PCRI is providing very important and NEEDED information. It is imperative for men to be educated and not fall victim to the medical system. I have learned firsthand that we must be our own advocate and NOT depend on what the medical system default “standard” of care involves.
hai perfettamente ragione. Dopo prostatectomia radicale il mio psa sta correndo ma dopo 3 pet psma gallio 68 con psa 0,24- 0.54 - 1,14 non viene fuori ancora nulla. Penserò ad eventuale terapia soltanto quando una pet psma evidenzierà qualcosa.
I must say that your podcasts over the last 3 to 6 Months have been excellent. Before that I thought you were speaking in generalities about the minuses of prostate cancer treatment. In short it's like the side effects of treatment were being swept under the rug. You are now hitting these issues head on. Big props to you!
I was diagnosed in 2018 - Gleason 9 … I was terrified and told by the urologist that my life expectancy was around 3 to maybe 5 years. I had a radical prostatectomy in July, 2018. By the end of the year my PSA had returned to 0.2 again. I was very disappointed and worried. I live in Canada, but went to California for an axiom PET scan and they could only see a very faint uptake in the prostate bed. They suggested laser ablation of that spot, which I did. Back in Canada I was put on hormone therapy as well. After a year or so, my PSA again rose to 0.2 and, in a few months got up to just over 1.0 - I was sent to Montreal for a Gallium PET Scan. Again, it showed a small uptake in the prostate bed. I did 5 weeks of low dose radiation and my PSA again went to undetectable for a year or so. Then, it started to rise again - got to 1.5 … back to Montreal for another PSMA - one small lesion was found on my hip bone - luckily my radiation oncologist is a progressive thinker. I had 2 doses of high dose radiation and once again my PSA went down to undetectable. A few months ago, it started to rise again. I went to Edmonton for a PSMA scan and they found a small spot on my right femur. The areas of disease previously found in my prostate bed and hip bone had not returned. I again had high dose radiation in December and my PSA is on its way down again. I’m at a loss as to why it keeps coming back, and am also worried about a recurrence that is more than just one small, localized spot. It seems to pop up and say hello every couple of years. (btw, I have been on lupron injections and enzalutamide during this time). Am I unlucky enough to be in the small percentage that will never be cured? Will the roller coaster ever end? I guess if I just have to monitor and get treated every couple years I can live with that. I know my oncologist had to fight with the cancer board to be allowed to treat me this way. Usually in Canada if you get bone mets it’s just hormone therapy, maybe chemo and palliative radiation to bones. That is definitely NOT what I want. Do you have any comments with regards to my situation? I am 64 now and feel fine and am otherwise healthy - how concerned should I be?
Hi, I'm an electrical and mechanical kind of guy, but have been doing some reading. Your post struck a note with my thinking, so I'll share my thoughts below. The root cause of "biochemical recurrence" is metabolic, which is the same reason for the cancer to occur in the first place. (Aside from the "insults" to cell mitochondria from carcinogens in our diets and the environment, electro-magnetic exposure, hypoxia, etc) But instead of addressing the metabolic roots of cancer, the SOC (standard of care) clips the dead leaves off the tree, so to speak, without making the tree healthy "from the roots" first. So "of course" there will be a biochemical recurrence. Read Dr Thomas Seyfried's book- "Cancer as a Metabolic Disease". The first thing that should be done with any early stage cancer patient is to put them on a tailored Keto diet. This reduces serum glucose, which removes one of the two energy sources for cancer cells (any type of cancer cell, anywhere in the body) The second and final source of energy for cancer cells is glutamine, which can be reduced through fasting. Even intermittent fasting helps reduce glutamine. Also, glutamine reducing drugs such as "DON" may used, when it becomes available. Reducing glucose and glutamine removes the fuel source for cancer cells to produce ATP thru fermentation, and the cancer cells become weakened. (Normal cells with healthy mitochondria are like "flex fuel" vehicles, making energy thru oxidative phosflorylation. They can use glucose and even make ATP with the ketones from burning fat, but cancer cells cannot, because of their damaged or mutated mitochondria) After the cancer cells are weakened thru this targeted "starvation", relatively small doses of SBRT or chemo may be used to further damage the cancer cells, without toxifying the patient. This is done gradually, to avoid dumping an abundance of dead cancer cells into the body, giving time for them to be eliminated naturally. The patient actually becomes stronger on the Keto diet. Contrast this with the emaciated patient receiving chemo, with their hair falling out and constant sickness. Then the hospital kitchen brings them a meal high in carbohydrates and sugar! Exactly the fuel that cancer thrives on! WHAT'S WRONG WITH THIS PICTURE? Reduce carbs to about 50 grams max a day, and reduce sugar to 5 grams max a day! Eat healthy fats like salmon, avocados, cruciferous veggies like cabbage and broccoli, real food! Stay away from processed foods. Doing this will weaken any type of cancer cell, slow, stop, and possibly reverse tumor growth. Then if further action is needed, radiotherapy or chemo can be used in a "one, two punch" to eradicate or manage a tumor. Dr Thomas Seyfried calls this the "Press/Pulse" method of cancer therapy. If the metabolic origins of cancer growth are not addressed, the proverbial "can has only been kicked down the road", and of course there will be a "biochemical recurrence", because absolutely zero has been done to address the metabolic environment of the body. Instead, after failing with radical prostectomy, the SOC moves to chemical castration, and after failing with that, the cancer has metasticized, and the SOC falls on its face again and then the patient dies. The SOC fumbles around with chemo, operations, etc, chasing cancer like they're herding cats. To ignore the metabolic origins of cancer is unscientific and obtuse, and harmful to patients that need help.
I am extremely new to this. I am 3+4 Gleason score. 61 years old. Coming up to 15 years no alcohol. I am very happy for this forum. Thank you for your story. I wish you the best.
That is so intense and we are so sorry you have gone through this. 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 was diagnosed gleason 10 in 2022 , on all cores , now in remission , i dd the tritherapy approach , chemo plus two hormone therapies , and a bit of radiotherapy , it had spread to the spine , hip and lympth nodes , all gone now -) thanks for hte videos , i was so well informed thanks to you guys
I Was Just Treated For Glaeson 6,7,8 In Three Of 12 Cores ,9 Of The Cores Had No Cancer.All Was Still In Prostate ,PSA 4.5 I Under Went EBT Radiation Seed Implant .No ADT Hormone Therapy .I Refused That .Now 9 Months After Iam Now With My PSA Down To 0.6 And Feeling Great.
These are by far the most well thought out and well expressed discussions about prostate cancer anywhere on the internet. The doctor is very knowledgeable, honest and careful in his wording but also doesn't protect doctors who were overtreating. In addition, the young lady that does the questioning is not only very intelligent and asks very intelligent questions, but the love that she expresses through her every question comes through clearly. It reminds me of the old phrase nobody cares How much you know until they know how much you care. It's clear that she cares.
DX Sept 2021 Gleason 10, urologist, who is a friend, said " it doesn't get any worse than this " he said " i don't want to do surgery as i would be lying if i said i could get it all" recommended radiation. PSMA showed camcer still only in prostate. Did the research, found PCRI amd watched evey video. Radiologist thought microscopic amounts would likely have got to lymph nodes but were not showing on scan and suggested doing wholw pelvic area. Completed 39 fractions 78Gy. Zoladex ADT. Today two years later im PSA undetectable and feeling great. Radiologist thinks we may have got the bugger. Thank you PCRI for your time and videos, they made the difference, they gave me hope.
You did not have any surgery, just radiation and ADT. I was just diagnosed, 10 of 18 cores positive 1 3+3, 8 3+4, and 1 4+5. Bone scan, CT scan and PSMA CT PET all negative for spread. Most of the cancer is in the right lobe. Urologist presented 2 options surgery, radiation or radiation, and 2 to 3 years ADT. Seemed negative about the second option thought surgery was best, but because it is mostly on the right said ED 60 to 70% and incontinence 5 to 10. I currently have an appointment with another doc to see if I would be candidate for single port RP What were your side effects. Thinking I may be heading in the wrong direction.
Hi Ron, being G10 and highly aggressivei was advised to have the whole pelvic area zapped. PSMA is not perfect, it can detect cancer down to about 2mm, radiologist was very keen to zap pelvic area to make sure he caught any microscopic cells that may have escaped and were not showing on scan. He said you have one good shot at this do it all and do it hard.@ronwise4380
@@DaleJohnston-i6z Just read it thanks for getting back. Have decided to go radiation route rather than surgery. Looking for a good place to go near me
My psa went 7.2 to 12 to 27.1 over 3 months. The MRI was bad and they told me radiation was needed right away. Nothing ever said about what type of cancer it was, how fast it grew, or what options I had except surgery wasn't an option
So pleased to have found this U tube channel and wealth of information and comfort. My husband is 69 and disabled with MS(30 years). His PSA was 4.3(2023), 5.4(8/2024) and 7.0(11/2024). I read that having sex right before can cause higher PSA? As well as having a colonoscopy?(10/2024)Anyone know if that is true? So his urologist is scheduling his MRI soon and we may have a biopsy? Of course hubby’s first thought is surgery if they find something😳😩. But after watching these videos and reading online, we don’t feel so frightened. Thank you for these videos and all the great comments and encouragement from other patients❤️
78 year old. 2 MRI past 5 years Pirad 1-2, Decipher.51, negative PSMA, Gleason 4-3 in 2 cores 5% & 15%, 2 cores 3-3, 8 cores benign. Seriously considering no treatment due to age.
Four months ago I thought I was healthy, 1-12-24, we diagnosed with G9, and a biopsy bone scan showed Met. in five areas. Was just apposed for a PSMA scan. I'm hoping for the best. So glad I found this channel. Thank you for all the info.
Good Luck John. Keep spirits up. Husband G score 9 - two tumours in the prostate and it had got out to surrounding tissue. Had robotic surgery (oldest patient this surgeon had operated on). Recovered quickly. Bladder good. PSA not as expected post op. Doubled twice fairly rapidly. Went on to do 36 radiations to pelvic floor (shot of hormone to help radiation but no hormone since). PSMA scan following radiation - no detectible cancer. Last two PSA tests since - 0.008 and >0.008.
My husband was diagnosed Gleason 9 in 2021, with mets to some abdominal lymph nodes. With 26 rounds of radiation and ADT (hormone) therapy, he's been in remission for almost 3 years, with his PSA remaining
100 % my brother got downgraded from 3+4 to 3+3 on second opinion . His urologist was pushing for surgery. Thank god we got a second. I can't wait for PSMA to be insured for primary diagnosis and staging. Once again, an excellent segment.
