitely worse than the worst case of radical prostectomy,leading all the way to early death!
@@vijaysampath5482 I’m more than likely going with the robotic removal surgery myself. I’ve read so much the more I read from people’s testimonies the more I feel I can’t choose. About to roll the dice and get the thing removed and have to live with how it goes from there. Then it’s done
I am so sorry to hear this. I have been researching all of this for months, and have never heard of a case like your brother after beam radiation treatments There are many safety protocols to follow: The bladder must be full of water A custom pelvic, leg mold form for each patient is made, so your lower body stays in the same position for each treatment. Oncologist follow exam every week or 2. The settings on the radiation machine should be at an established standard set processional associations and oncologists. My husband had one 6 month hormone injection, Lupron, 2 months later---low dose rate brachytherapy, from an oncologist who performs over 400 procedures a year in the U.S. (out-patient procedure performed in a hospital) 2 months later-- 25 treatments of beam radiation. Was on Flomax for 2 months to help with urination. No current severe side effects. My husband saw proctectomy has not the best choice of treatment because of the many well known side effects, and for reoccurrence of cancer.
Such a great laying out of the process for deciding the right plan. Invest the time to learn about the different forms of prostate cancer and how different they all are. Focus in on the options for treating your specific form and stage of prostate cancer (with a second opinion on your specific diagnosis from a centre of excellence, if you have any doubts). Look at both survival and quality of life outcomes for each option. Take some time to sit and weigh these outcomes from both the survival and QOL perspectives to become comfortable that you’re making the right choice for you. Get the best doctor you can to deliver the treatment you’ve decided on. As Dr. Scholz explains, it really does take a methodical and disciplined approach, and some time. Don’t rush.
The real issue isn't lack of information. It's the disconnect from the emotions and ability to sort through the information correctly. Humans have selection bias if you propose as an analogy an investment to many men that has a 90% chance of gain and a 10% chance of loss many will just focus in on the 10% loss aspect through biases the human brain has. This is why so many men ignore the incontinence ED and other issues that come with surgery when they're not presented the proper information and even when they are presented the proper information, the emotional aspects of this is so great it doesn't register with them.
@@pinotwinelover I think it's another reason not to rush. Allow time for the some of the initial emotional response to abate. Take time to research then sit with both the survival and quality of life outcomes of different options. I took 3 months to research and have discussions with both my urologist and radiologist. By the time I decided what course of action was right for me and my priorities, it didn't feel like an emotional decision. There's always some uncertainty, but I felt reasonably confident and comfortable that I was making the right choice.
Thank you for this. 🙏 Spouse just received positive diagnosis yesterday with Gleason 7 and Urologist recommended prostate removal (seemed to imply that it should happen soon) said radiation was a distant 2nd option (like not the best option) and wants to schedule a bone scan asap. Shame on us that we didn’t even start researching cancer info after MRI biopsy procedure because we thought he would be negative for Cancer. I Found this resource and we’re realizing there is so much we didn’t know and didn’t know to ask the Urologist who delivered the CA diagnosis. Spouse is only 56 and super healthy and very physically active so we’re blindsided.
@@dawng540 oh, yes, it takes anyone who's extremely healthy like myself and your husband by surprise. But life is full of surprises and how we deal with them. At least for this surprise we can effectively treat it and hopefully live a normal life span. The medical complex process is the first choice surgery but that isn't the choice I made I think it is guided by the medical industrial complex and guided by doctors and the emotional aspects of men wanting it out. However, when you study the reoccurrence rates of prostate cancer, even with the prostate removed it reoccurs essentially at the same rate. For those who disconnect their emotions and can process data and research surgery seems to be the last choice that offends certain people and I'm not concerned with that Dr. Scholls also recommends surgery as one of the last choices with the advancements in radiation and focal care because as the oxford study showed no matter what treatment option you take, they have about the same mortality rate. It's the quality of life issue that surfaces if you can disconnect the emotions from the treatment options.
PSA 22.5 - 25 (three different labs). MRI shows 22.5 and PI-RADS 4. Biopsy and MRI Guided Biopsy Scheduled April 11 so we will see. The channel has helped me a lot. Colonoscopy scheduled two weeks after the biopsy. When all this is done, I would like a PET or Bone scan to check my body for cancer. Thank you,
Did you get a DRE ( Digital Rectal Exam) Good luck to you. I just had my prostate removed three weeks ago. A experienced urologist will provide a relatively painless biopsy. It is uncomfortable a bit but over quickly. Be strong and once its over no pain since you will get a local anesthetic,
I had my biopsy as an outpatient in the hospital, I would definitely recommend that way to go I was put under and treated as if I was having major surgery, this way is so seamless and totally pain free.
@@tomasso883i got my biopsy done and i didn't get sedated it was a big mistake cause i could feel too much, did u get a genaral anesthetic?? If i get another biopsy i will ask for that, but don't know if its available, but it is over quickly on the plus side.
@@hyway62 I’m not sure I was totally put under by the anesthesiologist who gave me a few injections and when I woke up it was all over, was driven home like it never happened. BTW i insisted it be done in the hospital with IV antibiotics as well. I ultimately opted for proton radiation PSA prior to proton treatment was 14 2-years out my PSA is .5 the oncologist is ecstatic. Now if I can only convince her to do a PSMA test looking for potential metastasis, she insists there are none, I would feel better having a PSMA confirmation.
