If you have questions about prostate cancer and need help from our Helpline team, you can email us here: help@pcri.org

Diagnosed with prostate cancer a year ago. Had a prostatectomy… and a follow up of 37 radiation treatments, because the surgeon did not get all the cancer out, where the Prostate was, and in 2 lymph nodes. Switched doctors and found a oncologist radiologist for the prostate only, to figure out successful treatments. Radiation sessions were very good. My doctor placed gold markers in me to absolutely pin point radiation. Kept the bladder full and the bowels empty. PSA is now undetectable. Just 18 months of hormone treatment. Some side effects from hormone deprivation. Still have E.D…. Otherwise on track to getting better.

@PackFan-tv5pj

2 жыл бұрын

Would you possibly share your Dr's info? I have a similar situation and would like to see if same treatment may apply. Thanks in advance.

@kevinvitale8980

2 жыл бұрын

@@PackFan-tv5pj He is Brian Christopher Baumann @ BJC (Barnes Jewish Center) Radiation Oncologist in St. Louis Wishing you success.

@PackFan-tv5pj

2 жыл бұрын

@@kevinvitale8980 Thanks!

@duaneluchsinger5736

2 жыл бұрын

I’m dealing with a nearly identical situation: advanced late stage 3, early stage 4, Gleason score 9 PC. Had a prostatectomy, followed by 38 radiation treatments along with hormone therapy. On hormone therapy for 18 months, PSA became non detectable for a couple years, but now has been on the rise for the last 6 months. I’m back on hormone therapy but with my oncologist retiring, I’m having to figure out where to go from here. PSA numbers are minuscule but I would like to get off the Eligard.

@kevinvitale8980

2 жыл бұрын

@@duaneluchsinger5736 good luck to you. I sought out specialist with prostate oncology… and who was up to date with latest science and technology. My ‘network’ group of oncologist were only ‘standard of care’ and that was not good enough for me. I too will have to start my search again for an equally good prostate oncologist, once we move to Florida later this year. I should be done in 12 months with good results. BUT, if like you it goes back up, I want a good doctor watching over me.

“To tell you the truth, you wouldn’t want to do surgery in any circumstances”. Grateful for Dr Scholz’ courage to be transparent and honest with your good recommendations. PCRI guided me from surgery to second opinions and ultimately radioactive seeds which has worked well. Thank you.

@kennytraylor6798

2 жыл бұрын

Grateful when and where did you do the seeds ? What was your Gleason score and what was your PSA ? Thanks for your input

@Rixdog01

2 жыл бұрын

The comment you quote applies to salvage treatment, not initial treatment.

@normanhowes7245

2 жыл бұрын

@@kennytraylor6798 Kenny check out Johns Hopkins in Baltimore Md. They do Brachytherapy all the time. I had a PSA of 11.5 and 3+4=7 Gleeson score and I had the Brachytherapy with Dr Song @ Johns Hopkins and highly recommend.

@kennytraylor6798

2 жыл бұрын

@@normanhowes7245 thanks Norman. It could do the seeds or Proton therapy. 99% sure I am going with 5 sessions of Protons SBPT. Monday, Wednesday,Friday then Monday, Wednesday. At Emory Proton Center Atlanta. Do you live near Hopkins ?

@kennytraylor6798

2 жыл бұрын

@@normanhowes7245 when did you have the seeds done. What is your PSA now ?

Of course, the average patient has no way to have access to the best surgeons in the world. They'll be lucky to get the best surgeons in their local area.

The big question is : How do I know if the clinic or hospital I visit has the " Modern " Radiation Therapy ? If I ask them, they will expectedly say Yes. They're not going to say we have old radiation technologies.

Great video, only thing my urologist told me about radiotherapy was secondary cancers can possibly develop 20 years down the line! Can dr scholz please address this issue some time! Many thanks again for the great info!

I have an appointment tomorrow. Previously I did hear the comment that do surgery first from my doctor.

Thank you for the information which is always so relevant and helpful.