Thank you for all your videos! What i have found is you can ask 100 doctor's and oncologist/radiation specialists the same question and get 100 different answers. That's a problem! I watched a lot of people in my life die of cancer. My position is, if you have cancer, get it treated now, then later. And yes, I am currently being treated for prostate cancer at 65 years.
Another excellent video. Gleason 6 myself, been on Active Surveillance for years. Recently had a PET scan only to see if anything has been been missed, as my PSA level is still significantly elevated after TURP surgery last July which seems unusual; reassured by my urologist today that there was nothing to be concerned about from the scan.
My PSA levels gradually went up over two or three years. 5.56 but came down to 4.3 last blood work. I've been seeing a PA who works for an aging urologist and he advocated for me to get an MRI with contrast. I will get the results tomorrow from that scan. I've had several weeks to watch videos on the subject of prostate cancer since then. If the scan has found lesions, there's a good chance im heading for a biopsy. At my age (72), I'm still able to have sex and ejaculate. If something is found and is still in the prostate capsule, I'm leaning towards active surveillance, if its not an aggressive type of cancer. I know I'm putting the cart before the horse. Wish me luck. Prayers are appreciated. P.S. One of your best videos yet.
I'm going tomorrow for an MRI.... My PSA was 5.1......... I'm going to do the same thing you are..... I've talked to too many guys who had it removed and the problems they are having now are worse. Quality of life is important. I've also read articles of studies done.. one took 10 guys.....5 were treated with removal or radiation, hormone treatments.. long story short the 5 treated and the 5 not treated both groups lived another 10 years...... Pray for me, I'll pray for you....
@@edwright4745 I'm praying for you. I got my MRI results and I have an 8mm lesion in the left anterior portion of the prostate. As far as they can tell, they don't see anything else in the prostate, lymphnodes or pelvic area. I found a report of an old full body CT scan I had done 15 years ago because of an auto accident. It showed a "calcification" of the prostate. It wasn't mentioned by the physician at the time, so I thought nothing of it and filed it away. I'm beginning to wonder exactly what they're seeing on the MRI. Haven't scheduled the biopsy yet. I'm trying to remain hopeful.
@@akashsuryavanshi8257 I had the biopsy. 14 samples were taken, including two from the lesion. Although the prostate has three types of disease, no çancer was found. But it does not answer the question of why my PSA levels are intermittently high. Some inflammation was found which could possibly be the answer to that issue. I am to be retested in six months. Side note on the biopsy, although having the biopsy was not very painful, I did bleed a little afterwards. Especially when ejaculating. Almost a month. I'm very thankful for the results.
You guys have helped me tremendously in my prostate cancer journey , im in south africa and there is very little you are told here about the disease , my treatment for my gleason 9 prostate cancer was well under way when i came across you guys and through what i found out from your articles im pretty happy to say that my Urologist and oncologist basically gave me the treatment that was 100% bang on with what you people recommended , thanks again for an insightful and easy to understand series on this disease
Great discussion, so timely for me. I’m 71 living in Cambridge, England. Thank you Dr Scholz for helping me understand my prostate cancer. After rising PSA over the past 18 months I had a mpMRI in January 2024 with a biopsy last month (March) Results show two areas of cancer contained within the prostate both 3+4=7 Dr Scholz you have helped me to understand what choices I have prior to meeting my consultant next week. I can now prioritise the next steps knowing I have time to make those choices. Although I have had a heart attack back in 2021 Royal Papworth fitted 3 stents and I am back to full fitness. I would not want anything to affect our plans to celebrate our 50th Anniversary this June. And as I have no symptoms or effects I will request active surveillance for the rest of this year. Thank you one again! John
Thankyou for both of your. It calm me down right away. 2019 my Gleason score was 9. I got radiation and 2 years hormone therapy. Now my total psa less than 0.05 undetectable. Your information is valuable for me and others for sure.
@@ajayzarekar270 In 2021, my husband was diagnosed with Gleason 9, PSA 24, mets to the lymph nodes. He initially received 26 rounds of radiation, and has been on ADT therapy since then, which includes Lupron injections every 3 months and daily Abiraterone (Zytiga) + prednisone. His PSA dropped to
What this woman said in the first two minutes is 100% true. I had prostate CA with a PSA of 15 and a Gleason of 4 + 3. I did not know what any of that meant. No one sat down with me and explained very much. I like my urologist/surgeon but he was always in a hurray. I went on the internet which is filled with experts who have different opinions. I had a radical prostatectomy and here I am 21 years later. A lot has changed since them and I have tried to console men who are recently diagnosed. Unfortunately, most do want to talk about it. Treatments have changed but the counseling that men need is still not there. It can be lonely, scary road to travel on as with any cancer diagnosis.
So glad to have found these videos with some sanity about the situation. As forewarned, my urologist immediately suggested after the biopsy that I have radical treatment as intermediate favorable (3+4) "usually metastasizes" according to him and would be a danger to me if not attacked right away. The amount of "4" in my 3+4 cores was very small and only in a very few cores. Did the Prolaris genomics test and it says my genes in the biopsy samples are pretty good at not generating aggressive cancer. The various nomagram web sites that I entered my data into also helped give me a saner perspective of what I'm facing. Radical treatments (RP or EBRT) will have only a very minimal life saving benefit vs. AS (only 3% less mortality danger in 10 years when I'm 80!) and the side effects risks of radical treatments are at least at the moderate levels. Plus, buying time for better treatments in the future sounds logical to me when I observe what's coming down the pike. Once you take the radical treatments you can't undo the damage they inflect on you. They are called "radical" for a very good reason. I cannot emphasize enough, talk to additional doctors, get second opinions (even with your biopsy readings), etc. Prostate cancer is unique. Walk into this situation with your eyes wide open in terms of the risks vs. the benefits. Don't assume that your doctor has fully analyzed the situation you are facing. It's up to you to get up to speed on your situation and the risks vs benefits your are facing. Don't ignore the real risks but also don't blow them out of proportion. Thank goodness that getting fully informed is much easier these days. All those hundreds of thousands of men back in 2005-2014 who had their prostates suddenly removed for the minor situation of Gleason 3+3.... just wow! Take that lesson to heart.
I am facing almost an identical situation. Awaiting uros opinion. Thank God, for these sites. I could not agree with you more of the importance of learning as much as you can about your condition and being your own, well informed, as you so elouquently defined it, advocate.
Hello and thank you. I just had my targeted biopsy two days ago. I am currently waiting on my pathology report. Your information is invaluable to me and many others.
@ericb547 I had my biopsy about a month ago that revealed Gleason 4+4. I have a bone scan, pelvic MRI and PSMA PET scan in the coming weeks. I spoke to a couple of friends that had it. One went the surgery route, the other did radiation treatments. It was good to get their insights.
@@brockjennings The PET scan is the best. My Gleason score is 4+4 with limited bone metastases. I've just finished ten radiation treatments on a rib, and next week I start twenty radiation treatments for prostate. I hope yours has a great outcome.
My urologist who was also a surgeon told me that I had prostate cancer, a lesion about 10mm and Gleason 4/3 with a lot of 4 and they they would not operate because of my age (76} and the prostate was large but that I was an ideal candidate for radiation treatment along with hormone therapy which they suggested that I start straight away and asked if I wanted to proceed. Of course they also told me about all the side effects as well and the choice was down to me. I asked what if I did nothing and the reply was “that is a very interesting question”. I delayed my answer for a couple of months during which I was given another scan to see if the cancer had spread, which it had not. It was localised on one side of the prostate….on telling me this, I decided to have radiation treatment…that was 10 months ago and I have had the intensive treatment over 7 sessions and also all the side effects I was warned about. BUT now I come through it , I am back to almost 100% normal health and so relieved, I had eventually agreed to getting treated. But I know it could have been a different outcome. It is a gamble whatever one decides .
These shows are phenomenal. They deal with the toughest questions- what to do in the grey areas. I also appreciate that Dr Scholz doesn’t hem and haw. He notes the risks and uncertainties of given situations but gives his bottom line opinion. Sure, everyone’s situation is different, but what good are mountains of information and disparate treatment options without an experienced, objective guiding hand to direct one to the right result?
Yeah , my doctor knew of Dr. Scholz and said “stop doing research”. I should have told him, if it wasn’t for him, I would not have gotten a PSMA-Pyl PET/CT.
Everyone needs to be their own patient advocate!! I spent days researching prostate ca and treatment for my husband. My husband was diagnosed with prostate cancer even with a normal PSA. Why? HIs PSA results from 6 months before that one was 2 points lower, and that is a big red flag for cancer if your PSA results changes by 2 points in 6 months. We know of someone who said he waited to late, and was diagnosed with prostate ca years ago .First thing he had was a radical proctectomy. Off course the cancer was not gone, and it spread. He had salvage radiation and chemo., was told by his doctor-(not sure if it was an oncologist), that he has cancer somewhere in his body. I asked him what was the results of his PSMA Pet scan. He said they never did that exam. OMG why?? He said he is now on lifetime hormone treatment to remove his testosterone. I told him, he needs to strongly insist on this exam. How can you treat metastases if you don't know where it is in the body? Definitely the PSMA pet scan should be done, along with other exams to confirm the correct staging of prostate ca, especially if a MRI prostate shows highlighted regions, and a high risk Gleason score is found. Always get a second opinion on the biopsy, which may change the Gleason score, and get a decipher test done as well. Extended PSA and testosterone tests. With all of this information a more informed decision can be made as to the different options to treat prostate cancer. Yes, his urologist he's had for years, wanted to jump into surgery. You have to take a step back and understand all of your options, get recommendations, and try to seek out the best oncologist. My husband now has a treatment plan, two oncologist from two different states has coordinated his plan. It does not include surgery. Thanks to God alone, my husbands is more into checking things out medically, and staying on top of routine exams and testing. I think he was told a 90-93% cure rate, and with yearly surveillance that he will not likely die from prostate cancer.
Sounds like its time to find a new Dr. My experience is many Dr's don't like to be questioned. They seem to know it all. Not every Dr. but enough to be frustrated.
