4 years ago a doctor told me I had prostate cancer. He was going to do the random biopsy. I refused and fought for the MPMRI. Good thing, over the years where I had, had hernia surgeries, the mesh had come out and migrated into the prostate, uretha tube and the sigmoid colon. After a 6 hour surgery to remove and repair all this, psa levels came down, I got well. Lesson, ALWAYS ask questions, and do your own research. You are the only person living in the body you got, and you know it better than any doctor.
Interesting! I told my Drs I had hernia mesh in my abdomen 20 yrs ago. I had sudden onset bleeding with clots and they said it's just BPH thus far with a CT scan pending for my bladder. I do have an upcoming MRI with the VA. Any specific questions, would be appreciated. I had two lower inguinal hernias, second was a repair too but no mesh use there if I recall. Thanks for sharing!
In November 1995 a doctor told me to get ready for death because of prostate cancer. Four months later I ran the 100th running of the Boston marathon. Are there any studies being made on exercise and the effect on psa testing?
They do advise no bike riding, extreme exercise, even sex two days Before, if I recall a PSA test is conducted. Don't know about any specific exercise studies conducted. @@jcolumbiap
This channel is invaluable! After my PSA went from 4-6-7 over two years I went in for the 3T MRI. ONLY after that showed a lesion (tumor) did I get the Biopsy. The Biopsy came back as a 3+4=7. The urologist recommended surgery in 2 weeks. (They are surgeons, so of course that's what they recommend!) I took the advice of THIS channel and got a 2nd reading on the biopsy. (That's right guys, reading a biopsy slide is subjective NOT objective). I sent it to John Hopkins: It came back as a 3+3=6. THANK the Good LORD, I didn't listen to the urologist!! Then the radiologist I met with, recommended Radiation. (Of course he did! Lol...) BUT he doesn't do Proton-Beam because that's a completely different type of radiation and he's not trained in it. So, off I went to consult w/ a Proton-Beam specialist. The point is this: We have time! SLOW-Down~~~~ The Proton-Beam staff has me scheduled for another 3T MRI AND they want to read my Biopsy slides also. They aren't rushing me into anything....I like that.
As I know, a Gleason 6 "cancer" never advancing enough to cause any harm during patient's lifetime. Some doctors even wanted to reclassify Gleason 6 to some kinds of irregularity than cancer as I quote here and you can search for it: "Currently, such abnormalities are classified as “Gleason 6” in the scoring scale of prostate cancer grades. However, some urologists believe they shouldn't be classified as a cancer at all because, though highly unlikely to kill, the label causes distress and influences patient decision-making." So, IMO, you should not get treatment at all, active surveillance is all you need.
You should read other comments below to see people with Gleason 6 went with active surveillance for 12 yrs already, and it is still okay, as Dr. Scholz said clearly: Gleason 6 patients can postpone treatment indefinitely
Everyone is different. And from what I've read, 35% of patients who do the surgery, THEN require radiation down the road too. Dr. Scholz no longer recommends surgery and I'm not doing it. Radiation (both standard and Proton Beam have made HUGE strides in the last few years. My recommendation is to read: "You Can Beat Prostate Cancer: And You Don't Need Surgery to Do It" by Robert J. Marckini BUT get the updated 2nd edition! It's much more current from the 1st edition. Hope this helps~~@@ricardoabella1436
By far, the most credible source of information on prostate cancer. I've watched numerous TH-cam videos on the subject, but I can't recall any other website. Both Alex and Dr. Scholz are incredibly enthusiastic, dedicating substantial effort to providing global awareness. Cheers from Sydney, Australia!
I watch a lot of TH-cam videos.I prostate cancer by learning one thing. Most of these videos are sponsored byesterday by the medical profession. Different medical groups. So they will always be positive. You have to find the ones that are individually posted. And not sponsored by a medical group.
My urologist is pushing real hard for surgery, right now. Go on some hormone therapy and radiation and scaringvme that "it's probably already in my bones." Of course: I have a PSA of 69, and the mri is showing some "lesions" inside the prostate. Should I get another opinion? I don't even know what a Gleason score-is. Your thoughts..
I was diagnosed with Gleason 6 in 2011 when I was 61. First biopsy showed cancer in one plug out of 12 and second biopsy showed no cancer in any of the 12 plugs. I was ready to pull the trigger on seeds, but then my primary physician told me to cool my jets and explained active surveillance to me. It has now been 12 years since my diagnosis and my last PSA reading in June was 5.3. It has brought me a great feeling of relief to hear Dr. Scholz's opinion on not needing immediate treatment on Gleason 6 and the benefits of active surveillance.