I was diagnosed with Gleason six I started active surveillance. I want to know what other options I have because I don’t want to live with this disease
Active surveillance for a Gleason six is the standard of care regular follow ups measuring your PSA may be every couple year biopsy if you're really concerned, but Gleason six does not metastasize. It does not grow the question would be then. Do you get other cancers in your prostate, that's would be the concern. Have a good urology team that follows up with you actively and your proactivity. Surgery radiation or focal care does not get it out. It can remove the lesion but all of them have the same recurrence rates so the argument if you go through the videos is weather Gleason six is even a cancer in the sense that it cannot metastasize. I know mentally it's weird knowing you have a cancer sitting in your body but some arent even referring to Gleason six is cancer now. I don't think you rush out to do any treatment at this point. I just carefully monitor yourself with a good urology team. If you're hyper concerned you can get the genetic testing, Prolaris. They have a man on these chain of videos that had Glisan six and he was shocked how many people did extreme treatments that debilitated their lifestyle not knowing that particular lesions not gonna kill them.
The biggest problem was majority of cancer patient relied on doctor to make decision. for them as in any other illness. I am one of the few exception that I always tried to find out my illness or injury before I went to see the doctor.
"Go slow". Right, it's going to take me months just to get an MRI. I don't see any point in a random biopsy, so there's nothing else to be done until I get an MRI.
Newer studies are saying cancer cell growth is linked to glucose and glutamine per Prof. Thomas Seyfried and many others in the space. PCRI can you confirm this notion?
Hi, My father 76 years old has been suffering prostate cancer with gleason score10(5+5) and he has been diagnosed with hormon therapy for first 3 month and how visiting doctors in Delhi,One doctor is suggesting to for for srgery and another doctor is suggesting for raido therapy.We are in confusion what we will do?Please advice.How can i get video consultancy with Dr Scholz? Thanks
Hello, we are not able to answer case questions on our comment section but we can help you through our Helpline who can speak with you either by phone or email. Here is the link to contact them: pcri.org/helpline
I'm trying to find the interview in which Dr. Scholz discusses a recent, high-quality study - 750 + 750 men - in which the outcomes of radiation with androgren therapy were compared with those for radiation therapy alone. Does anyone have the link to it?
Hello, here is the interview you are looking for: Intermediate-Risk: Do You Need Hormone Therapy With Radiation? ruclips.net/video/cyY0nHXvzGc/видео.htmlfeature=shared Here is the study: pubmed.ncbi.nlm.nih.gov/37104748/
Why does the doctor not recommend surgery? What is his main reasons? Is it because of the ED and incontinence? If so, in other videos, he also says various radiation treatments caused just as much ED. So what is the main difference between surgery and radiation, in terms of side effects?
off topic but I don't understand that on one side they say.. Gleeson 6 will never metastasize then on the other 50% of patients with Gleeson 6 go on to have treatment within 10 years.. Can gleeson 6 change to Gleeson 7.. Anyone. Please help.
I went from 3+3 in 2022 to 4+3 here in 2024. They found another tumor by doubling the number of cores they drilled out of me in biopsy. So did it get worse? Or did they miss it the first time? No way to tell.
No test is 100% accurate, this incudes a biopsy. Your doctor can use TRUS to perform a prostate biopsy. MRI-guided prostate biopsy. MRI of the prostate, or using genetic testing can also help confirm the diagnosis. You can also run a free and total PSA testing after a PSA screening. Researchers say the PUR test can detect prostate cancer and help determine which men are up to eight times less likely to need treatment within five years of diagnosis. Researchers developed a urine-based test that can distinguish between slow-growing prostate cancers that pose little risk and more aggressive cancers that need treatment. The test could help some patients avoid unnecessary biopsies and other tests that carry potential risks You need a confirmed diagnosis of prostate cancer for insurance companies to pay for a PSMA Pet Scan, which is used to check for metastatic disease.
Alex can you and Dr. Scholz address Choline in eggs and it's effect on Prostate Cancer? I was recently given a Pi-Rads 4 rating from a recent MRI and I love eggs and eat them almost daily. The report I read from several reputable sources said that not only can Choline cause Prostate Cancer but if you already have it, It can make the cancer deadly!
Good video, but why is age never mentioned? If you are 50 it's one scenario, but if you are 80 it's completely different. The 50 year old has perhaps 35 years remaining, while the 80 year old may have 5 years.
Generaly the younger its found the more agressive, and active treatment is advised. The older man with PC has less years ahead and its possible another disease or just natrual causes. Hence it is said You may die with prostate cancer , but not beause of it.
He frequently mentions age as a consideration in other videos. Here I suppose his reference to the importance of quality of life considerations because men might live “another 10 or 20 years after diagnosis” indirectly raises age as a factor. I was 62 when I was diagnosed, and both my parents lived into their mid 90s. So QOL was a big factor for me in choosing treatment when I was diagnosed. Yes, I wanted to survive this disease, but I didn’t want another 30 years if they were going to be miserable. I ultimately chose hdr brachytherapy + external beam radiation + 6 months hormone therapy for my unfavourable intermediate diagnosis. So far, so good. No signs of cancer, and my QOL hasn’t been too badly impacted.
Thank you for your comment. I am 65 and recently diagnosed with a gleason 8 without metastasis. I have seen the local Radiation Oncologist and was given one option and was not given brachytherapy+external beam radiation as that option. I now have an appointment in mid May at Mayo to talk about HDR brachytherapy+ external beam. My research is telling me that it might be the right option for me. Did you start the hormone therapy before radiation? It is nice to hear the so far so good for you and the QOL is not to bad. It is comforting to see this treatment working out for you. Thank you again. @@robbujold7711
@@robbujold7711 A friend of mine chose the same treatment as you but without the hormone therapy, and he is doing fine now. He had genetic testing, and learned he was Braca2.