I just had my prostate removed robotically 2 weeks ago and am recovering very nicely. My surgeon discussed the radiation option with me, but I elected to have the surgery due to the fact that if the radiation was unsuccessful, surgery would no longer be possible. Hopefully the surgery is all that I'll need, but if not, radiation will still be an option. It's the hormone therapy that really scares me. I'm 72 and have been very active all my life with sports, weight training, and cycling. Losing all my muscle mass and endurance would be the equivalent of a death sentence for me. Sad, but true. Keeping my fingers crossed. Great videos! Thanks.

@tumalo710

Жыл бұрын

How’s your recovery gone so far? I had my Prostatectomy in May. Around the same as you I’m guessing. I’m now having to have Salvage radiation because my PSA has doubled from 0.01 to 0.04 so my RO. Recommends the early the better. I just had a PMSA scan and no cancer detected. But most likely microscopic cancer left in the prostate bed. Hopefully the radiation will be my last hurdle. Hope your doing well. Ps. Took 6 months to get continence.

@sokuntheasor

Жыл бұрын

@@tumalo710 how was your margin after surgery?

Thanks for sharing your knowledge in this area

I can positively say at 67 with 40 sessions of proton radiation I did not know and feel as if I ever had radiation, for me its truely miraculous. My PSA went from 14 to 1.14 in 6-months. Still early though.

Excellent

Informative video, as usual. I wish, however, Dr. Scholz spoke a bit more about salvage radiation after prostatectomy with recurrent prostate cancer. Are the potential short- and long-term side effects from radiation different in that situation, and do they occur at a more frequent rate and are they more significant? Dr. Scholz frequently mentions "center[s] of excellence" in his videos, and it would be helpful to know what qualifies a treatment facility to be considered a center of excellence. Sure, there's the biggies like Johns Hopkins, Mayo, et al., but not everyone has access to those facilities. It would be helpful to know what to look for when "shopping" for something more accessible (either because of our health insurance or because of geography).

@imxploring

2 жыл бұрын

Excellent point... the issue becomes RT to the prostate bed on a local reoccurrence. Side effects do occur... some immediate... some occur years out!

I had barely finished 5 Cyberknife treatments when I started having urinary constriction. Finally had to go to the ER one night and have a Foley catheter put in because of urinary retention. My urologist's nurse taught me how to self-catheterize with disposable one-time-use catheters, so that was a lot better than a Foley. My urologist thought my problem was due to inflammation from the radiation and had me do a short course of prednisone, which helped greatly, but sometimes I still need to use a catheter.

You frequently speak about carefully choosing an excellent person to do radiation etc. What are the parameters the patient needs to look at to select s competive practictioner?

I’m surprised that he didn’t mention that even successful radiation can cause erectile dysfunction, frequent urination, and bladder control issues. These things are covered in another PCRI video.

What is your opinion on additional focal radiation treatments to treat detectable PSA after the failure of IMRT/IGRT salvage radiation treatment 10 years ago? Does this greatly increase the risk of secondary cancers?

I’ve watched many of your videos (which are great!)and in a number of the you refer to finding a good radiologist… Can you do a video on how to search out and select a good radiologist… I feel like I’m just limited to the local hospital and the doctors there…

@ThePCRI

2 жыл бұрын

It is hard to know for sure, but the best bet is to look for hospitals that see a high-volume of prostate cancer patients and that have a good reputation for cancer care. Academic institutions commonly fall into this description. They institutions most likely to have radiologists who have a lot experience and regular practice reading prostate MRIs. That is not to say that there are not well-qualified radiologists in community hospitals, but it is harder to know for sure. It might be possible to call the radiology departments and to ask about their experience with reading prostate MRI and whether they've been trained to use the PI-RADS (www.acr.org/Clinical-Resources/Reporting-and-Data-Systems/PI-RADS/Primer-for-Prostate-MRI) system, for example. We have a helpline with a patient advocate who may be able to provide you with more information. You can find our contact information at pcri.org/helpline. Here is a list of NCI-designated centers: www.cancer.gov/research/infrastructure/cancer-centers/find And here is US news's list of best cancer hospitals in the United States: health.usnews.com/best-hospitals/rankings/cancer

@ThePCRI

2 жыл бұрын

We also have this video on the topic: kzread.info/dash/bejne/k3WEyrabiNbXl7g.html

My PSA has risen from .1 to .2 in the last six months, 3yrs post robotic prostatectomy. A PSMA PET was performed and showed no indication of cancer. The doctor suggests salvage radiation as a preventative procedure. Is this the standard procedure in this situation? Thank you in advance for your comments.