No. That's the "problem". It's a silent killer. BUT it's a SLOW cancer. Very/VERY Slow. Watch ur PSA. If it gets over 10....or you see it consistently "jumping" like mine did. (4, 6, 7---over 2 years) then you schedule a 3T MRI. (NOT a standard MRI...must be 3T). ONLY if that shows a tumor (IMO) do you go for a biopsy. @@jamescalifornia2964
Thank you so much! I can't tell you how much bad information I have received from urologists over the years. I am so happy that I didn't pull the trigger on treatment with Gleason 6. You are doing a true service to humanity.
I quote here and you can search for it: "Currently, such abnormalities are classified as “Gleason 6” in the scoring scale of prostate cancer grades. However, some urologists believe they shouldn't be classified as a cancer at all because, though highly unlikely to kill, the label causes distress and influences patient decision-making."
I too have a Gleason 6 and was directed towards robotic surgery. Having stumbled across this amazing channel I am now doing more research and asking more questions. The biggest worry to me is that my report says I have 90% in one chamber. I definitely need to do more research.
I just went for my Biopsy today, It went well a bit painfull. Now I can talk about it with first hand knoledge, My psa 8.75 it was 3.5 in 2019. I didnt know I had growing psa untill February this year I have a small prostate. I waited to get the biopsy . DRE in February was indicative of a small nodule on the right side. I feel mostly very good, except for today. Every one have a blessed day
I want to thank you so much for these videos. I was diagnosed with Gleason 4 + 3 last week and I went into full panic mode. Your wisdom and expertise have helped me tremendously
Gleason 4+3 isn’t a death sentence but it does require treatment. I hope you won’t ignore what’s happening in your prostate on the basis of what is posted on the internet.
I have spoken to three radiation oncologists and two surgeons. Every one of them have said “do surgery.” So, going to have the surgery (not scheduled yet)
@@edwardreiller6269 Hi. I was just diagnosed with Gleason 6 (3+3) cancer. My PSA was 9, but my free PSA was .9%, which was very low (not good). My MRI showed Pi-Rad 4 lesions. I had a transrectal biopsy and they found high volume cancer in 1 core (55%) and also cancer in all of the right side cores. I am scheduled for a PSMA PET CT scan -- I hope my insurance covers it. You never know. I also hope to get a Decipher test before I make a decision on treatment. I am 54, so the risks are higher for me than older patients. I haven't decided a treatment yet. If I had 4+3, I would be more inclined to get surgery than 3+3. But I need to know more about my high volume cancer, where the tumor(s) are located, and maybe the Decipher test. I think volume, location, and age are also factors.
Doc’s got some great ties! I went to Moffitt Cancer Center in Tampa today, Gleason 7. However they’re looking at my slides again to be sure my biopsy was interpreted and graded correctly. If it downgrades to Gleason 6 I’ll likely go to Active Observation. If not I’ll be treating with SBRT, no rush into it, and they’re the third oncologist I’ve spoken to! @Prostate Cancer Research Institute has been a tremendous resource for me!
I did my biopsy in Moffitt Cancer Center recently, and my Gleason is 7. I am in the process of evaluation what kind treatment I should take. Your sharing here is great help and I hope can get more from your experience.
@@NancyNie-ri6gq if you have any questions at all, I’m nearly four months out from treatment and my numbers are right where they need to be! I’ll be happy to try to answer any questions that might come up with you.
I had a psa of 9.5. Tests showed a small but aggressive type of cancer. The surgeon was very pushy. So, I went for radiation and no hormone treatment. After treatment, I was 1.9, 12 months, 2.7, and 18 months, 3.5. So, I have been a bit worried at the rise in PSA. However, after watching this session, I feel so very much relaxed with the future. I am an active and busy 71 year old. Thank you.
I’am 68 was diagnosed a year ago with high PSA .had biopsy showed aggressive 4+3 Gleason had 43 rounds of radiation and hormonal therapy went for my check up PSA is almost undetectable. I’am living a life without the fear of cancer it’s in complete remission . Some people like to gamble or pretend they don’t have it,but it’s not going away if you don’t treat it properly. This video is telling you to research your options before making your decision,then make your decision based on your choice. Good luck to everyone who is going through this journey ,there is hope and great outcomes. 👍
At age 72, my Gleason score was 3+4 intermediate cancer. I chose surgery, and the pathology report showed it was bulging and ready to spread. It was removed just in time. PSA test now show a score of .1
One of the things that Dr. Scholz knows from his experience is that prostate cancer in the aging male is ubiquitous and most of the time it will not harm us in our life and we'll die of something else. He absolutely wants us working with our doctor on the issue, keep on top of it, and make good decisions. But, if you go to him or doctors like him, he's likely to also ask you about more dangerous aspects of your health. I've been to their office, I currently don't have prostate cancer (but if I live long enough I'll highly likely to get it), and their office ended up prescribing me a coronary calcium test... So, what's the lesson there: Yes, keep an eye on your prostate but don't be myopic about it. Losing track of other aspects of your health may be more dangerous for you than prostate cancer. Keep an eye on heart health!!