I was diagnosed with Gleason 3+3 in 2019 and was put on active monitoring. Last year my PSA went up to 6 (from around 4 in 2019) and an MRI was conducted in June, which showed the cancer was well contained in the prostate. Subsequently a biopsy was done in January this year and the result was 4+3. As a result I went to see a radiation oncologist for proton treatment and he ordered pet scan and decipher score for me before we do anything. The result came back with big surprises. They showed that the cancer had metastasized to a lymph node with a size of nearly 2 cm, and the decipher score is 0.97 out of a max of 1. So it seemed like the cancer is extremely aggressive and spread to lymph node between July last year and January this year, on contrary to the understanding of slow growing nature of prostate cancer. I am starting to think in my case it might be better to treat earlier when it is still 3+3 before it got so aggressive. I don’t have a treatment plan worked out yet. I am wondering if a chemo maybe required. Anyone has experience with nymph node metastasis and had beef cured? Thank you.
Were you getting yearly MRI's between 2019 and 2023? I am 3+3 and on AS. I get my PSA checked every 6 months (it goes up and down) get yearly MRI's. They will repeat the biopsy when the 4T MRI indicates any changes (or my PSA spikes significantly) PSA naturally goes up with age and fluctuates so it's part of the puzzle but a small one once PC is confirmed. MRI's and biopsy's are the gold standard to indicate changes.
That’s the biggest fear of active surveillance -the Katy bar the door problem if you wait. I would like Dr Scholz to address that because what you experienced seems really problematic.
Thank you both so very much for this forum! This IS a new world to me and I have created a lead sheet just from the first half of this segment. this is providing me with HOPE. I am very grateful for your guidance. I am 61 with a gleason report of 3+4 and a 5.7 PSA. Will be going to UCSF here in San Francisco Referred by General Hospital. Thanks again.
Thanks to you both. Just diagnosed last week with 3+4. meeting with my Urologist in two days. So glad I found your channell. It's been lonely and stressful.
Im 51, psa level 4, Recently diagnosed with gleason 6. The kicker is that it was found in 10 out of 13 cores. The urologist is recommending prostatectomy
These videos are super helpful, and reassuring. Well done. One question: Dr Scholz, at about 15:15, says "if a tumor is not unduly large..." What would be considered unduly large, please?
Just diagnosed at Gleason6, I already new about Surveillance and Waiting so am very comfortable to do this and have been offered 4/6 months Testing Greatly impressed byDr Scholz great input looking forward to waiting the next 10 years or so. Feel lucky I am this stage at 80. Hope to contribute soon Mike M
My Dr. told me I had cancer, you need surgery I can get you in next week. He didn't offer any other treatment options. I brought up radiation, he talked that down. He gave me a folder telling me what to expect, didn't tell me anything. I didn't see your channel until it was too late. I enjoy watching your channel. Just to find out all information in case I see anyone else with prostate cancer. Thanks for you channel.
I have a tendency to pepper doctors with lots of questions. You have to be your own advocate. If a Dr. doesn't answer questions or seems irritated, the it may be time to move on.
Wow. He just wanted to cut and chop. Malpractice, in my opinion, of a most egregious kind. Not classic "malpractice," mind you, but of a more insidious variety. . .
I was diagnosed with prostate cancer in July 2023.A Gleason score on left prostate of 3+4 and on right side prostate of 3+3.I underwent treatment with a great Radiologist in NYC named Dr. Michael Zelefsky. He recommended SBRT. After nearly 4 months no impotence and no incontinence. PSA dropped from a 5 to 0. Just a little irritation when urinating. Follow up soon with MRI.Other than that feel great.
I'm 69.I wanted active surveilance,but the Dr. recommended treatment.Surgery or Radiation.I opted radiation.But I selected a very good Radiation Oncologist,from NY Memorial Sloan Kettering.If you skip treatment chances are it's going to metastize.Get regular checks for early detection of other cancers that may occur.But it's important to treat it.
The timing of me seeing this excellent presentation couldnt be more perfect. Just yesterday, my consultation with my Doctor informed me, my biopsy results are 3+3=6. One core out of 12 showed cancer and was extremely small. He said no treatment necessary and will monitor PSA. I am generally comfortable with that but is checking PSA alone, enough? Should another MRI or biopsy be considered in the future, however distant? He did say, if something occurs in future, hormone treatment might be considered. Watching this gave me confidence in my doctor in any event. Thank you for your efforts.
He is really good and i am recommending him to other people with Prostrate Cancer. I was diagnoised with Non Metasized cancer with one core having a Gleason score of 8 and 2 others with 7. I just had Hormone therapy and Fìducary markers Implanted. will be treated in 2025 with targeted radiaton.
The better question is, what are the chances the cancer will spread if you get a prostatectomy. That's what I did. The doctor told me I ought to get my prostate removed (Gleason 9) so I wouldn't have to worry about it in the future. The pathologist said the margins were clear, meaning the cancer hadn't escaped the prostate though it was 40 cancerous when removed. Four years later, I have prostate cancer in my lungs. So I believe the surgery caused the cancer to spread. I'm pissed!
I live in the Uk so healthcare is free at point of use but as you say there is still a system which can complicate matters as was suggested. Interestingly I had a Gleason 4+3= 7 pre treatment score and decided to go for surgery based on my own specific care needs. The results of surgery were good, no cancer spotted after 6 months, no leakeges but erectile issues which I’m fine with as I’m 75 and single. However, my post Gleason score was 3+4=7 which a previous video suggested would be an observation situation.
in 2016 my gleason was 3+4 and 4+3 I don't know the percentages, my PSA was 48 I was age 50. I recently talked to someone whos father is 81 with a psa 5 and gleason 10. I didn't realize that gleason 10 was so rare. I was glad to hear what you said about it not being the kiss of death. Thanks for another information packed video.
@@JasonRoberts556 It was suggested I be aggressive and I took the offered start ADT for a month, 45 radiation treatments, wait a month 6 docetaxel, continue with ADT for 3 years. I didn't work. PSA was trying to double after it was done. Axumin scan showed cancer at the end of the radiation treatment field, in 2021 I did 25 more radiation treatments with ADT for 2 years. I stopped ADT early because long covid had sucked the life out of me. I got my testosterone back in November. It looks like my psa is going to level out at 0.33.
@@JasonRoberts556 I stopped everything. I did not have an Axumin scan in 2016 I did have other standard scans of the day. The Axumin scan was new in 2016 I believe and Idaho doctors are not known as leading edge which is why I went to Anschutz in Denver a Center of Excellence.
It is also important to know what type of prostate cancer you have. I was diagnosed with Ductal Prostate Cancer, PSA 4.7 and G=4+4. My cancer spread to the pelvic area (Stage 4A)at the time they found it. Went all in. Surgery, radiation and a mixture of Lupron and Zytiga. I have been NED since 2018.
We did A PSMA pet scan on Feb 15 and it show more then 6 metastases in the bones and the lymph nodes around the prostates and the neck area and with Gleason 4+4. He is 63 years old. 1st time diagnosis with PC. We have consulted with 2 urologists and 3 Oncologist in the past 3 weeks. I Urologists and 2 Oncologist advocate Hormonal therapy plus Chemotherapy. The rest advocate only Hormonal therapy. Radiotherapy options has been ruled out by all the consulted doctors. Urologist has started the hormonal therapy with Casodex on Feb 17, and followed by Lucrin on Feb 29. The last visited Oncology took over the above treatment scheme but stopped Casodex and started on Erleada immediately. He will use Zoladex instead of the Lupron on the May 20th. Please advise is this the correct treatment and what is the survival rate? Should we consider the Chemo too? And does Chemotherapy enhance the survival rate? Is there other treatment options that will increase the survival rate? Thank you so much.
I can only explain what my husband is doing. Testing: biopsy Gleason of 4+3, decipher test, MRI prostate and PSMA pet, only showed highlights in the prostate. Treatment: 1 shot of hormone treatment, which lasts 6 months(Lupron), 2. and 1/2 months later... radiation seeds by one oncologist who does 500 or more of these procedures-most in the country. Then wait a few more weeks , then do radiation treatment once a day for 5 weeks. After all of this, he will be placed on active surveillance. His urologists' wanted to jump to proctectomy. After urologist recommendation for a oncologist, he has two oncologist in 2 different states. The one shot hormone treatment is first because it remove testosterone which feeds the cancer. It knocks it the cancer down, like sticking it in a freezer, should slow/stop growth. Then treatment with radiation seeds in the area of the cancer-highlighted by the MRI prostate, along with a ultrasound of the prostate. After the radiation seeds starts wearing off, then start with the localized radiation treatment-5 min a day for 5 weeks. He was given 90-93% cure rate. My husband is lucky, both oncologist coordinated his treatment, everything was discussed in detail, before he started. Being 65 he wanted to make sure the first battle with cancer was the strongest. Every cancer case is different, I hope you both get the answers you seek and get the best treatment for the cancer.
I have learned from the videos presented by PCR. I do not only question my urologist, but also my oncologist about the variety of treatments, and how I should proceed. I am 81 years old and still sexually active with a Gleason score of 4+4 = 8, and the decipher score of .62. Because of my age and the fact that the cancer is a 4+4 it was critical to pick the right therapy. I have acted out for an SBRT radiation regimen of only the prostate utilizing true beam for 26 treatments with no hormone therapy to maintain my quality of life after treatment. Thanks to PCRI I have been able to fashion the treatment that is acceptable to me and my future. I appreciate the videos and Dr. Schollz Various videos by other medical experts, presented by PCRI!
Diagnosed G6 5+ years ago on active surveillance since. Last random/targeted biopsy came back G9. Not sure what is going on. Having PSMA PET scan soon. Bad luck or what? 8:13
I can't quit commenting on this video it's everything I discover pretty much on my own confirm by someone I really respect and yet on most of the prostate cancer forum boards people just rushed to get surgery. They can't even explain why other than the statement I want it out. I've been very fortunate every doctor I've talk to said you could watch it even though I'm at 3+4 and I do have 40% but it's a very small lesion my radiation oncologist and I discussed a hypothetical, pretending I said what if I was against any form of medical care, religious reasons or what not what would my particular cancer look like in your best guess he said probably 6 to 7 years it would metastasize, and then we could treat another for five years probably it shows you why so many men rush in the surgery is not potentially wise choice, considering ED and incontinence in a mental health associated with those things
Decisions. 4+3 Gleason...3 positive cores of Gleason 4...Cancer completely Contained after PSMA Pet Scan...Urologist insisted on Radical Surgery (I'm 65). I got a second opinion from Radiation Oncologist And they said Perfect for SBRT Therapy...No one has told me about Life Long Side Effects???? All we need in Full Information from Specialists! Love your Podcasts.. Thanks from Australia.
