This is asuperb video for anyone facing this decision. I was 49 at diagnosis and treatment. PSA7.1 Gleason 7 (3+4) T3A I took the radical prostatectomy route . I saw it as the fastest way to a cure and was also advised due to my young age this is a more favourable option. I lost half my nerves as a result and sadly still suffer with ED 18 months on. I was incontinent but after 3-4 months I regained most of it and as of typing this I am now a good 95% with just some minor mishaps here and there. Make the decision that’s right for you and consider all options. Life will go on afterwards so keep that at the front of all your thoughts. I thought this consultant in this video was fantastic and wish he had been mine. Hope this comment helps the reader.
Had result of biopsy this morning 3+4=7. Found this video just the tonic this evening. I’m a very fit healthy 58 year old. Think I’m going to ask for Active Surveillance as I’m looking to alternative therapies. Thank you 👍🏽
Coming from a urological surgeon, this is a surprisingly balanced explanation. Very well done, Sir! He refers to alternative treatment options such as radiotherapy (brachytherapy and external beam) and the complications associated with surgery (incontinence and impotence). I wish all urologists were this objective.
3+4=7, Age 66 w/ PSA rising....4-6, then hitting 7 over 2 years. Was thinking surgery but after reading Robert Marckini's book; "You Can Beat Prostate Cancer" (2nd Edition), I will be going in for Proton Beam Radiation this winter. Survival rate is the same as both surgery and standard radiation; but with less side effects. Best of luck to all~~~
It is covered 80% by Medicare. Then our secondary insurance covers the remaining 20%. Contact your own insurance company to ask. The book that I highly recommended above has a chapter on "Insurance" and why the Insurance companies are fighting it. We chose the UF Health Proton Therapy Institute in Jacksonville, FL They are excellent. @@MikeSanz-qw5cq
Gleason 9. Thanks - this the best and most clear explanation I’ve had. Mine had already spread on diagnosis and immediate hormone injections with interesting but acceptable effects followed by 160 mg/day pills. Onward with the bucket list while still fit …….. considering all the current pressures, lots of praise for the way the NHS has handled all this.
I had a radical prostatectomy carried out by Adam Jones and his team at RBH in July 2020. I was then aged 63. Histology showed Gleason 3 + 4 prostate cancer with a small area of Gleason 5. I recovered quite well and was leak free by day 30 which I think was pretty good. This can be a major issue for many. After a biological reoccurrence with rising PSA I had salvage radiotherapy (33 sessions) January to March 2023. My PSA numbers are below - note the doubling time. On the ED front despite trying all the PED drugs nothing worked. But we live in hope! Undetectable - July 2023 0.033 April 2023 (after radiotherapy Jan-Mar) 0.686 30th December 2022 0.401 18th October 2022 0.173 8th September 2022 0.088 18th May 2022 0.044 10th November 2021 0.040 July 2021 0.035 10th March 2021 0.027 November 2020 0.084 August 2020 (5 weeks post surgery)
Hello, I am facing almost the same process, surgery in Jan 2021, went to 0, but now it climbed to 0.27 and I will go through radio therapy. Did you do Beam Proton Radio Therapy or Traditional Radio (photons) and what were your side effects after radio therapy? Thanks much, Good Luck and Congrats!
This was excellent consultation with all the options for treatment. I had 3+4 =7 with 75% of the prostate cancer . Had prostatectomy In January and doing ok . Staying dry from day one which was my worry so pleased with that and still having erection issues which may take some time but all in all glad I chose to have my prostate removed.