But the eighty year old has prostate cancer already. I bet if they had a biopsy of all eight year olds that seventy five percent would have a gleason of three plus four equals seven. I'm thinking it's normal.
the dr told me if i do radiation and the cancer comes back we do not have many options left, but if i have surgery and cancer comes back we have radiation. is this true
What Dr. Scholz says on this video between 11 and 12 minutes is very relevant to you. Listen to it and remember "if you go to a barber your gonna get a haircut". Get opinion from radiation oncologist and consider your options. Good luck.
That is true but you have to think about that. You're going to risk surgery which has high incontinence high ED rates with surgery and the concept is well I avoid radiation for surgery because it's hard to do surgery afterwards. But the point of avoiding surgery is because it comes with all the complications so if you radiated and surgery is not an option, your original choice of radiation is still available. How many men have surgery and then have to go to radiation, so they suffer through both
My dad had PCA and did radiation. Unfortunately when it reoccurred, he had no option at the time beyond ADT. Eventually it became castrate-resistant and it killed him. So for mine, I did HIFU first, but now it may have come back and am considering radiation. I am concerned though as I am only 62, if it does reoccur again, I'll be in the same situation as my dad.
Hello, we are not able to answer case questions on our comment section but we can help you through our Helpline who can speak with you either by phone or email. Here is the link to contact them: pcri.org/helpline
I am 60, T3b tumor, spread to lymph, I switch to Keto diet, use cannabis, the hospital only offers hormone therapy and radiation, stand-off-care for 20 years, Danes dies 55% more than people in Sweden and Germany. I don’t know what to do!
After 8 months of researchs, I thought that a brachytherapy was ok, for I have a gleason score of 7(3+4), located prostate K, within a small prostate, bilateral but with grade 6 in small areas on the left lobe, no spread outside of the prostate detected by the petscan. But today I have seen a surgeon who is the only one in Paris to put the spaceoar gel(only with SBRT) and he told me , you must NOT do brachytherapy, because of the location of your cancer partly at the Apex of the gland. The seeds will burn the sphincter if you do that. He wants me to have an ablation. All what I tried to avoid for 8 months. Is it reliable, this view of the side effects of brachytherapy, on an Apex lesion ? There is no information on this particular area's treatment by BT or CyberKnife.
I have a PSA that has crept from 3 to 5 over the seven years since I turned 60. DRE showed asymmetrical enlargement, and bladder ultrasound showed PVR > 500 ml. I was switched from Doxazosin to Tamsulosin, and have worn a catheter for 5 weeks now, and the transrectal biopsy is still six weeks or more out, and I’m told to keep the catheter at least until biopsy. I have requested MRI before biopsy and requested a transperineal biopsy targeted at any lesions that may show in the MRI. Both requests were rejected without discussion. I’m now considering leaving the Urology department as they seem intent on scaring me into surgery, and seeking Interventional Radiology treatment called Prostate Artery Embolization. Thoughts?
Earliest I've been here too. My MRI has just recently shown an 8mm lesion in the left anterior portion of my prostate but looks like it's confined to the capsule with nothing else seen in the pelvic area. PSA was 5.56 but dropped off to 4.3 after getting MRI and retested. Pirads 4 biopsy is recommended but hasn't been scheduled yet. I was diagnosed 15 years ago with a "calcification" in the prostate via a full body CT scan because of an accident, but was never advised to follow up. I'm hoping that's what they're seeing now. I have been seeing a urologist for years with regular blood work, due to BPH, and to check PSA levels. After recent rise in numbers, I was offered an MRI, which I had about a month ago. I have some hope that the biopsy will not show anything aggressive and praying for a Gleason 6 or something better. I'm going to take this doctor's advice and truly weigh my options. I'm 72, not married or currently seeing anyone, but I would like to keep my sexual health because right now I'm fully "capable". I binge watch this show regularly and it has given me the best hope yet. Wish me luck and prayers are appreciated.
Good luck, Terry. Please keep us updated.
Will Pray for good news for you Terry. My story is similar to yours. 70 years old, PSA went from 4.5 to 9.2 in the last year. MRI shows a 17mm lesion. Left side only like you, still just in the capsule too. Just had trans-perennial MRI ultrasound guided biopsy last week. Waiting for results. Trying to do as much research now, while I wait the 2 to 3 weeks for results. My prostate measures 58cc. MRI came back Pirads 5, and my PHI came back 60, both the worst case scenario.
@@keithcolegrove2924 Praying for you too.
Praying for you!
All the best Terry. My situation is very much like years. I will have to have the MRI fusion guided biopsy shortly. I do have a caution that I would like to share with my fellow warriors as we all navigate this journey. I have been battling the odds for many years now, because of a strong family history of prostrate cancer. I have been seeing urologists for more than 20 plus years, and doing all the various test and monitoring. Within the last two to three years I have been taking T3, MpMRI scans w/wo contrast. Less than a year ago, 2 of those scans showed only Pi rad 2 lesions. My PSA kept rising and my previous urologists wanted to just do a Trus random sampling. I saw no point because there was no lesion to aim at and thought it made no sense. In retrospect maybe he was right because I put a lot of faith in the scans. My current urologist sent me to a different facility for the same type of scan except they used a pelvic camera. Also, the sounds etc, coming from this T3 scanner were totally different from the previous scans. Anyway, they found 2 pi-rad 4, lesions. I am really confused as to how quickly the diagnosis changed from one facility to the next, and the fact that one used the pelvic camera with the same test, but completely different results. Make of it what you will. However, it may be wise to really research where you get your scans, and what type.
All the best to everyone as we all move through this journey.