Just how tightly can the radiation treatment be confined?

Really helpful video! Love the frankness in saying that surgery is not typically the optimal choice today. I’m in the process of choosing a treatment plan - with favorable intermediate stage prostate cancer. Cyber knife (Sbrt) and Brachytherapy are by far my leading options right now.

@kennytraylor6798

2 жыл бұрын

Michael we are in the same boat. I have a Gleason 3+4 but less then 5% is 4. Trying to decide what to do for a treatment. Been on AS for a little over a year now. PSA is 6.4

@michaelfavole5692

2 жыл бұрын

@@kennytraylor6798 My psa is currently 3.6 - it peaked out at 4.1 around a year ago. I switched to a vegetarian diet, gave up beer, and made a number of other lifestyle changes and that seemed to have helped all my numbers including psa. The labs after biopsy ranked it a T1c, grade 2, 4 cores were 3+4 and 2 were 3+3. The 4's were also a low percent, so yes we sound similar. I'm hoping to decide on a definitive treatment by year end and move forward with the plan hopefully in January.

@kennytraylor6798

2 жыл бұрын

@@michaelfavole5692 yeah Michael I’m just waiting on my decipher report to come back which should be the end of this year early January. Then that’s going to help me make a decision as well I’m gonna definitely do something in 2020 probably earlier than later. Wishing you happy holidays and hope everything works out good for you on your prostate cancer venture keep in touch my friend

@michaelfavole5692

2 жыл бұрын

@@kennytraylor6798 Happy Holidays to you as well and good luck with making your decision. We will all get through this. Keep in touch.

@kennytraylor6798

2 жыл бұрын

@@michaelfavole5692 amen 🙏 my friend. How old are you ? I am 60.

what are your thoughts about proton Beam therapy promising less danger to normal tissue

Urethral stricture - could it not be corrected with a stent?

I'm on Orgovyx for the last three month and almost at the half way point of my 45 radiation treatments. My regular doctor just prescribed Xarelto for my A-fib that I've just began taking during radiation my question is am I in danger taking a blood thinner during radiation??

Thanks for the vid! I noticed no mention of SpaceOar which Dr. Scholz has mentioned in the past for helping avoid rectal damage. Please correct my assumption that SpaceOar is still a prudent precaution to use despite the improved radiation targeting technology. Thanks again.

@ransomcoates546

2 жыл бұрын

I think by now SpaceOar is taken for granted. It was for me before the radiation starts.

@richardkremmen7811

2 жыл бұрын

@@ransomcoates546 Sorry to say a friend of mine here in Hawaii was about to undergo IMRT and I told him about SpaceOar. His doc was surprised when he asked her for it. She had to research to find out where it's available. Fortunately he can get it in a town across the island.

@randypeterman6924

2 жыл бұрын

@@ransomcoates546 I'm receiving EBRT in the Johns Hopkins system, and I didn't get SpaceOAR. My radiation therapist explained that's because I'm getting EBRT followed by brachytherapy; that generally everyone receiving ONLY EBRT gets SpaceOAR because they're getting a higher dosage of radiation that could affect the rectum, while generally no one receiving EBRT + seeds gets SpaceOAR, because the risk of damage to the rectum from the lower dose of EBRT is minimal while the SpaceOAR can complicate the implantation of the seeds.

@familymanof6169

2 жыл бұрын

I'm here researching which way I want to go with my prostate cancer. My gleason score is at 7 so I have the option of surgery or radiation. Although young the radiation doctor was very thorough in informing me about the risk and options of radiation therapy. One of the first things that he recommended was SpaceOar. I'm 65.

I it a good idea to get the triple therapy? Hormone therapy, external radiation and brachytherapy?

You cant keep radiation off the urethra. Prostate size and tumor locationmay play a role in select patients. Strictures happen but often it manifests a few years later

Several years ago, proton radiation was considered no better, but much more expensive, than standard radiation therapy. Have updated studies and experience shown any difference in efficacy and side effect occurrence between these two modes of treatment?