Thanks this was really helpful. I have Gleason 3+4 =7 No evidence of spread beyond prostate. Initially the support team were very reluctant to advise on the type of treatment so I chose Radiotherapy, as it is less invasive and asked to discuss with the Radiologist. However he said as I have two hip replacents fitted it was not the best choice as the metal in the replacement hips restricts access for the external beam and would cause higher dose radiation to the bowel and bladder with significant risk of damage and complications. Although replacement hips is actually fairly common with elderly patients this complication was not discussed with me by support team and not mentioned in the literature provided by Prostate Cancer Research, until I met the radiologist. My research suggested radiology by IMRT was poor with two replacent hips but a Radiation by VMAT procedure avoided complications caused by two hip replacements. My radiolgoist said this was not true and it was just a different method of delivery and was NOT better for two replacement hips. I am now confused as he is the expert Radiologist contradicting a research paper! The consequence is I am now opting for robotic surgery, IF the surgeon agrees I am suitable. I first raised the possibility of prostate cancer with my GP in June 2023 and he initially tried to put me off by suggesting I was over reacting to the Media raising awareness of Prostate cancer. I had to insist on a PSA test. It is now late Nov 2023 so the time from symptoms to treatment is protracted.
I wonder why they did not talk about ablation therapy, especially with 3+4. This is why men need to educate themselves. Institutions, wonderful institutions, have a standard of care and may not advice beyond that.
Thank you for the video it’s very informative and helpful, It’s still a minefield of witch treatment to go for and very daunting to think of the side effects and the possibility it could come back, it would be interesting to see what you think about cryotherapy as that’s what I’m thinking about having, once again thank you for all the information
A useful discussion, thanks. I am 3+4 T2 N+0 M+0 and am at the stage of deciding what to do. RT is out as they won't do it due to scoring 18 on IPSS and RT will make urinary issues worse, surgery sounds scary. I'm leaning towards Active Surveillance for the time being. It might be worth clarifying the Hormone part of the HT/RT regime, as I understand it you're not actually getting hormones, you're supressing testosterone production which brings it own set of side effects before you even start on the RT side effects! These can continue long after the RT is finished.
Hi - I was 3+3 and under active surveillance which then tipped into 3+4. Went for surgery (robotic laparoscopy) which I didn't find anywhere near as bad as the fear I held about it beforehand. Surgery just over 3 months ago and probably 90% recovered now. All good so far and PSA at 6 weeks and 3 months both
Have you had a genomic test done? This is a good biomarker for how aggressive the cancer may be. Also, the BRCA 1/2 is another good why to check the box that it is not a DNA problem (I think I said that right). Also, did they inform you from your biopsy how much cancer there was in each sample. I also have 3+4 with less than 10% within the sample; low Dicipher test; negative on the BRCA; nothing on the digital exam. There is also ablation therapy if something needs to be done.
@@MM-sf3rl how were you able to get the genomic decipher and BRACA tests done. Was this initially offered? There's cryo, nanoknife and hifu that might be suitable
@@JaniceCharters The BRCA was done through my hospital. They send me an envelope; I spit in the tube; results were sent to me via email; a consultation was done through a genetic advisor. This guy was not a doctor. More just explain BRCA 1/2. For the Decipher Test, I asked the doctor who did the biopsy to send samples of the biopsy to Decipher. I also got the bill, which was $4,000. I called them and they said because the insurance would not cover the claim, they dropped the price to $300. What a relief. I asked the gal at Decipher about the next test for my 1 year active surveillance follow up, and she said it will be $300 again. Hope this helps.
@@JaniceCharters I also wanted to mention that there are many tests and depending on cells, kind of cancer found, etc., one test many be more effective than the other. I know I’m not explaining that very well, but I hope you get the idea.
What they missed on the discussion was erectile problems after beam radiation. It is the reverse of prostatectomy. After 6 months mine went to nothing and viagra isn't really helping so far.
No mention of holep which removes the core of the prostate with a laser beam. I had this before my hormone/radiotherapy treatment. (PSA was 6 with a 3 plus 4). Had18 months of hormone with 3 months to go. PSA is "below minimum Detectable Level".
Excellent discussion and touched on all the considerations of 3+4=7 Gleason Group 2. I had this diagnosis and was directed to IMRT radiation in 28 treatments. No Hormone. Radiology/Oncologist said I was highly favorable and the treatment was curative. On the 7th of 28 treatments and then 6 month interval PSA testing.