Dr. Scholz, Alex, you guys are amazing people. Thank you.
Hope this helps... My annual PSA test went from a 3 to an 8 over 7 years. The biopsy confirmed cancer and the doctors at TUCC in Denver recommended 43 radiation treatments at 5 sessions a week or a 1 day surgery for removal. I chose the radiation and my PSA dropped to a 2 and is expected to go lower. The 12 core biopsy was done at the center and they made it almost painless. "Don't be bashful because we're not. We do this everyday." was mentioned several times. They also tattooed 3 dots on my midsection to line up the radiation machine and each session took about 6 minutes. They provided filtered water to help keep your bladder full and they had cookies on Friday. Oh yeah, request a sample pack of Flomax around your second week of treatments in case flow starts to slow/hurt. Everything was back to normal about 2 months after the treatments were completed. All the best!
Thank you for sharing. May I ask how your sexual function is after the treatments? Also, are you experiencing any incontinence?
@@troyelam8978 sexual function improved, possibly because of the flomax (Tamsulosin 0.4 mg). No incontinence and no pain of any kind. Looks like the total cost is going to come in around 19K which was covered by Medicare part A and B plus a separate G plan. Surgery would have also been covered for around 30K.
@@skyking228 hi so glad you are doing fine. Two questions please. Did you have cyberknife as an option and did they give your hormone therapy as well. Thank you.
What does TUCC stand for?
@@lindawitt4661 The Urology Center of Colorado, found an article they closed, not sure why, possibly reopening in new location
I was diagnosed at 51. MRI pirad 3, PSA 3.9, Gleason 3+4 with 5 percent of one core being 4. Decipher score .37. History of PC in family therefore I watched my PSA. Decided with HDR BRACHYTHERAPY monotherapy at Barnes in St. Louis. PSA dropped to 1.1 after 3 months. Nadir at .6. Bouncing now but it is expected at my age. Sexual function preserved however lower amount of ejaculate fluid, as was expected. I’m hoping my PSA to drop after this bounce within 2 years of therapy. I hope this helps, thus channel was immensely helpful and comforting. God bless
My dad was diagnosed with CA prostate stage 4 with bone metastatic in Dec 2022, He had a turp surgery since then he is into various treatments chemotherapy, radiation and now into Harmone therapy Apalutamide.. his condition has not improved however I feel the psa levels plays a great role.. praying for his wellness and hope!
How is he now
I have just been diagnosed of localised prostrate cancer. I am 56yrs and test results as follows: psa 4.7, gleason score 7(3+4), T2, M0. I cancer is localised inside the left lobe of the prostate only. Not spread to lymph nodes. Dr scholz kindly sdvice best treatment option. Urinary incontinence and or bowel issues are critical for me.
Which treatment you’ve chosen?
Im 63 3+4 gleason7
I had a turp.
Gold markers and space gel
I have to have 28 radaition treatments starting august 12 24
June 2024 had my prostate removed and the lymph nodes vis robotic surgery.
Prostate was 80% cancer but all contained.
Zero % in the lymph nodes.
No radiation as we wanted to monitor the PSA through blood work.
Negative zero on my last three blood tests and we just skipped a month and next month we will test again.
On TRT shot (once a week) as the gel really didn't do much.
So far so good and I'm thankful to this video producers and all of you.
We will keep moving forward but one thing is for sure, some of the various videos people create on YT might need a little more explaining or steps and some experience in there but it really wasn't that bad.
Removing the 20" drain tube was an experience I don't want to go through again!
Again,
Thank you all!
For those new to his videos, he hardly ever recommend surgery anymore because of the potential morbidity issues watch all his videos with the advancement in radiation and focal treatments especially one who has a great deal of experience. She's post surgery way down the line yet men rush out, like he mentions, and get surgery and live with the aftermath. Even the best surgeons who are highly skilled nerve and facia sparing know that the highest incontinent and ED rates come from what they do. This saves many peoples life's surgery has for many years. It was the only treatment option that was truly life-saving. Now with more information studies like the Oxford study, which show 15 your rate, mortalities the same no matter what treatment option you took why do the most invasive treatment first unless absolutely necessary
Christ bless you! You guys are great!
All great advice here from Dr. Scholz. Knowing the basics of prostate cancer helped immensly. Gleason 4+3 Psa 8.7. Pirads 3. I had two readings of my biopsy by pathologist localy and Johns Hopkins Consult. Any major city will have experienced urologists, clinics, hospitals and options for treatment. I personaly have a major practice outside of Chicago close to me where I am receiving care. Thank you PCRI !
Hi Nick. How were you able to arrange the Hopkins consult? I have my MRI images and would like a second opinion. Thanks.
I live near Chicago what place do you recommend?
60 years old, BPH and Prostatitis for years, 90cc prostate (that's large), PSA 3.5 to 5.5 over the last 4 years, up and down. MRI 4 years ago, PIRADs 3, but Biopsy negative, but biopsy showed inflammation--prostatitis and calcification. PSA leveled off to 5 last year (2023), but my prostate density is low because of the size of my prostate. I had a follow up MRI last year (2023), showed a 6mm nodule, PIRADs 4. But my PSA went down to 4.5. Then had another MRI (without contrast) 3 months ago, 6mm nodule did not grow and radiologist thought it might just be a BPH nodule. I'm going to do a PSA every 6 months and an MRI once a year--sort of Active Surveillance without ever having a positive biopsy. Being vigilant and watching these videos gives me a lot of confidence if or when the time comes. My mortality becoming focused has actually made me appreciate and love my life, family, and friends each moment and each day.
Wish you the best of luck !!!