My fiance has just found out that he is PSA 7.34. (no symptoms, regular VA annual check ) hes 56, has history of kidney stones, and is being referred to a urologist. I'm really frightened for him.... the love of my life. I wish I could do something to help him 😢😢😢
Sounds like he already has amazing support! Learning about the next steps and how to take them together is key. Feel free to reach out to our helpline if you have any questions you need answered
Why is diet not talked about more as a way to lower psa and use food to help heal the body. My husband is on ADT and the side effects can be really bad. I was shocked at how quickly he lost muscle mass. Through research I have changed his diet drastically and believe it plays a super large roll in any disease including prostate cancer.
Grateful for Dr Sholz and for this fine young lady host they are really educating me to the point people are being referred for me for advise on prostate cancer and i am a chiropractor
These videos r so helpful! I felt i had some understanding when we met with the Dr. i am re watching, because now i have more questions b4 we proceed with Surgery. Thank you !!
I know Dr. Scholz is not a fan of surgery such as radical prostectomy and carefully justifies this with the statistics of cure rates and side effects. But there are several newer "surgical" treaments which don't involve removing the entire prostate. I'm thinking here of such procedures as Holmium Laser Enucleation of the Prostate (HoLEP). I have had this treatment in the UK, which was "sold" to me on the basis of the fact that by simply removing (most of) the internal tissue of the prostate and leaving the enclosing capsule intact, the nerves and blood vessels associated with erection etc. are spared. I just wondered if Dr. Scholz had any comments specifically about the HoLEP procedure especially with regard to his valid concerns over radical prostectomy? In my own case I was Gleason 3 plus 4, had Deca-Pentyl Androgen Deprivation Therapy (18 months) before and after Radio Therapy, (20 focussed cycles over 4 weeks 37 Gray total). I'm now 9 months after completion of treatment and my PSA has been steady at 0.02. I'm on a six monthly PSA monitoring regime (next one in three weeks time - fingers crossed!) and my likleyhood of cure was given to me at the start of treament as "upwards of 90%". Thank you for your outstanding presentations.
My husband age 75 has been diagnosed with Gleason score 7 (1 core of 12 was 4+3) we find that most Radiology docs we’ve interviewed say that ADT is mandatory for a good result. Knowing the side effects of the hormone blocking pills/injections for 5 or more months are drastic, we both are hesitant to agree to this approach. Can you address this?? Thank you for your website. It’s very helpful.
My father has recently been diagnosed with advanced bone metastases prostate cancer; he is in his 70s. The oncologist suggested surgical castration and then starting Abiraterone and later Docetexal as it had already spread to the backbones, sternum, pelvis, and ribs. My question is, how relevant is Gleason's score in his case? Secondly, what are the chances of cure and prognosis? Thank you in advance for providing valuable information.
Please Alex l have gleson 7 (3+4) with PSA 6.4 surgery is being suggested by my consultant should l go ahead l do not have any symptoms. I am in England
Hello David, please reach out to our helpline. They can help you sort out the details of your case and give you information on all your options: pcri.org/helpline
@@Dr.NedalAlchaar No. Psma looks at where the cancer is located and if there are methastasis. Biopsy on 12 points checks how aggressive the cancer is and how many types of cancer there are.
My biopsy showed a Gleason score or 3+4=7. I felt pretty good. Then a Genomics test was run and it showed a score of .92 with the highest being 1.0. This is very agressive. This number was in conflict with an intermediate Gleason score. I suggest that those with prostate cancer get a Genomics test. It's more good information to help make a better decision.
... Question: Are PSMA rsults "Definitive"? My PSMA showed re-current cancer in the prostate and a cavial lymph node. Yet... both were biopsied afterward and both were Benign?... My Urologist is confused and prescribed a course of anti-biotics and another PSA after to rule out Prostatitis. Your thoughts?
Thank you for the information. My husband has a mass seen on an MRI and a very high Psa level. He gets his biopsies done on Thursday. He's extremely scared, understandably and believes it's best to just get his prostate removed. He's only 53 year's old. All of this is informative, but it seems more confusing. I'm trying to help him make a decision, but now it seems regardless cancer is the outcome, eventually. I have been extremely positive during this. Now I have no idea what to suggest to him. 😢😢
I have a Gleason of 4+4=8. My Urologist says it’s best to just remove the Prostate. I already have an Oncologist which he said I definitely shouldn’t have my Prostate removed and just have radiation and hormone therapy. From what I’ve read, I’m way more worried about the hormone therapy than an operation. The list of severe side effects from the therapy is bad and long. I guess my question is would hormone therapy still be necessary after surgery? Totally not sure what direction to take here. Also, going for a PET scan next week, the surgeon says that results from PET scan doesn’t change his course 95%of the time.
Also an 8, here in Philly. Waiting for PET. Read an abundance of literature on and watched numerous vids like this about--TREATMENT. So many guys have the surgery and the cancer returns, necessitating radiation and ADT. ALL THESE "TREATMENTS" result in horrible, many times unfixable, after-effects. Not to mention SIDE-effects. The "Two I's," impotence and incontinence for surgery and radiation, and loss of penile length. The ADT causes rapid--RAPID!!--muscle wast
Also an 8, here in Philly. Waiting for PET. Read an abundance of literature on and watched numerous vids like this about--TREATMENT. So many guys have the surgery and the cancer returns, necessitating radiation and ADT. ALL THESE "TREATMENTS" result in horrible, many times unfixable, after-effects. Not to mention SIDE-effects. The "Two I's," impotence and incontinence for surgery and radiation, and loss of penile length. The ADT causes rapid--RAPID!!--muscle wast
Also an 8, here in Philly. Waiting for PET. Read an abundance of literature on and watched numerous vids like this about--TREATMENT. So many guys have the surgery and the cancer returns, necessitating radiation and ADT. ALL THESE "TREATMENTS" result in horrible, many times unfixable, after-effects. Not to mention SIDE-effects. The "Two I's," impotence and incontinence for surgery and radiation, and loss of penile length. The ADT causes rapid--RAPID!!--muscle wast
Also an 8, here in Philly. Waiting for PET. Read an abundance of literature on and watched numerous vids like this about--TREATMENT. So many guys have the surgery and the cancer returns, necessitating radiation and ADT. ALL THESE "TREATMENTS" result in horrible, many times unfixable, after-effects. Not to mention SIDE-effects. The "Two I's," impotence and incontinence for surgery and radiation, and loss of penile length. The ADT causes rapid--RAPID!!--muscle wast
Also an 8, here in Philly. Waiting for PET. Read an abundance of literature on and watched numerous vids like this about--TREATMENT. So many guys have the surgery and the cancer returns, necessitating radiation and ADT. ALL THESE "TREATMENTS" result in horrible, many times unfixable, after-effects. Not to mention SIDE-effects. The "Two I's," impotence and incontinence for surgery and radiation, and loss of penile length. The ADT causes rapid--RAPID!!--muscle wast
I'm 72 this year, been on active surveillance since 2008 , high psa reading then ,had several biopsies since and Mri scans , but nothing other than elevated psa between 12 and 14 now up from around 7 of 8 initially. Never heard of Gleason , only figures I've had are PSA,until this year after an MRI scan I was told I had a density figure of 0.24 , haven't a clue what that means maybe someone can shed some light on that , next appointment is May .
Not a doctor. I've read that the density measure has to do with PSA levels as they relate to prostate size and the size of the mass targeted. Generally, lower is better and 0.24 is fairly high. 0.16 is low.
@@1dariansdad So that means tge bigger the prostate the bigger the psa reading Latest reading is 9 but 14 last year, so seems my prostate is small compared to psa reading , I wonder how much of an indicator And thanks!
This was the video I really needed on a low mood day today! Thank you so much 👍🏽😁 Gleason 3+4=7 but using lifestyle, nutrition and off label metformin, mebendozole, atorvastatin and doxycycline and trying to avoid Hormone and radiation therapy which is all the NHS want to do!
I was gleason 6, (3+3). Four months later after surgery the pathology was T3 as it had grown to the prostate wall so yeah, no. The surgeon said that if I had waited 5 yrs, I'd be in real trouble. No one pushed surgery on me, I went to see a radiation oncologist and then an out of town surgeon and made my own decision.
How I wish I could have Dr.Scholz as my oncologist. The man is brilliant. Everything he says resonates and makes absolute sense.
We have them both here though!
PCRI is providing very important and NEEDED information.
It is imperative for men to be educated and not fall victim to the medical system.
I have learned firsthand that we must be our own advocate and NOT depend on what the medical system default “standard” of care involves.
hai perfettamente ragione. Dopo prostatectomia radicale il mio psa sta correndo ma dopo 3 pet psma gallio 68 con psa 0,24- 0.54 - 1,14 non viene fuori ancora nulla. Penserò ad eventuale terapia soltanto quando una pet psma evidenzierà qualcosa.
Absolutely correct.
You both are pure GOLD! Thanks for all you do.
I must say that your podcasts over the last 3 to 6 Months have been excellent. Before that I thought you were speaking in generalities about the minuses of prostate cancer treatment. In short it's like the side effects of treatment were being swept under the rug. You are now hitting these issues head on.
Big props to you!
I was diagnosed in 2018 - Gleason 9 … I was terrified and told by the urologist that my life expectancy was around 3 to maybe 5 years. I had a radical prostatectomy in July, 2018. By the end of the year my PSA had returned to 0.2 again. I was very disappointed and worried. I live in Canada, but went to California for an axiom PET scan and they could only see a very faint uptake in the prostate bed. They suggested laser ablation of that spot, which I did. Back in Canada I was put on hormone therapy as well. After a year or so, my PSA again rose to 0.2 and, in a few months got up to just over 1.0 - I was sent to Montreal for a Gallium PET Scan. Again, it showed a small uptake in the prostate bed. I did 5 weeks of low dose radiation and my PSA again went to undetectable for a year or so. Then, it started to rise again - got to 1.5 … back to Montreal for another PSMA - one small lesion was found on my hip bone - luckily my radiation oncologist is a progressive thinker. I had 2 doses of high dose radiation and once again my PSA went down to undetectable. A few months ago, it started to rise again. I went to Edmonton for a PSMA scan and they found a small spot on my right femur. The areas of disease previously found in my prostate bed and hip bone had not returned. I again had high dose radiation in December and my PSA is on its way down again.
I’m at a loss as to why it keeps coming back, and am also worried about a recurrence that is more than just one small, localized spot. It seems to pop up and say hello every couple of years. (btw, I have been on lupron injections and enzalutamide during this time).
Am I unlucky enough to be in the small percentage that will never be cured? Will the roller coaster ever end?