All the considerations? Again where are they for 3+4=7 (which I have) I have read plenty of other options elsewhere, but this is not the only two available.. Cheers
Don't know the definitive answer to that but I had quite a few more than that ,hope everything goes well in the future I had radical prostectamy and Psa has been 0.07 for 4 1/2 year's
Thanks very much. I get my biopsy results in three days' time. If I need further treatment, my age, 74, and my Atrial Fibrillation will influence decision-making. My fingers are crossed!
An excellent video - but the elephant in the room was somehow missed. You talk about side effects for surgery and radiation, but not for hormone therapy. This is a pity since some of them are both physically and psychologically important and may have a considerable effect on the dynamics of the couple. From the point of view of the oncologist its understandable that they focus more on curing the cancer than on preparing the man for the ways his life may change after the treatment. Understandable, but I feel it's selling the guy a pig in a poke. Or to switch metaphors, when offering advice to a complete novice in chess, telling them that taking the queen is a really good thing to do, without warning them to foresee how that capture might degrade their future prospects, does not help the novice to understand how to play the game.
Развлечения
This is asuperb video for anyone facing this decision. I was 49 at diagnosis and treatment. PSA7.1 Gleason 7 (3+4) T3A
I took the radical prostatectomy route . I saw it as the fastest way to a cure and was also advised due to my young age this is a more favourable option.
I lost half my nerves as a result and sadly still suffer with ED 18 months on. I was incontinent but after 3-4 months I regained most of it and as of typing this I am now a good 95% with just some minor mishaps here and there.
Make the decision that’s right for you and consider all options.
Life will go on afterwards so keep that at the front of all your thoughts.
I thought this consultant in this video was fantastic and wish he had been mine.
Hope this comment helps the reader.
Had result of biopsy this morning 3+4=7. Found this video just the tonic this evening. I’m a very fit healthy 58 year old. Think I’m going to ask for Active Surveillance as I’m looking to alternative therapies. Thank you 👍🏽
Excellent summary, wish i had heard it b4 my prostatectomy, it would have provided clearer expectations
Coming from a urological surgeon, this is a surprisingly balanced explanation. Very well done, Sir! He refers to alternative treatment options such as radiotherapy (brachytherapy and external beam) and the complications associated with surgery (incontinence and impotence). I wish all urologists were this objective.
3+4=7, Age 66 w/ PSA rising....4-6, then hitting 7 over 2 years. Was thinking surgery but after reading Robert Marckini's book; "You Can Beat Prostate Cancer" (2nd Edition), I will be going in for Proton Beam Radiation this winter. Survival rate is the same as both surgery and standard radiation; but with less side effects. Best of luck to all~~~
My boyfriend has prostrate cancer. He’s in the intermediate stage 3+4 = 7. I’m so scared.
Hi is Proton Beam Radiation covered by Medicare insurance? Which location did you choose? Do you have an overall cost.?
It is covered 80% by Medicare. Then our secondary insurance covers the remaining 20%. Contact your own insurance company to ask. The book that I highly recommended above has a chapter on "Insurance" and why the Insurance companies are fighting it. We chose the UF Health Proton Therapy Institute in Jacksonville, FL They are excellent. @@MikeSanz-qw5cq
@@lindamastropietro4429 Prayers for you both.
Gleason 9. Thanks - this the best and most clear explanation I’ve had. Mine had already spread on diagnosis and immediate hormone injections with interesting but acceptable effects followed by 160 mg/day pills. Onward with the bucket list while still fit …….. considering all the current pressures, lots of praise for the way the NHS has handled all this.
Look at the site how to starve cancer naturally i have prostate cancer its an imvakuable site to use in conjunction wirh your yreatment plan
That is most informative and helpful, thank you. No reference to natural therapies?
I had a radical prostatectomy carried out by Adam Jones and his team at RBH in July 2020. I was then aged 63. Histology showed Gleason 3 + 4 prostate cancer with a small area of Gleason 5.