I have a Pirad FIVE!! Gleason 7 . 3+4=7! (5 out of 12) . I don't mind the Gleason as much as the LESION. I hadJ. Hopkins look and they DIDNT EVEN MENTION THE PIRAD !!! I am so confused, now.
so you had lesions from bph/prostatitis? I also, 62, have had prostatitis for years, bph last few years, and latest MRI found 2 lesions.. i just went through an episode of really bad inflammation for a few months (was given antibioitics vs. anti-inflammatory..finally got the latter and things cleared up). I am hoping the lesions are from something else other than cancer.
@@dmcardenDid you find out about your lesions? Hopefully all is well.
@@jpjp3873 unfortunately it turned out that my cancer came back..right outside of my prior treatment zone.. getting ready to do radiation for the two lesions.
This video series is invaluable. Apparently I chose wisely. Seeing the radiation doc in a week to discuss recent blood tests. PSA went from 4.5 to 0.06
Alex, you are a fantastic example of a truely caring and compassionate health care champion. I love your work and the very good advice given by Doctor Scholz.
If I can offer one suggestion though, I love the ties, but please ask the Doctor to not wear the grey suit for the video!
I have a 4+5 = 9 of
Thanks yet again for your valuable insights
this is sooo helpful!!! thank you
Dr Scholz and Alex are incredible in reducing the anxiety and raising the hope and awareness for anyone with a prostate cancer diagnosis. It would be nice to see a video about the difference in biopsy procedures(transrectal vs transperineal). I only wish their videos were required viewing for all urologists who often are matter of fact and often not hopeful. Thank you both for your dedication, time and information. It makes a world of difference to every patient. I encourage everyone to donate to PCRI to insure more videos can be forth coming.
In 9/2016 my precious husband at the of 67, was diagnosed with stage 4 prostate cancer. His start PSA was 1140. By the time he saw a doctor it had increased to 1980.
Thanks to all the new ways of treatment to bring to today2024,. He is on Pluvicto and happy to say is helping. Last PSA was very low.
The main thing he complains about behind his left knee hurts really bad and his quality of sleep at night is minimal.
Yes his cancer is all in his bones.
I truly appreciate your RUclips videos.
Any suggestions for the knee pain and sleep??
Thx
If you don’t mind me asking how low? Thanks
I am 67 with stage 4 cancer diagnosed 3 months ago. Currently receiving Radiation Therapy and Hormone Therapy (Lupron). I don't like taking sleep aids but I was prescribed Hydroxyzine (basically like benedryl) 10mg two tablets and that helps me sleep and isn't habit forming. I use Diclofenac sodium Topical gel for my knee pain and tylenol. Praying for the best.
To answer how low in February is was 0.48
To reply about suggestions for my husband’s knee and sleep. Thank you. He is already doing those. Appreciate the suggestions.
Try CBD oil
Link to his book?
Thank you
Just schedule my first appointment with the Tampa Moffitt Cancer Center, after a Gleason 10 diagnosis.🤗
Thanks for all your help.
How did ur treatment go ?
I have 3+4 gleason 7
Had a turp.
Had markers and space gel.
28 ex beam radaition treatments starting on august 12 24
@@leonardola9161 PSA back to 0.3🤗
Gave your foundation a donation and it is matched by my employer. Thanks for all the good information. It is reassuring.
Thank you so much! We truly appreciate you!!
I’m very interested in learning more about these “centers of excellence” at the 6:50 mark of the video. I have my images from the MRI (PI-RADS 3, 7mm lesion) and I’d love to get a second opinion.
Do a search for NCI-designated cancer centers. Most are at university medical centers in the U.S.A.
You need to consider location with respect to where you live also. You may be making multiple daily visits for radiation, for example, so reasonable distance should be considered. Centers such as Mayo Rochester NY, Sloan-Kettering in NY, UCSF in California, Cleveland Clinic in Ohio, are such centers, but there are many others that might be more practical locations for you. These centers can often develop treatment plans that are administered by your local providers if you are not near one. The NCI list is a good place to start your search. You can also ask PCRI for a volunteer to call and help you get started.
@@eddiegardner8232 and @groove9tube - thanks for the responses. I’m very close to UCSF so that will be my direction. Appreciate it.
I would request that you do a video on low-PSA tumors, and and how the treatment options change in that type of situation. For example, I have Gleason 9 cancer, but my PSA never exceeded 2.5, and I'm sure there must be others in similar situations
You guys help enlighten people to well rounded overall treatment options. Thanks for what you do.
cool tie
We're 3 generations of PC mortality.. As I prepare for my biopsy (psa of 3.7,age 58), I am also coping with the devastating and possibly mortal radiation side effects of my elder brother's (age 72) Beam radiation therapy. He developed an anal fissure after one year, , and a horrible recto urethral fistula (urine passes from rectum) and random infected abscesses. He's on a colostomy bag, urostomy bag and at highest pain levels, which even opiods can't stop. Bedridden for the rest of life and howling in pain 24/7. Sadly due to complications of late detection he didn't have the option of Prostectomy.
Seeing all this I'm planning to go for a radical prostectomy if it comes to that. Radiation is out - I don't want some thing coming up 3 or 10 yrs later and I die of radiation sideffects instead of PC . Here in India, radical prostectomy is so common, almost universal, and I have yet to meet someone who's had ED or permanent Incontinence. I trust a good doc with a robotic expertise. Also docs here also say That after radiation you lose the option of later prostectomy, whereas after prostectomy, all other options are open lifelong. Please do check out how many people get radiation proctitis before taking the call. It can hit anytime in the future, years after your initial radiation procedure. If I am diagnosed with localised pc I will only do a prostectomy. Better a diaper instead of your bowels and urine hanging out!! I wonder why it is not being discussed that CHRONIC radiation proctitis affects UPTO 30% of patients (from reports available online). PCRI should do an episode only on this and discuss the high probabilities, as the consequences of this side effect are infinitely worse than the worst case of radical prostectomy,leading all the way to early death!