I guess if I just have to monitor and get treated every couple years I can live with that. I know my oncologist had to fight with the cancer board to be allowed to treat me this way. Usually in Canada if you get bone mets it’s just hormone therapy, maybe chemo and palliative radiation to bones. That is definitely NOT what I want.
Do you have any comments with regards to my situation?
I am 64 now and feel fine and am otherwise healthy - how concerned should I be?
Hi, I'm an electrical and mechanical kind of guy, but have been doing some reading. Your post struck a note with my thinking, so I'll share my thoughts below.
The root cause of "biochemical recurrence" is metabolic, which is the same reason for the cancer to occur in the first place. (Aside from the "insults" to cell mitochondria from carcinogens in our diets and the environment, electro-magnetic exposure, hypoxia, etc)
But instead of addressing the metabolic roots of cancer, the SOC (standard of care) clips the dead leaves off the tree, so to speak, without making the tree healthy "from the roots" first. So "of course" there will be a biochemical recurrence. Read Dr Thomas Seyfried's book- "Cancer as a Metabolic Disease".
The first thing that should be done with any early stage cancer patient is to put them on a tailored Keto diet. This reduces serum glucose, which removes one of the two energy sources for cancer cells (any type of cancer cell, anywhere in the body) The second and final source of energy for cancer cells is glutamine, which can be reduced through fasting. Even intermittent fasting helps reduce glutamine. Also, glutamine reducing drugs such as "DON" may used, when it becomes available.
Reducing glucose and glutamine removes the fuel source for cancer cells to produce ATP thru fermentation, and the cancer cells become weakened. (Normal cells with healthy mitochondria are like "flex fuel" vehicles, making energy thru oxidative phosflorylation. They can use glucose and even make ATP with the ketones from burning fat, but cancer cells cannot, because of their damaged or mutated mitochondria)
After the cancer cells are weakened thru this targeted "starvation", relatively small doses of SBRT or chemo may be used to further damage the cancer cells, without toxifying the patient. This is done gradually, to avoid dumping an abundance of dead cancer cells into the body, giving time for them to be eliminated naturally.
The patient actually becomes stronger on the Keto diet. Contrast this with the emaciated patient receiving chemo, with their hair falling out and constant sickness. Then the hospital kitchen brings them a meal high in carbohydrates and sugar! Exactly the fuel that cancer thrives on! WHAT'S WRONG WITH THIS PICTURE?
Reduce carbs to about 50 grams max a day, and reduce sugar to 5 grams max a day! Eat healthy fats like salmon, avocados, cruciferous veggies like cabbage and broccoli, real food! Stay away from processed foods. Doing this will weaken any type of cancer cell, slow, stop, and possibly reverse tumor growth. Then if further action is needed, radiotherapy or chemo can be used in a "one, two punch" to eradicate or manage a tumor.
Dr Thomas Seyfried calls this the "Press/Pulse" method of cancer therapy.
If the metabolic origins of cancer growth are not addressed, the proverbial "can has only been kicked down the road", and of course there will be a "biochemical recurrence", because absolutely zero has been done to address the metabolic environment of the body.
Instead, after failing with radical prostectomy, the SOC moves to chemical castration, and after failing with that, the cancer has metasticized, and the SOC falls on its face again and then the patient dies. The SOC fumbles around with chemo, operations, etc, chasing cancer like they're herding cats.
To ignore the metabolic origins of cancer is unscientific and obtuse, and harmful to patients that need help.
I am extremely new to this. I am 3+4 Gleason score. 61 years old. Coming up to 15 years no alcohol. I am very happy for this forum. Thank you for your story. I wish you the best.
That is so intense and we are so sorry you have gone through this. 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
@@ThePCRI It would be nice if you could though as the rest of us would like to educate ourselves.
@@F8Tributo Keto may work with other forms of cancer but seems to feed prostate cancer.
I think this is your best video yet it puts everything in perspective and shows that whatever grade you have there is definite hopeI
I was diagnosed gleason 10 in 2022 , on all cores , now in remission , i dd the tritherapy approach , chemo plus two hormone therapies , and a bit of radiotherapy , it had spread to the spine , hip and lympth nodes , all gone now -) thanks for hte videos , i was so well informed thanks to you guys
Stay positive and exercise, cut sugar, add turmeric to your foods, and consider taking fenbendazole for 6-months and you'll live to 95~
I Was Just Treated For Glaeson 6,7,8 In Three Of 12 Cores ,9 Of The Cores Had No Cancer.All Was Still In Prostate ,PSA 4.5 I Under Went EBT Radiation Seed Implant .No ADT Hormone Therapy .I Refused That .Now 9 Months After Iam Now With My PSA Down To 0.6 And Feeling Great.
These are by far the most well thought out and well expressed discussions about prostate cancer anywhere on the internet. The doctor is very knowledgeable, honest and careful in his wording but also doesn't protect doctors who were overtreating. In addition, the young lady that does the questioning is not only very intelligent and asks very intelligent questions, but the love that she expresses through her every question comes through clearly. It reminds me of the old phrase nobody cares How much you know until they know how much you care. It's clear that she cares.
DX Sept 2021 Gleason 10, urologist, who is a friend, said " it doesn't get any worse than this " he said " i don't want to do surgery as i would be lying if i said i could get it all" recommended radiation. PSMA showed camcer still only in prostate. Did the research, found PCRI amd watched evey video. Radiologist thought microscopic amounts would likely have got to lymph nodes but were not showing on scan and suggested doing wholw pelvic area. Completed 39 fractions 78Gy. Zoladex ADT. Today two years later im PSA undetectable and feeling great. Radiologist thinks we may have got the bugger. Thank you PCRI for your time and videos, they made the difference, they gave me hope.
You did not have any surgery, just radiation and ADT. I was just diagnosed, 10 of 18 cores positive 1 3+3, 8 3+4, and 1 4+5. Bone scan, CT scan and PSMA CT PET all negative for spread. Most of the cancer is in the right lobe. Urologist presented 2 options surgery, radiation or radiation, and 2 to 3 years ADT. Seemed negative about the second option thought surgery was best, but because it is mostly on the right said ED 60 to 70% and incontinence 5 to 10. I currently have an appointment with another doc to see if I would be candidate for single port RP What were your side effects. Thinking I may be heading in the wrong direction.
Hi Ron, being G10 and highly aggressivei was advised to have the whole pelvic area zapped. PSMA is not perfect, it can detect cancer down to about 2mm, radiologist was very keen to zap pelvic area to make sure he caught any microscopic cells that may have escaped and were not showing on scan. He said you have one good shot at this do it all and do it hard.@ronwise4380
@@ronwise4380 hi Ron did you get my reply, old fart here may have messed it up.
@@DaleJohnston-i6z Just read it thanks for getting back. Have decided to go radiation route rather than surgery. Looking for a good place to go near me
My psa went 7.2 to 12 to 27.1 over 3 months. The MRI was bad and they told me radiation was needed right away. Nothing ever said about what type of cancer it was, how fast it grew, or what options I had except surgery wasn't an option
So pleased to have found this U tube channel and wealth of information and comfort. My husband is 69 and disabled with MS(30 years). His PSA was 4.3(2023), 5.4(8/2024) and 7.0(11/2024). I read that having sex right before can cause higher PSA? As well as having a colonoscopy?(10/2024)Anyone know if that is true? So his urologist is scheduling his MRI soon and we may have a biopsy? Of course hubby’s first thought is surgery if they find something😳😩. But after watching these videos and reading online, we don’t feel so frightened.
Thank you for these videos and all the great comments and encouragement from other patients❤️
78 year old. 2 MRI past 5 years Pirad 1-2, Decipher.51, negative PSMA, Gleason 4-3 in 2 cores 5% & 15%, 2 cores 3-3, 8 cores benign. Seriously considering no treatment due to age.
Dr.Scholz and my urologist do reason exactly the same way. I really feel that I am taken seriously by this. Love the great conversation.
Four months ago I thought I was healthy, 1-12-24, we diagnosed with G9, and a biopsy bone scan showed Met. in five areas. Was just apposed for a PSMA scan. I'm hoping for the best. So glad I found this channel. Thank you for all the info.
Well wishes and positive thoughts sent…be well!
Good Luck John. Keep spirits up. Husband G score 9 - two tumours in the prostate and it had got out to surrounding tissue. Had robotic surgery (oldest patient this surgeon had operated on). Recovered quickly. Bladder good. PSA not as expected post op. Doubled twice fairly rapidly. Went on to do 36 radiations to pelvic floor (shot of hormone to help radiation but no hormone since). PSMA scan following radiation - no detectible cancer. Last two PSA tests since - 0.008 and >0.008.
My husband was diagnosed Gleason 9 in 2021, with mets to some abdominal lymph nodes. With 26 rounds of radiation and ADT (hormone) therapy, he's been in remission for almost 3 years, with his PSA remaining
100 % my brother got downgraded from 3+4 to 3+3 on second opinion . His urologist was pushing for surgery. Thank god we got a second. I can't wait for PSMA to be insured for primary diagnosis and staging. Once again, an excellent segment.
Does a second opinion entail another biopsy, or just someone else analyzing the original biopsy?
@@jpjp3873 Great question that I'd also like to know the answer to!
Thank you for all your videos! What i have found is you can ask 100 doctor's and oncologist/radiation specialists the same question and get 100 different answers. That's a problem! I watched a lot of people in my life die of cancer. My position is, if you have cancer, get it treated now, then later. And yes, I am currently being treated for prostate cancer at 65 years.
Another excellent video. Gleason 6 myself, been on Active Surveillance for years. Recently had a PET scan only to see if anything has been been missed, as my PSA level is still significantly elevated after TURP surgery last July which seems unusual; reassured by my urologist today that there was nothing to be concerned about from the scan.
My PSA levels gradually went up over two or three years. 5.56 but came down to 4.3 last blood work. I've been seeing a PA who works for an aging urologist and he advocated for me to get an MRI with contrast. I will get the results tomorrow from that scan. I've had several weeks to watch videos on the subject of prostate cancer since then. If the scan has found lesions, there's a good chance im heading for a biopsy. At my age (72), I'm still able to have sex and ejaculate. If something is found and is still in the prostate capsule, I'm leaning towards active surveillance, if its not an aggressive type of cancer. I know I'm putting the cart before the horse. Wish me luck. Prayers are appreciated. P.S. One of your best videos yet.
I'm going tomorrow for an MRI.... My PSA was 5.1......... I'm going to do the same thing you are..... I've talked to too many guys who had it removed and the problems they are having now are worse.
Quality of life is important.