I had RT for colorectal cancer in 2010. Mri last week shows a single lesion in my prostate. Biopsy scheduled 7/13/23. Since Radiation is now so precise would i possibly be able to have any form of RT for Pc? Or wll surgery be my only option?

@arunib

11 ай бұрын

Which stage colorectal ca? Was it cured with radio therapy alone?

@thomaslehmann5981

11 ай бұрын

@arunib CRC was stage 3. Cured by chemo, radiation and surgery. Radiation Oncologist has offered prostate brachytherapy but no beam radiation of any type. My cancer is a single lesion but it is gleason 4+4. So the ideal treatment would be SBRT+brachytherapy. Surgeon is saying due to the prior radiation it would not be possible to do prostatectomy without leaving me totally incontinent. This sucks

74 years old with 3+3 and 3+4 both at less than 5%. PSA at 62 then 71 and now 82. Would active survalence be appropriate?

@ThePCRI

2 жыл бұрын

Hello, our free helpline is available during weekdays to talk with you about your case. You can find our contact information at pcri.org/helpline.

@kamalsh6123

Жыл бұрын

Hi! I happen to be in the same boat. Out of 12 cores, 6 are BPH, Out of remaining 6, 5 are 3+3 and one is 3+4 with 5% of the 4 variety. PSA fluctuates between 30 and 40 due to bacterial prostatitis. What did you finally do? May help me in deciding what to do.

Secondary cancers (10-20 years) later caused by excess radiation is a concern for younger (40’s, 50’s and 60’s) guys with Prostate Cancer. It does seem that this younger cohort opts more for radical prostatectomy and one suspects this concern for secondary cancers explains this. Perhaps this could be the subject of a future video.

I have lower back pain stiffness in hips and pelvis sometimes in my legs plus I see 2 urologist and my regular physician been getting a psa for 3 years now are those signs of cancer??

@richardkremmen7811

2 жыл бұрын

I'll intercede here a little now. Dr. Scholz has said in the past that symptoms that accompany PCa induced bone cancer are typically accompanied by a gigantic PSA. PCa is dx'd via imaging and biopsy and those tests are usually ordered if the PSA (in the absence of prostatitis) is high.

@andrewgynn4502

2 жыл бұрын

I had alot of back pain in my lower back i had a psa20.58 stage 3tb prostate cancer had my prostate out i now have no back pain at all.

@richardkremmen7811

2 жыл бұрын

@@andrewgynn4502 Thanks for the info. Best to you!

kzread.info/dash/bejne/iXiqzZKYhs3QdtI.html "most people that have modern radiationb will be cured by the radiation; they won't need a backup plan" But what about the the risk of radiation necrosis (radionecrosis) with that approach?

I saw a urologist and he slammed his hand on the table and said the cure rates are the same. But my urologist said surgery is the gold standard and only did trans rectal biopsy. So I switched doctors. Seeding sounds like maybe the best. Just wonder if the worry at bladder and rectal problems are still there. Worry about the urinary track thing. But that can be damaged in surgery to since they have to cut it and then reattach. Wearing a catheter for 2 weeks is no picnic. Very painful. Problem with Seeding is there no money in it . So hard to find a good Doctor. And guys who cares about ED when we're talking about saving you life. The damn thing barely works on older men 65 plus anyway.

@familymanof6169

2 жыл бұрын

I must disagree, I'm 65 and that thing works like it did in my 20's! I'm worried. But like you said if comes down to my life or that thing. Take it and my wife, just give me more life!

@MJ-hg1mk

Жыл бұрын

Had mine cut out July 2020. I wish I'd gotten radiation. Cancer gone but the ED & incontinence looks like forever. (I don't want a pump. Did a month on catheter post op. Never doing that voluntarily again.) Since then, everything I've read & heard as well as observed in other guys as well as personally experienced - says radiation if u r a candidate for it. I regret my choice. The docs were NO help in the decision making process. & I didn't know the right questions to ask, which is essential to squeeze what u need out of them.

Encouraging insight bout radiation efficacy & safety mascott hunter proves tolerance d max but breeds sniffing urine voc in PC detection would've been great mascott candidates wid such higher sensitivity & efficacy of 99 r c 98 %

Dr. Scholz must take a lot of heat from the cutters in his profession. And there are still a large number of them.