@@vijaysampath5482 I’m more than likely going with the robotic removal surgery myself. I’ve read so much the more I read from people’s testimonies the more I feel I can’t choose. About to roll the dice and get the thing removed and have to live with how it goes from there. Then it’s done
I am so sorry to hear this.
I have been researching all of this for months, and have never heard of a case like your brother after beam radiation treatments
There are many safety protocols to follow:
The bladder must be full of water
A custom pelvic, leg mold form for each patient is made, so your lower body stays in the same position for each treatment.
Oncologist follow exam every week or 2.
The settings on the radiation machine should be at an established standard set processional associations and oncologists.
My husband had one 6 month hormone injection, Lupron,
2 months later---low dose rate brachytherapy, from an oncologist who performs over 400 procedures a year in the U.S. (out-patient procedure performed in a hospital)
2 months later-- 25 treatments of beam radiation.
Was on Flomax for 2 months to help with urination. No current severe side effects.
My husband saw proctectomy has not the best choice of treatment because of the many well known side effects, and for reoccurrence of cancer.
Such a great laying out of the process for deciding the right plan. Invest the time to learn about the different forms of prostate cancer and how different they all are. Focus in on the options for treating your specific form and stage of prostate cancer (with a second opinion on your specific diagnosis from a centre of excellence, if you have any doubts). Look at both survival and quality of life outcomes for each option. Take some time to sit and weigh these outcomes from both the survival and QOL perspectives to become comfortable that you’re making the right choice for you. Get the best doctor you can to deliver the treatment you’ve decided on. As Dr. Scholz explains, it really does take a methodical and disciplined approach, and some time. Don’t rush.
The real issue isn't lack of information. It's the disconnect from the emotions and ability to sort through the information correctly. Humans have selection bias if you propose as an analogy an investment to many men that has a 90% chance of gain and a 10% chance of loss many will just focus in on the 10% loss aspect through biases the human brain has. This is why so many men ignore the incontinence ED and other issues that come with surgery when they're not presented the proper information and even when they are presented the proper information, the emotional aspects of this is so great it doesn't register with them.
@@pinotwinelover I think it's another reason not to rush. Allow time for the some of the initial emotional response to abate. Take time to research then sit with both the survival and quality of life outcomes of different options. I took 3 months to research and have discussions with both my urologist and radiologist. By the time I decided what course of action was right for me and my priorities, it didn't feel like an emotional decision. There's always some uncertainty, but I felt reasonably confident and comfortable that I was making the right choice.
Thank you for this. 🙏 Spouse just received positive diagnosis yesterday with Gleason 7 and Urologist recommended prostate removal (seemed to imply that it should happen soon) said radiation was a distant 2nd option (like not the best option) and wants to schedule a bone scan asap. Shame on us that we didn’t even start researching cancer info after MRI biopsy procedure because we thought he would be negative for Cancer. I Found this resource and we’re realizing there is so much we didn’t know and didn’t know to ask the Urologist who delivered the CA diagnosis. Spouse is only 56 and super healthy and very physically active so we’re blindsided.
@@dawng540 oh, yes, it takes anyone who's extremely healthy like myself and your husband by surprise. But life is full of surprises and how we deal with them. At least for this surprise we can effectively treat it and hopefully live a normal life span. The medical complex process is the first choice surgery but that isn't the choice I made I think it is guided by the medical industrial complex and guided by doctors and the emotional aspects of men wanting it out. However, when you study the reoccurrence rates of prostate cancer, even with the prostate removed it reoccurs essentially at the same rate. For those who disconnect their emotions and can process data and research surgery seems to be the last choice that offends certain people and I'm not concerned with that Dr. Scholls also recommends surgery as one of the last choices with the advancements in radiation and focal care because as the oxford study showed no matter what treatment option you take, they have about the same mortality rate. It's the quality of life issue that surfaces if you can disconnect the emotions from the treatment options.
@@robbujold7711 What did you decide?
PSA 22.5 - 25 (three different labs). MRI shows 22.5 and PI-RADS 4.
Biopsy and MRI Guided Biopsy Scheduled April 11 so we will see.
The channel has helped me a lot.
Colonoscopy scheduled two weeks after the biopsy.
When all this is done, I would like a PET or Bone scan to check my body for cancer.
Thank you,
Did you get a DRE ( Digital Rectal Exam) Good luck to you. I just had my prostate removed three weeks ago. A experienced urologist will provide a relatively painless biopsy. It is uncomfortable a bit but over quickly. Be strong and once its over no pain since you will get a local anesthetic,
I had my biopsy as an outpatient in the hospital, I would definitely recommend that way to go I was put under and treated as if I was having major surgery, this way is so seamless and totally pain free.
@@tomasso883i got my biopsy done and i didn't get sedated it was a big mistake cause i could feel too much, did u get a genaral anesthetic?? If i get another biopsy i will ask for that, but don't know if its available, but it is over quickly on the plus side.
@@hyway62 I’m not sure I was totally put under by the anesthesiologist who gave me a few injections and when I woke up it was all over, was driven home like it never happened. BTW i insisted it be done in the hospital with IV antibiotics as well. I ultimately opted for proton radiation PSA prior to proton treatment was 14 2-years out my PSA is .5 the oncologist is ecstatic. Now if I can only convince her to do a PSMA test looking for potential metastasis, she insists there are none, I would feel better having a PSMA confirmation.