I've also read articles of studies done.. one took 10 guys.....5 were treated with removal or radiation, hormone treatments.. long story short the 5 treated and the 5 not treated both groups lived another 10 years......
Pray for me, I'll pray for you....
This video is I think the best yet it puts everything in perspective and shows men there is definite hope whatever grade you have! Thanks
@@edwright4745 I'm praying for you. I got my MRI results and I have an 8mm lesion in the left anterior portion of the prostate. As far as they can tell, they don't see anything else in the prostate, lymphnodes or pelvic area. I found a report of an old full body CT scan I had done 15 years ago because of an auto accident. It showed a "calcification" of the prostate. It wasn't mentioned by the physician at the time, so I thought nothing of it and filed it away. I'm beginning to wonder exactly what they're seeing on the MRI. Haven't scheduled the biopsy yet. I'm trying to remain hopeful.
How are u now
@@akashsuryavanshi8257 I had the biopsy. 14 samples were taken, including two from the lesion. Although the prostate has three types of disease, no çancer was found. But it does not answer the question of why my PSA levels are intermittently high. Some inflammation was found which could possibly be the answer to that issue. I am to be retested in six months. Side note on the biopsy, although having the biopsy was not very painful, I did bleed a little afterwards. Especially when ejaculating. Almost a month. I'm very thankful for the results.
You guys have helped me tremendously in my prostate cancer journey , im in south africa and there is very little you are told here about the disease , my treatment for my gleason 9 prostate cancer was well under way when i came across you guys and through what i found out from your articles im pretty happy to say that my Urologist and oncologist basically gave me the treatment that was 100% bang on with what you people recommended , thanks again for an insightful and easy to understand series on this disease
Great discussion, so timely for me. I’m 71 living in Cambridge, England. Thank you Dr Scholz for helping me understand my prostate cancer. After rising PSA over the past 18 months I had a mpMRI in January 2024 with a biopsy last month (March) Results show two areas of cancer contained within the prostate both 3+4=7
Dr Scholz you have helped me to understand what choices I have prior to meeting my consultant next week. I can now prioritise the next steps knowing I have time to make those choices. Although I have had a heart attack back in 2021 Royal Papworth fitted 3 stents and I am back to full fitness.
I would not want anything to affect our plans to celebrate our 50th Anniversary this June. And as I have no symptoms or effects I will request active surveillance for the rest of this year.
Thank you one again!
John
Thankyou for both of your. It calm me down right away.
2019 my Gleason score was 9. I got radiation and 2 years hormone therapy. Now my total psa less than 0.05 undetectable.
Your information is valuable for me and others for sure.
in harmone therapy which tablet you used with in 2 years please help me
@@ajayzarekar270 In 2021, my husband was diagnosed with Gleason 9, PSA 24, mets to the lymph nodes. He initially received 26 rounds of radiation, and has been on ADT therapy since then, which includes Lupron injections every 3 months and daily Abiraterone (Zytiga) + prednisone. His PSA dropped to
What this woman said in the first two minutes is 100% true. I had prostate CA with a PSA of 15 and a Gleason of 4 + 3. I did not know what any of that meant. No one sat down with me and explained very much. I like my urologist/surgeon but he was always in a hurray. I went on the internet which is filled with experts who have different opinions. I had a radical prostatectomy and here I am 21 years later. A lot has changed since them and I have tried to console men who are recently diagnosed. Unfortunately, most do want to talk about it. Treatments have changed but the counseling that men need is still not there. It can be lonely, scary road to travel on as with any cancer diagnosis.
May God continue to bless this channel and bring hope to those who are experiencing this dilemma. God Bless
So glad to have found these videos with some sanity about the situation. As forewarned, my urologist immediately suggested after the biopsy that I have radical treatment as intermediate favorable (3+4) "usually metastasizes" according to him and would be a danger to me if not attacked right away. The amount of "4" in my 3+4 cores was very small and only in a very few cores.
Did the Prolaris genomics test and it says my genes in the biopsy samples are pretty good at not generating aggressive cancer. The various nomagram web sites that I entered my data into also helped give me a saner perspective of what I'm facing. Radical treatments (RP or EBRT) will have only a very minimal life saving benefit vs. AS (only 3% less mortality danger in 10 years when I'm 80!) and the side effects risks of radical treatments are at least at the moderate levels. Plus, buying time for better treatments in the future sounds logical to me when I observe what's coming down the pike. Once you take the radical treatments you can't undo the damage they inflect on you. They are called "radical" for a very good reason.
I cannot emphasize enough, talk to additional doctors, get second opinions (even with your biopsy readings), etc. Prostate cancer is unique. Walk into this situation with your eyes wide open in terms of the risks vs. the benefits. Don't assume that your doctor has fully analyzed the situation you are facing. It's up to you to get up to speed on your situation and the risks vs benefits your are facing. Don't ignore the real risks but also don't blow them out of proportion. Thank goodness that getting fully informed is much easier these days. All those hundreds of thousands of men back in 2005-2014 who had their prostates suddenly removed for the minor situation of Gleason 3+3.... just wow! Take that lesson to heart.
I am facing almost an identical situation. Awaiting uros opinion. Thank God, for these sites. I could not agree with you more of the importance of learning as much as you can about your condition and being your own, well informed, as you so elouquently defined it, advocate.
You Guys ARE THE BEST. The Knowledge I have Acquire from watching All These LIVE SAVING VIDEOS, IS PRICELESS. ✊🙏
this is your best video yet greetings from ireland
Hello and thank you. I just had my targeted biopsy two days ago. I am currently waiting on my pathology report. Your information is invaluable to me and many others.
@ericb547 I had my biopsy about a month ago that revealed Gleason 4+4. I have a bone scan, pelvic MRI and PSMA PET scan in the coming weeks. I spoke to a couple of friends that had it. One went the surgery route, the other did radiation treatments. It was good to get their insights.
I wish you the very best outcome.
best of luck
@@brockjennings The PET scan is the best. My Gleason score is 4+4 with limited bone metastases. I've just finished ten radiation treatments on a rib, and next week I start twenty radiation treatments for prostate. I hope yours has a great outcome.
@@mrbr549 Thanks for the information. Good to know their other 4+4 folks going through treatment. Best of luck to you as well 👍
You guys are really great! What a blessing 🙏
My urologist who was also a surgeon told me that I had prostate cancer, a lesion about 10mm and Gleason 4/3 with a lot of 4 and they they would not operate because of my age (76} and the prostate was large but that I was an ideal candidate for radiation treatment along with hormone therapy which they suggested that I start straight away and asked if I wanted to proceed.
Of course they also told me about all the side effects as well and the choice was down to me.
I asked what if I did nothing and the reply was “that is a very interesting question”.
I delayed my answer for a couple of months during which I was given another scan to see if the cancer had spread, which it had not.
It was localised on one side of the prostate….on telling me this, I decided to have radiation treatment…that was 10 months ago and I have had the intensive treatment over 7 sessions and also all the side effects I was warned about.
BUT now I come through it , I am back to almost 100% normal health and so relieved, I had eventually agreed to getting treated.
But I know it could have been a different outcome.
It is a gamble whatever one decides .
These shows are phenomenal.
They deal with the toughest questions- what to do in the grey areas.
I also appreciate that Dr Scholz doesn’t hem and haw. He notes the risks and uncertainties of given situations but gives his bottom line opinion. Sure, everyone’s situation is different, but what good are mountains of information and disparate treatment options without an experienced, objective guiding hand to direct one to the right result?
Yeah , my doctor knew of Dr. Scholz and said “stop doing research”. I should have told him, if it wasn’t for him, I would not have gotten a PSMA-Pyl PET/CT.
Everyone needs to be their own patient advocate!!
I spent days researching prostate ca and treatment for my husband. My husband was diagnosed with prostate cancer even with a normal PSA. Why? HIs PSA results from 6 months before that one was 2 points lower, and that is a big red flag for cancer if your PSA results changes by 2 points in 6 months.
We know of someone who said he waited to late, and was diagnosed with prostate ca years ago .First thing he had was a radical proctectomy. Off course the cancer was not gone, and it spread. He had salvage radiation and chemo., was told by his doctor-(not sure if it was an oncologist), that he has cancer somewhere in his body. I asked him what was the results of his PSMA Pet scan. He said they never did that exam. OMG why?? He said he is now on lifetime hormone treatment to remove his testosterone. I told him, he needs to strongly insist on this exam. How can you treat metastases if you don't know where it is in the body?
Definitely the PSMA pet scan should be done, along with other exams to confirm the correct staging of prostate ca, especially if a MRI prostate shows highlighted regions, and a high risk Gleason score is found. Always get a second opinion on the biopsy, which may change the Gleason score, and get a decipher test done as well. Extended PSA and testosterone tests. With all of this information a more informed decision can be made as to the different options to treat prostate cancer.
Yes, his urologist he's had for years, wanted to jump into surgery. You have to take a step back and understand all of your options, get recommendations, and try to seek out the best oncologist.
My husband now has a treatment plan, two oncologist from two different states has coordinated his plan. It does not include surgery. Thanks to God alone, my husbands is more into checking things out medically, and staying on top of routine exams and testing. I think he was told a 90-93% cure rate, and with yearly surveillance that he will not likely die from prostate cancer.
I am a doctor and I have never heard anything from Dr. Scholz that sounds crazy. Sounds like your doctor was insecure. Sorry you had that experience
You need to change Drs, that is absurd
Stop doing research??? What???!!! Crazy!
Sounds like its time to find a new Dr. My experience is many Dr's don't like to be questioned. They seem to know it all. Not every Dr. but enough to be frustrated.
This has been an excellent series of questions and answers with Dr. Scholz. Extremely helpful and appreciated.
Amazing amount of valuable information. Thanks
I was diagnosed with Gleason 3+3 in 2019 and was put on active monitoring. Last year my PSA went up to 6 (from around 4 in 2019) and an MRI was conducted in June, which showed the cancer was well contained in the prostate. Subsequently a biopsy was done in January this year and the result was 4+3. As a result I went to see a radiation oncologist for proton treatment and he ordered pet scan and decipher score for me before we do anything. The result came back with big surprises. They showed that the cancer had metastasized to a lymph node with a size of nearly 2 cm, and the decipher score is 0.97 out of a max of 1. So it seemed like the cancer is extremely aggressive and spread to lymph node between July last year and January this year, on contrary to the understanding of slow growing nature of prostate cancer. I am starting to think in my case it might be better to treat earlier when it is still 3+3 before it got so aggressive. I don’t have a treatment plan worked out yet. I am wondering if a chemo maybe required. Anyone has experience with nymph node metastasis and had beef cured? Thank you.