I recovered quite well and was leak free by day 30 which I think was pretty good. This can be a major issue for many.
After a biological reoccurrence with rising PSA I had salvage radiotherapy (33 sessions) January to March 2023. My PSA numbers are below - note the doubling time.
On the ED front despite trying all the PED drugs nothing worked. But we live in hope!
Undetectable - July 2023
0.033 April 2023 (after radiotherapy Jan-Mar)
0.686 30th December 2022
0.401 18th October 2022
0.173 8th September 2022
0.088 18th May 2022
0.044 10th November 2021
0.040 July 2021
0.035 10th March 2021
0.027 November 2020
0.084 August 2020 (5 weeks post surgery)
Hello, I am facing almost the same process, surgery in Jan 2021, went to 0, but now it climbed to 0.27 and I will go through radio therapy. Did you do Beam Proton Radio Therapy or Traditional Radio (photons) and what were your side effects after radio therapy? Thanks much, Good Luck and Congrats!
Excellent, clear explaination.
This was excellent consultation with all the options for treatment. I had 3+4 =7 with 75% of the prostate cancer . Had prostatectomy In January and doing ok . Staying dry from day one which was my worry so pleased with that and still having erection issues which may take some time but all in all glad I chose to have my prostate removed.
All options for treatment? What about Proton beam, Hifu, Tulsa pro etc? Anyone? Thnx
You have an update, 8mos later?
Thanks this was really helpful. I have Gleason 3+4 =7 No evidence of spread beyond prostate. Initially the support team were very reluctant to advise on the type of treatment so I chose Radiotherapy, as it is less invasive and asked to discuss with the Radiologist. However he said as I have two hip replacents fitted it was not the best choice as the metal in the replacement hips restricts access for the external beam and would cause higher dose radiation to the bowel and bladder with significant risk of damage and complications. Although replacement hips is actually fairly common with elderly patients this complication was not discussed with me by support team and not mentioned in the literature provided by Prostate Cancer Research, until I met the radiologist. My research suggested radiology by IMRT was poor with two replacent hips but a Radiation by VMAT procedure avoided complications caused by two hip replacements. My radiolgoist said this was not true and it was just a different method of delivery and was NOT better for two replacement hips. I am now confused as he is the expert Radiologist contradicting a research paper! The consequence is I am now opting for robotic surgery, IF the surgeon agrees I am suitable. I first raised the possibility of prostate cancer with my GP in June 2023 and he initially tried to put me off by suggesting I was over reacting to the Media raising awareness of Prostate cancer. I had to insist on a PSA test. It is now late Nov 2023 so the time from symptoms to treatment is protracted.
I hope everything goes well for you.
I wonder why they did not talk about ablation therapy, especially with 3+4. This is why men need to educate themselves. Institutions, wonderful institutions, have a standard of care and may not advice beyond that.
Useful imformation but he totally did not discuss SBRT “cyberknife” radio therapy
Thank you for the video it’s very informative and helpful, It’s still a minefield of witch treatment to go for and very daunting to think of the side effects and the possibility it could come back, it would be interesting to see what you think about cryotherapy as that’s what I’m thinking about having, once again thank you for all the information
A useful discussion, thanks. I am 3+4 T2 N+0 M+0 and am at the stage of deciding what to do.
RT is out as they won't do it due to scoring 18 on IPSS and RT will make urinary issues worse, surgery sounds scary. I'm leaning towards Active Surveillance for the time being.
It might be worth clarifying the Hormone part of the HT/RT regime, as I understand it you're not actually getting hormones, you're supressing testosterone production which brings it own set of side effects before you even start on the RT side effects! These can continue long after the RT is finished.