They will put me under or close to it they said @@hyway62
How can I find a MD local who follows pcri guidelines?? Riverside Ca
Getting a "bracky something" radiation treatment, should I get a high dose or a low dose
What is the Center of Excellence referred to by Dr. Scholz, for a second opinion on biopsy slides and scanned images?
Are there permanent side effects from getting a biopsy? What are the risks?
I was diagnosed with Gleason six I started active surveillance. I want to know what other options I have because I don’t want to live with this disease
Active surveillance for a Gleason six is the standard of care regular follow ups measuring your PSA may be every couple year biopsy if you're really concerned, but Gleason six does not metastasize. It does not grow the question would be then. Do you get other cancers in your prostate, that's would be the concern. Have a good urology team that follows up with you actively and your proactivity.
Surgery radiation or focal care does not get it out. It can remove the lesion but all of them have the same recurrence rates so the argument if you go through the videos is weather Gleason six is even a cancer in the sense that it cannot metastasize. I know mentally it's weird knowing you have a cancer sitting in your body but some arent even referring to Gleason six is cancer now. I don't think you rush out to do any treatment at this point. I just carefully monitor yourself with a good urology team. If you're hyper concerned you can get the genetic testing, Prolaris. They have a man on these chain of videos that had Glisan six and he was shocked how many people did extreme treatments that debilitated their lifestyle not knowing that particular lesions not gonna kill them.
@@pinotwinelover thank you for all the information you provide i’m just in a State of shock
@@pinotwinelover Thank you Sir for your response and care. My Best Regards
@@pinotwinelover surgery, radiation or focal care does not get it out?
The biggest problem was majority of cancer patient relied on doctor to make decision. for them as in any other illness.
I am one of the few exception that I always tried to find out my illness or injury before I went to see the doctor.
how might having HoLEP surgery alter treatment choices for prostate CA - G7 low volume - localized. Negative PSMA Dicipher .51
"Go slow". Right, it's going to take me months just to get an MRI. I don't see any point in a random biopsy, so there's nothing else to be done until I get an MRI.
Newer studies are saying cancer cell growth is linked to glucose and glutamine per Prof. Thomas Seyfried and many others in the space.
PCRI can you confirm this notion?
Can you provide a link to those studies?
@dondgc2298. Put his name in RUclips, lots on his work , sugar and carbs causing all our problems
Hi,
My father 76 years old has been suffering prostate cancer with gleason score10(5+5) and he has been diagnosed with hormon therapy for first 3 month and how visiting doctors in Delhi,One doctor is suggesting to for for srgery and another doctor is suggesting for raido therapy.We are in confusion what we will do?Please advice.How can i get video consultancy with Dr Scholz?
Thanks
If 1/3 of patients do very well after surgery, what happened to the other 2/3?
How do you send your biopsy and PSMA scan to a center of excellence for an opinion?
Hello, we are not able to answer case questions on our comment section but we can help you through our Helpline who can speak with you either by phone or email. Here is the link to contact them: pcri.org/helpline
I would love to talk to this doctor
You can call his clinic he does not charge much I did
Me too just for 5 minutes.
I'm trying to find the interview in which Dr. Scholz discusses a recent, high-quality study - 750 + 750 men - in which the outcomes of radiation with androgren therapy were compared with those for radiation therapy alone. Does anyone have the link to it?
Hello, here is the interview you are looking for: Intermediate-Risk: Do You Need Hormone Therapy With Radiation? ruclips.net/video/cyY0nHXvzGc/видео.htmlfeature=shared
Here is the study: pubmed.ncbi.nlm.nih.gov/37104748/
What state does this doctor have his practice...?
Based on other videos he seems to be in Los Angeles.
You didn't talk about reoccurrence and secondary cancers for radiation
Why does the doctor not recommend surgery? What is his main reasons? Is it because of the ED and incontinence? If so, in other videos, he also says various radiation treatments caused just as much ED. So what is the main difference between surgery and radiation, in terms of side effects?
He doesnt like surgery bcuz that a last resort.
To many long term side effects.
off topic but I don't understand that on one side they say.. Gleeson 6 will never metastasize then on the other 50% of patients with Gleeson 6 go on to have treatment within 10 years.. Can gleeson 6 change to Gleeson 7.. Anyone. Please help.
I went from 3+3 in 2022 to 4+3 here in 2024. They found another tumor by doubling the number of cores they drilled out of me in biopsy. So did it get worse? Or did they miss it the first time? No way to tell.
@@1donjuegohe discusses this exact situation in another video from about a month ago. “Why Gleason scores matter” I think is the title.
@@1donjuegohe also has a video specifically on Gleason 6 and targeted biopsies. Definitely worth checking out.
No test is 100% accurate, this incudes a biopsy. Your doctor can use TRUS to perform a prostate biopsy. MRI-guided prostate biopsy. MRI of the prostate, or using genetic testing can also help confirm the diagnosis. You can also run a free and total PSA testing after a PSA screening.
Researchers say the PUR test can detect prostate cancer and help determine which men are up to eight times less likely to need treatment within five years of diagnosis.
Researchers developed a urine-based test that can distinguish between slow-growing prostate cancers that pose little risk and more aggressive cancers that need treatment.
The test could help some patients avoid unnecessary biopsies and other tests that carry potential risks
You need a confirmed diagnosis of prostate cancer for insurance companies to pay for a PSMA Pet Scan, which is used to check for metastatic disease.