Were you getting yearly MRI's between 2019 and 2023? I am 3+3 and on AS. I get my PSA checked every 6 months (it goes up and down) get yearly MRI's. They will repeat the biopsy when the 4T MRI indicates any changes (or my PSA spikes significantly) PSA naturally goes up with age and fluctuates so it's part of the puzzle but a small one once PC is confirmed. MRI's and biopsy's are the gold standard to indicate changes.
That’s the biggest fear of active surveillance -the Katy bar the door problem if you wait. I would like Dr Scholz to address that because what you experienced seems really problematic.
I just met with the doctor Chan in flushing queens New York
Absolutely a gem like this Dr shcolz
Thank you both so very much for this forum! This IS a new world to me and I have created a lead sheet just from the first half of this segment. this is providing me with HOPE. I am very grateful for your guidance. I am 61 with a gleason report of 3+4 and a 5.7 PSA. Will be going to UCSF here in San Francisco Referred by General Hospital. Thanks again.
THANK YOU…. you have both been so supportive and helpful…
Thanks to you both. Just diagnosed last week with 3+4. meeting with my Urologist in two days. So glad I found your channell. It's been lonely and stressful.
As always a great video. Appreciate your efforts. Many thanks Alex and Dr. Scholz.
Million thanks for the informative content videos. I have so much on the PC in the past 3 weeks.
Thanks to Dr Shutlz and you young lady.
THANK YOU BOTH VERY EDUCATIONAL AND INFORMATIVE THANK YOU 🙏 IT REALLY HELPS TO UNDERSTAND AND HAVE THESE QUESTIONS ANSWERED 😊
This is so helpful in understanding the critical details! Thank You
Im 51, psa level 4, Recently diagnosed with gleason 6. The kicker is that it was found in 10 out of 13 cores. The urologist is recommending prostatectomy
These videos are super helpful, and reassuring. Well done. One question: Dr Scholz, at about 15:15, says "if a tumor is not unduly large..." What would be considered unduly large, please?
Thank you both and God bless you for this program. ❤
Just diagnosed at Gleason6, I already new about Surveillance and Waiting so am very comfortable to do this and have been offered 4/6 months Testing
Greatly impressed byDr Scholz great input looking forward to waiting the next 10 years or so. Feel lucky I am this stage at 80.
Hope to contribute soon
Mike M
Thanks for the info, but what about 3+4 and seminal vesicle invasion or other issues
My Dr. told me I had cancer, you need surgery I can get you in next week. He didn't offer any other treatment options. I brought up radiation, he talked that down. He gave me a folder telling me what to expect, didn't tell me anything. I didn't see your channel until it was too late. I enjoy watching your channel. Just to find out all information in case I see anyone else with prostate cancer. Thanks for you channel.
I have a tendency to pepper doctors with lots of questions. You have to be your own advocate. If a Dr. doesn't answer questions or seems irritated, the it may be time to move on.
Wow. He just wanted to cut and chop. Malpractice, in my opinion, of a most egregious kind. Not classic "malpractice," mind you, but of a more insidious variety. . .
I was diagnosed with prostate cancer in July 2023.A Gleason score on left prostate of 3+4 and on right side prostate of 3+3.I underwent treatment with a great Radiologist in NYC named Dr. Michael Zelefsky. He recommended SBRT. After nearly 4 months no impotence and no incontinence. PSA dropped from a 5 to 0. Just a little irritation when urinating. Follow up soon with MRI.Other than that feel great.
How old are you? Some say tradition have long term effects like bladder or kidney cancer after 15 years. Is it true?
I'm 69.I wanted active surveilance,but the Dr. recommended treatment.Surgery or Radiation.I opted radiation.But I selected a very good Radiation Oncologist,from NY Memorial Sloan Kettering.If you skip treatment chances are it's going to metastize.Get regular checks for early detection of other cancers that may occur.But it's important to treat it.
The timing of me seeing this excellent presentation couldnt be more perfect. Just yesterday, my consultation with my Doctor informed me, my biopsy results are 3+3=6. One core out of 12 showed cancer and was extremely small. He said no treatment necessary and will monitor PSA. I am generally comfortable with that but is checking PSA alone, enough? Should another MRI or biopsy be considered in the future, however distant? He did say, if something occurs in future, hormone treatment might be considered. Watching this gave me confidence in my doctor in any event. Thank you for your efforts.
Thanks dr scholz & alex for all the info.
The video help us all.
He is really good and i am recommending him to other people with Prostrate Cancer. I was diagnoised with Non Metasized cancer with one core having a Gleason score of 8 and 2 others with 7. I just had Hormone therapy and Fìducary markers Implanted. will be treated in 2025 with targeted radiaton.
The better question is, what are the chances the cancer will spread if you get a prostatectomy. That's what I did. The doctor told me I ought to get my prostate removed (Gleason 9) so I wouldn't have to worry about it in the future. The pathologist said the margins were clear, meaning the cancer hadn't escaped the prostate though it was 40 cancerous when removed.
Four years later, I have prostate cancer in my lungs. So I believe the surgery caused the cancer to spread. I'm pissed!
Dr Campbell videos re fenbendazole and ivermectin.. God bless
I live in the Uk so healthcare is free at point of use but as you say there is still a system which can complicate matters as was suggested. Interestingly I had a Gleason 4+3= 7 pre treatment score and decided to go for surgery based on my own specific care needs. The results of surgery were good, no cancer spotted after 6 months, no leakeges but erectile issues which I’m fine with as I’m 75 and single. However, my post Gleason score was 3+4=7 which a previous video suggested would be an observation situation.
brilliant interview
in 2016 my gleason was 3+4 and 4+3 I don't know the percentages, my PSA was 48 I was age 50. I recently talked to someone whos father is 81 with a psa 5 and gleason 10. I didn't realize that gleason 10 was so rare. I was glad to hear what you said about it not being the kiss of death. Thanks for another information packed video.
What treatment did you choose?
@@JasonRoberts556 It was suggested I be aggressive and I took the offered start ADT for a month, 45 radiation treatments, wait a month 6 docetaxel, continue with ADT for 3 years. I didn't work. PSA was trying to double after it was done. Axumin scan showed cancer at the end of the radiation treatment field, in 2021 I did 25 more radiation treatments with ADT for 2 years. I stopped ADT early because long covid had sucked the life out of me. I got my testosterone back in November. It looks like my psa is going to level out at 0.33.
@@steinshaw2490 are you on ADT now? Or stopped everything all together. Did you have any scans in 2016?
@@JasonRoberts556 I stopped everything. I did not have an Axumin scan in 2016 I did have other standard scans of the day. The Axumin scan was new in 2016 I believe and Idaho doctors are not known as leading edge which is why I went to Anschutz in Denver a Center of Excellence.
It is also important to know what type of prostate cancer you have. I was diagnosed with Ductal Prostate Cancer, PSA 4.7 and G=4+4. My cancer spread to the pelvic area (Stage 4A)at the time they found it. Went all in. Surgery, radiation and a mixture of Lupron and Zytiga. I have been NED since 2018.
I love this guy. Great information. Thank You.
Thank you - I have been very worried about my diagnosis which came out of nowhere and you have been very helpful.
YOU BOTH ARE A GOD SEND THANKYOU FOR THE INFORMATION 🙂
I would love to see this Doctor
We did A PSMA pet scan on Feb 15 and it show more then 6 metastases in the bones and the lymph nodes around the prostates and the neck area and with Gleason 4+4. He is 63 years old. 1st time diagnosis with PC.
We have consulted with 2 urologists and 3 Oncologist in the past 3 weeks. I Urologists and 2 Oncologist advocate Hormonal therapy plus Chemotherapy. The rest advocate only Hormonal therapy. Radiotherapy options has been ruled out by all the consulted doctors.
Urologist has started the hormonal therapy with Casodex on Feb 17, and followed by Lucrin on Feb 29.
The last visited Oncology took over the above treatment scheme but stopped Casodex and started on Erleada immediately. He will use Zoladex instead of the Lupron on the May 20th.
Please advise is this the correct treatment and what is the survival rate?
Should we consider the Chemo too? And does Chemotherapy enhance the survival rate?
Is there other treatment options that will increase the survival rate?
Thank you so much.
I can only explain what my husband is doing. Testing: biopsy Gleason of 4+3, decipher test, MRI prostate and PSMA pet, only showed highlights in the prostate. Treatment: 1 shot of hormone treatment, which lasts 6 months(Lupron), 2. and 1/2 months later... radiation seeds by one oncologist who does 500 or more of these procedures-most in the country. Then wait a few more weeks , then do radiation treatment once a day for 5 weeks. After all of this, he will be placed on active surveillance.
His urologists' wanted to jump to proctectomy. After urologist recommendation for a oncologist, he has two oncologist in 2 different states.
The one shot hormone treatment is first because it remove testosterone which feeds the cancer. It knocks it the cancer down, like sticking it in a freezer, should slow/stop growth. Then treatment with radiation seeds in the area of the cancer-highlighted by the MRI prostate, along with a ultrasound of the prostate. After the radiation seeds starts wearing off, then start with the localized radiation treatment-5 min a day for 5 weeks. He was given 90-93% cure rate.
My husband is lucky, both oncologist coordinated his treatment, everything was discussed in detail, before he started. Being 65 he wanted to make sure the first battle with cancer was the strongest.
Every cancer case is different, I hope you both get the answers you seek and get the best treatment for the cancer.
@@threeftr3349how is your husband doing?
I have learned from the videos presented by PCR. I do not only question my urologist, but also my oncologist about the variety of treatments, and how I should proceed.
I am 81 years old and still sexually active with a Gleason score of 4+4 = 8, and the decipher score of .62. Because of my age and the fact that the cancer is a 4+4 it was critical to pick the right therapy. I have acted out for an SBRT radiation regimen of only the prostate utilizing true beam for 26 treatments with no hormone therapy to maintain my quality of life after treatment. Thanks to PCRI I have been able to fashion the treatment that is acceptable to me and my future.
I appreciate the videos and Dr. Schollz Various videos by other medical experts, presented by PCRI!
Thank you ❤
Once again...Such valuable information. Thank you.