Hi - I was 3+3 and under active surveillance which then tipped into 3+4. Went for surgery (robotic laparoscopy) which I didn't find anywhere near as bad as the fear I held about it beforehand. Surgery just over 3 months ago and probably 90% recovered now. All good so far and PSA at 6 weeks and 3 months both
Have you had a genomic test done? This is a good biomarker for how aggressive the cancer may be. Also, the BRCA 1/2 is another good why to check the box that it is not a DNA problem (I think I said that right). Also, did they inform you from your biopsy how much cancer there was in each sample. I also have 3+4 with less than 10% within the sample; low Dicipher test; negative on the BRCA; nothing on the digital exam. There is also ablation therapy if something needs to be done.
@@MM-sf3rl how were you able to get the genomic decipher and BRACA tests done. Was this initially offered? There's cryo, nanoknife and hifu that might be suitable
@@JaniceCharters The BRCA was done through my hospital. They send me an envelope; I spit in the tube; results were sent to me via email; a consultation was done through a genetic advisor. This guy was not a doctor. More just explain BRCA 1/2. For the Decipher Test, I asked the doctor who did the biopsy to send samples of the biopsy to Decipher. I also got the bill, which was $4,000. I called them and they said because the insurance would not cover the claim, they dropped the price to $300. What a relief. I asked the gal at Decipher about the next test for my 1 year active surveillance follow up, and she said it will be $300 again. Hope this helps.
@@JaniceCharters I also wanted to mention that there are many tests and depending on cells, kind of cancer found, etc., one test many be more effective than the other. I know I’m not explaining that very well, but I hope you get the idea.
What they missed on the discussion was erectile problems after beam radiation. It is the reverse of prostatectomy. After 6 months mine went to nothing and viagra isn't really helping so far.
No mention of holep which removes the core of the prostate with a laser beam. I had this before my hormone/radiotherapy treatment. (PSA was 6 with a 3 plus 4). Had18 months of hormone with 3 months to go. PSA is "below minimum Detectable Level".
To my knowledge HoLEP is used to remove tissue causing restrictions in BPH rather than prostate cancer
Excellent discussion and touched on all the considerations of 3+4=7 Gleason Group 2. I had this diagnosis and was directed to IMRT radiation in 28 treatments. No Hormone. Radiology/Oncologist said I was highly favorable and the treatment was curative. On the 7th of 28 treatments and then 6 month interval PSA testing.
All the considerations? Again where are they for 3+4=7 (which I have) I have read plenty of other options elsewhere, but this is not the only two available.. Cheers
superb explanation
Gleason was 3+4
Group two
PSA 7 and rising
Nodule felt
Decided on DaVinci.......
How'd it turn out?
I had 24 samples taken at a recent Prostate Biopsy. Is 24 an excessive number of samples to take?
Don't know the definitive answer to that but I had quite a few more than that ,hope everything goes well in the future I had radical prostectamy and Psa has been 0.07 for 4 1/2 year's
Thanks very much. I get my biopsy results in three days' time. If I need further treatment, my age, 74, and my Atrial Fibrillation will influence decision-making. My fingers are crossed!
Hi I had my biopsy a month ago and had 39 cores taken (9 positive) PSA 18 Gleason 8 (4+4)
Can anyone confirm what this gentlemen decided to do?x
I suspect it was another member of staff ‘acting’ 👍🏽
Gleason 3+4. AS for at least 6 monts.
An excellent video - but the elephant in the room was somehow missed. You talk about side effects for surgery and radiation, but not for hormone therapy. This is a pity since some of them are both physically and psychologically important and may have a considerable effect on the dynamics of the couple. From the point of view of the oncologist its understandable that they focus more on curing the cancer than on preparing the man for the ways his life may change after the treatment. Understandable, but I feel it's selling the guy a pig in a poke. Or to switch metaphors, when offering advice to a complete novice in chess, telling them that taking the queen is a really good thing to do, without warning them to foresee how that capture might degrade their future prospects, does not help the novice to understand how to play the game.
I have infiction after seeds brachytherapy
What is infliction from your therapy? Hope you are doing better
Can you elaborate please. Also did it lower your PSA?x
Probably a spell check of infection?
90% scores are bound to make profits for uroligists..............