I did very bad after surgery
Alex can you and Dr. Scholz address Choline in eggs and it's effect on Prostate Cancer? I was recently given a Pi-Rads 4 rating from a recent MRI and I love eggs and eat them almost daily. The report I read from several reputable sources said that not only can Choline cause Prostate Cancer but if you already have it, It can make the cancer deadly!
Good video, but why is age never mentioned? If you are 50 it's one scenario, but if you are 80 it's completely different. The 50 year old has perhaps 35 years remaining, while the 80 year old may have 5 years.
Generaly the younger its found the more agressive, and active treatment is advised. The older man with PC has less years ahead and its possible another disease or just natrual causes. Hence it is said You may die with prostate cancer , but not beause of it.
He frequently mentions age as a consideration in other videos. Here I suppose his reference to the importance of quality of life considerations because men might live “another 10 or 20 years after diagnosis” indirectly raises age as a factor. I was 62 when I was diagnosed, and both my parents lived into their mid 90s. So QOL was a big factor for me in choosing treatment when I was diagnosed. Yes, I wanted to survive this disease, but I didn’t want another 30 years if they were going to be miserable. I ultimately chose hdr brachytherapy + external beam radiation + 6 months hormone therapy for my unfavourable intermediate diagnosis. So far, so good. No signs of cancer, and my QOL hasn’t been too badly impacted.
Thank you for your comment. I am 65 and recently diagnosed with a gleason 8 without metastasis. I have seen the local Radiation Oncologist and was given one option and was not given brachytherapy+external beam radiation as that option. I now have an appointment in mid May at Mayo to talk about HDR brachytherapy+ external beam. My research is telling me that it might be the right option for me. Did you start the hormone therapy before radiation? It is nice to hear the so far so good for you and the QOL is not to bad. It is comforting to see this treatment working out for you. Thank you again. @@robbujold7711
@@robbujold7711 A friend of mine chose the same treatment as you but without the hormone therapy, and he is doing fine now. He had genetic testing, and learned he was Braca2.
But the eighty year old has prostate cancer already. I bet if they had a biopsy of all eight year olds that seventy five percent would have a gleason of three plus four equals seven. I'm thinking it's normal.
For sleep, try CBD or THC gummies. I've reduced my nocturnal bathroom trips from 5 times to one or 2.
the dr told me if i do radiation and the cancer comes back we do not have many options left, but if i have surgery and cancer comes back we have radiation. is this true
What Dr. Scholz says on this video between 11 and 12 minutes is very relevant to you. Listen to it and remember "if you go to a barber your gonna get a haircut". Get opinion from radiation oncologist and consider your options. Good luck.
Yes, it’s true. It’s what I heard as well.
That is true but you have to think about that. You're going to risk surgery which has high incontinence high ED rates with surgery and the concept is well I avoid radiation for surgery because it's hard to do surgery afterwards. But the point of avoiding surgery is because it comes with all the complications so if you radiated and surgery is not an option, your original choice of radiation is still available. How many men have surgery and then have to go to radiation, so they suffer through both
My dad had PCA and did radiation. Unfortunately when it reoccurred, he had no option at the time beyond ADT. Eventually it became castrate-resistant and it killed him. So for mine, I did HIFU first, but now it may have come back and am considering radiation. I am concerned though as I am only 62, if it does reoccur again, I'll be in the same situation as my dad.
@@dmcarden with sbrt and improvement in radiation tech, radiation can be as good if not better than surgery and without the risk of incontinence etc.
Diagnosed stage 4 a couple wks ago at 40 years old, many metastases, no pain, no history in family. Can Dr Scholz or Dr Kwon help me?
Hello, we are not able to answer case questions on our comment section but we can help you through our Helpline who can speak with you either by phone or email. Here is the link to contact them: pcri.org/helpline
I am 60, T3b tumor, spread to lymph, I switch to Keto diet, use cannabis, the hospital only offers hormone therapy and radiation, stand-off-care for 20 years, Danes dies 55% more than people in Sweden and Germany.
I don’t know what to do!
After 8 months of researchs, I thought that a brachytherapy was ok, for I have a gleason score of 7(3+4), located prostate K, within a small prostate, bilateral but with grade 6 in small areas on the left lobe, no spread outside of the prostate detected by the petscan. But today I have seen a surgeon who is the only one in Paris to put the spaceoar gel(only with SBRT) and he told me , you must NOT do brachytherapy, because of the location of your cancer partly at the Apex of the gland. The seeds will burn the sphincter if you do that. He wants me to have an ablation. All what I tried to avoid for 8 months. Is it reliable, this view of the side effects of brachytherapy, on an Apex lesion ? There is no information on this particular area's treatment by BT or CyberKnife.
I have a PSA that has crept from 3 to 5 over the seven years since I turned 60. DRE showed asymmetrical enlargement, and bladder ultrasound showed PVR > 500 ml. I was switched from Doxazosin to Tamsulosin, and have worn a catheter for 5 weeks now, and the transrectal biopsy is still six weeks or more out, and I’m told to keep the catheter at least until biopsy.
I have requested MRI before biopsy and requested a transperineal biopsy targeted at any lesions that may show in the MRI. Both requests were rejected without discussion.
I’m now considering leaving the Urology department as they seem intent on scaring me into surgery, and seeking Interventional Radiology treatment called Prostate Artery Embolization. Thoughts?
Dont let them scare you.
Do your research and make the decision for you.
I have treatment regret.
Can you elaborate? I know everyone is different of course. Do you wish you woulda had the surgery instead?
Prostate cancer in 2024, it is like marrying the wrong wife at aged 33 or 66?
1rst