Diagnosed G6 5+ years ago on active surveillance since. Last random/targeted biopsy came back G9. Not sure what is going on. Having PSMA PET scan soon. Bad luck or what? 8:13
I can't quit commenting on this video it's everything I discover pretty much on my own confirm by someone I really respect and yet on most of the prostate cancer forum boards people just rushed to get surgery. They can't even explain why other than the statement I want it out. I've been very fortunate every doctor I've talk to said you could watch it even though I'm at 3+4 and I do have 40% but it's a very small lesion my radiation oncologist and I discussed a hypothetical, pretending I said what if I was against any form of medical care, religious reasons or what not what would my particular cancer look like in your best guess he said probably 6 to 7 years it would metastasize, and then we could treat another for five years probably it shows you why so many men rush in the surgery is not potentially wise choice, considering ED and incontinence in a mental health associated with those things
Decisions. 4+3 Gleason...3 positive cores of Gleason 4...Cancer completely Contained after PSMA Pet Scan...Urologist insisted on Radical Surgery (I'm 65). I got a second opinion from Radiation Oncologist And they said Perfect for SBRT Therapy...No one has told me about Life Long Side Effects???? All we need in Full Information from Specialists! Love your Podcasts.. Thanks from Australia.
Please check with a Proton beam therapy.Best hospital for this treatment is Loma Linda medical center,California.Hope this will help you
My fiance has just found out that he is PSA 7.34. (no symptoms, regular VA annual check ) hes 56, has history of kidney stones, and is being referred to a urologist. I'm really frightened for him.... the love of my life. I wish I could do something to help him 😢😢😢
Sounds like he already has amazing support! Learning about the next steps and how to take them together is key. Feel free to reach out to our helpline if you have any questions you need answered
Why is diet not talked about more as a way to lower psa and use food to help heal the body. My husband is on ADT and the side effects can be really bad. I was shocked at how quickly he lost muscle mass. Through research I have changed his diet drastically and believe it plays a super large roll in any disease including prostate cancer.
@@sharonbarlow1506 what diet is your husband on?
Very very helpful information. Thank you Dr. And Alex.
Great video, keep up the good work.Knowledge is power and you have certainly empowered me in my decisions going forward.
Grateful for Dr Sholz and for this fine young lady host they are really educating me to the point people are being referred for me for advise on prostate cancer and i am a chiropractor
These videos r so helpful! I felt i had some understanding when we met with the Dr. i am re watching, because now i have more questions b4 we proceed with Surgery. Thank you !!
Such fantastic videos. Thank you
My husband's tumor is Gleason 6...we are looking into capsol-t supplement as an option.....do you have anything to add about capsol-t?
What about 3 + 4 with perineural invasion ?
Good question
I know Dr. Scholz is not a fan of surgery such as radical prostectomy and carefully justifies this with the statistics of cure rates and side effects. But there are several newer "surgical" treaments which don't involve removing the entire prostate. I'm thinking here of such procedures as Holmium Laser Enucleation of the Prostate (HoLEP). I have had this treatment in the UK, which was "sold" to me on the basis of the fact that by simply removing (most of) the internal tissue of the prostate and leaving the enclosing capsule intact, the nerves and blood vessels associated with erection etc. are spared.
I just wondered if Dr. Scholz had any comments specifically about the HoLEP procedure especially with regard to his valid concerns over radical prostectomy?
In my own case I was Gleason 3 plus 4, had Deca-Pentyl Androgen Deprivation Therapy (18 months) before and after Radio Therapy, (20 focussed cycles over 4 weeks 37 Gray total). I'm now 9 months after completion of treatment and my PSA has been steady at 0.02. I'm on a six monthly PSA monitoring regime (next one in three weeks time - fingers crossed!) and my likleyhood of cure was given to me at the start of treament as "upwards of 90%". Thank you for your outstanding presentations.
HoLEP is not indicated for cancer.
I have 3+4 7 and i did lupron 6 months adt.
Why did u have to do 18 months??
My husband age 75 has been diagnosed with Gleason score 7 (1 core of 12 was 4+3) we find that most Radiology docs we’ve interviewed say that ADT is mandatory for a good result. Knowing the side effects of the hormone blocking pills/injections for 5 or more months are drastic, we both are hesitant to agree to this approach. Can you address this?? Thank you for your website. It’s very helpful.
Please check with Loma Linda Medical center.Proton beam therapy they have a great testimonial.Also Read the book of Robert Marckini.
My father has recently been diagnosed with advanced bone metastases prostate cancer; he is in his 70s. The oncologist suggested surgical castration and then starting Abiraterone and later Docetexal as it had already spread to the backbones, sternum, pelvis, and ribs. My question is, how relevant is Gleason's score in his case? Secondly, what are the chances of cure and prognosis? Thank you in advance for providing valuable information.
Great video as usual.
I wish I could get a doctor like him in India !
Brilliant show. From the UK
Really like this Dr.
I love this thank u is there a way to verify my score with a second Gleason test
Please Alex l have gleson 7 (3+4) with PSA 6.4 surgery is being suggested by my consultant should l go ahead l do not have any symptoms. I am in England
Hello David, please reach out to our helpline. They can help you sort out the details of your case and give you information on all your options: pcri.org/helpline
Thx for the vids PCRI.
Hello , If the Gleason score is 5 can the cancer metastasis and should you have radiation treatment?
I have Glisson 6 but stage pT3a R1
Is PSMA Pet Scan a substitute for a Biopsy? We need a clear answer.
@@Dr.NedalAlchaar No. Psma looks at where the cancer is located and if there are methastasis. Biopsy on 12 points checks how aggressive the cancer is and how many types of cancer there are.
My biopsy showed a Gleason score or 3+4=7. I felt pretty good. Then a Genomics test was run and it showed a score of .92 with the highest being 1.0.
This is very agressive. This number was in conflict with an intermediate Gleason score. I suggest that those with prostate cancer get a Genomics test. It's more good information to help make a better decision.
... Question: Are PSMA rsults "Definitive"? My PSMA showed re-current cancer in the prostate and a cavial lymph node. Yet... both were biopsied afterward and both were Benign?... My Urologist is confused and prescribed a course of anti-biotics and another PSA after to rule out Prostatitis. Your thoughts?
My Gleason score was 6 and I never did anything about my prostate cancer.
Thank you for the information. My husband has a mass seen on an MRI and a very high Psa level. He gets his biopsies done on Thursday. He's extremely scared, understandably and believes it's best to just get his prostate removed. He's only 53 year's old. All of this is informative, but it seems more confusing. I'm trying to help him make a decision, but now it seems regardless cancer is the outcome, eventually. I have been extremely positive during this. Now I have no idea what to suggest to him. 😢😢
I have a Gleason of 4+4=8. My Urologist says it’s best to just remove the Prostate. I already have an Oncologist which he said I definitely shouldn’t have my Prostate removed and just have radiation and hormone therapy. From what I’ve read, I’m way more worried about the hormone therapy than an operation. The list of severe side effects from the therapy is bad and long. I guess my question is would hormone therapy still be necessary after surgery? Totally not sure what direction to take here. Also, going for a PET scan next week, the surgeon says that results from PET scan doesn’t change his course 95%of the time.
Also an 8, here in Philly. Waiting for PET. Read an abundance of literature on and watched numerous vids like this about--TREATMENT. So many guys have the surgery and the cancer returns, necessitating radiation and ADT. ALL THESE "TREATMENTS" result in horrible, many times unfixable, after-effects. Not to mention SIDE-effects. The "Two I's," impotence and incontinence for surgery and radiation, and loss of penile length. The ADT causes rapid--RAPID!!--muscle wast
Also an 8, here in Philly. Waiting for PET. Read an abundance of literature on and watched numerous vids like this about--TREATMENT. So many guys have the surgery and the cancer returns, necessitating radiation and ADT. ALL THESE "TREATMENTS" result in horrible, many times unfixable, after-effects. Not to mention SIDE-effects. The "Two I's," impotence and incontinence for surgery and radiation, and loss of penile length. The ADT causes rapid--RAPID!!--muscle wast
Also an 8, here in Philly. Waiting for PET. Read an abundance of literature on and watched numerous vids like this about--TREATMENT. So many guys have the surgery and the cancer returns, necessitating radiation and ADT. ALL THESE "TREATMENTS" result in horrible, many times unfixable, after-effects. Not to mention SIDE-effects. The "Two I's," impotence and incontinence for surgery and radiation, and loss of penile length. The ADT causes rapid--RAPID!!--muscle wast
Also an 8, here in Philly. Waiting for PET. Read an abundance of literature on and watched numerous vids like this about--TREATMENT. So many guys have the surgery and the cancer returns, necessitating radiation and ADT. ALL THESE "TREATMENTS" result in horrible, many times unfixable, after-effects. Not to mention SIDE-effects. The "Two I's," impotence and incontinence for surgery and radiation, and loss of penile length. The ADT causes rapid--RAPID!!--muscle wast
Also an 8, here in Philly. Waiting for PET. Read an abundance of literature on and watched numerous vids like this about--TREATMENT. So many guys have the surgery and the cancer returns, necessitating radiation and ADT. ALL THESE "TREATMENTS" result in horrible, many times unfixable, after-effects. Not to mention SIDE-effects. The "Two I's," impotence and incontinence for surgery and radiation, and loss of penile length. The ADT causes rapid--RAPID!!--muscle wast
I'm 72 this year, been on active surveillance since 2008 , high psa reading then ,had several biopsies since and Mri scans , but nothing other than elevated psa between 12 and 14 now up from around 7 of 8 initially.
Never heard of Gleason , only figures I've had are PSA,until this year after an MRI scan I was told I had a density figure of 0.24 , haven't a clue what that means maybe someone can shed some light on that , next appointment is May .
Not a doctor. I've read that the density measure has to do with PSA levels as they relate to prostate size and the size of the mass targeted. Generally, lower is better and 0.24 is fairly high. 0.16 is low.
@@1dariansdad
So that means tge bigger the prostate the bigger the psa reading
Latest reading is 9 but 14 last year, so seems my prostate is small compared to psa reading , I wonder how much of an indicator
And thanks!
This was the video I really needed on a low mood day today! Thank you so much 👍🏽😁 Gleason 3+4=7 but using lifestyle, nutrition and off label metformin, mebendozole, atorvastatin and doxycycline and trying to avoid Hormone and radiation therapy which is all the NHS want to do!
What does Gleason score 3 + 4 with tertiary pattern 5 along with extracapsular extension mean?
I was gleason 6, (3+3). Four months later after surgery the pathology was T3 as it had grown to the prostate wall so yeah, no. The surgeon said that if I had waited 5 yrs, I'd be in real trouble. No one pushed surgery on me, I went to see a radiation oncologist and then an out of town surgeon and made my own decision.