Indeed. I'm dealing with high blood pressure, diabetes 2, high tri glycerides and high cholestorl...also have genetic high ferritin. Focusing just on the prostate is not an option.
Great Great Video!! I'm Gleason 8. No spread. I'm on ADT last 10 days. Going to do Radiation in 3-4 weeks. These videos helped me a Lot. You guys deserve a lot a credit. I was scared to death 8 weeks ago. Now I know what to do. Thank you so much!!
Hi I was wondering if you had an update on you ADT treatment and how that is going? I had a prostatectomy in June 2023 followed by a related lymphocele infection that put me in the hospital for 6 days in September and set my recovery back. I'm doing fine now and feel well healed. They found metastatic disease once the prostate and adjacent lymph nodes were removed. My PSA seems to be increasing fairly quickly now. I was supposed to start ADT six weeks ago Abiraterone and Prednisone orally, and Lupron via injection. I haven't started yet because of the fear I have of the side effects and not having a good game plan in place to counter them.
@@steveschram575 I completely the 5.3 weeks of radiation in mid-November. Still on Lupron Depot till August. No complications. The shots do have side effects like hot flashes, etc., I’ve gotten use to it. My blood test was last week, it was
@@steveschram575 Yes, I finished the 5.3 weeks of IMRT. I went to Advent Health just 2 miles from me. Great experience there. Anyway I feel great, everything works good :). I have to continue the ADT until August 2024. Which I have no problem with. I really only have hot flashes with some fatigue. Still way better than surgery IMO. Too many risks.
@@9cyrus540 Thanks for your message. So your side effects from the ADT have been minimal over 6 months? I'm 58 yo. It seems like some of the older guys have severe side effects from the ADT. They want me to do the ADT for two years and six weeks (37) straight treatments of RT.
@@steveschram575 Sounds like you have a very aggressive cancer like mine. I got used the shot within 3-4 weeks. The hot flashes didn't last very long when I got one. But they will continue as long as you get the shots and probably 6 weeks after you stop. You will have no sex drive. But erections are possible as long as you had them before the shots. Now I'm a healthy 66 (my birthday was 6 weeks ago), I work out 3-4 a week, never smoked. I'm not slender, and losing weight is tough on the shots. Some other senior guys may not be that healthy and suffer worse or they are just unlucky. My doctor told me some men get no side effects and didn't think the shots even worked (but of course they do). So I guess I'm lucky. You will need to exercise once on the shots avoid losing muscle. I'm going stay on the shot as long as needed, I cannot take any chances. The trade-off is worth it. What is your Gleason score if I can ask?
Thank you, so reassuring, diagnosed April 22 Gleason 9 spread to bone and local lymphs, hormone treatment only for me, no radio no operations, psa almost zero, feel great, loads exercise, good diet, lifes good, grateful that the cancer I have is prostate and not something else, love your vlogs so educational Phil
I have Gleason 4+3=7 intermediate, brought my PSA down from 8 to 6 through Keto diet and exercise from December . Diagnosed w/ cancer in June no spreading serious fasting till radiation Sept 18. If PSA goes lower should I postpone and continue naturopathic healthy path? Also only had cat scan w/ dye should I have a PET SCAN? 3 of 14 biopsies had intermediate. Delay?
@@jameswpurviance7696 Radiation drops PSA slowly , could take years to bottom . As long as PSA trend is down (could be a bounce up one time but then continues down) , Yeah , just do healthy stuff and monitor PSA . it should eventually bottom below 1 . If several rises occur , eventually doubling from lowest reading , then at that point definitely jump into the scans & biopsy world . Keep track as the SPEED of the rises are an indicator of aggressiveness (I'm hoping that you have no rises!)
@@waldipup9010 hi, psa bounces after prostatectomy and radition normal? my father got the lowest psa read at 0.06 and now 3 months later got 0.08, and last radiation session was in march
@@bradastra6111 Hi Brad . Did he get hormones with the radiation? If so , that's why its so low so quickly , and not definitive of anything . If not , great . Yes , PSA bounce after radiation very common , and your levels are extremely low . If lowest reading more than doubles at that point new tests should be considered . But keep in mind that if hormones were given PSA can rise as they wear off and not mean radiation failure . Hormones temporary effects on PSA complicate the picture .
@@truthseeker1959 I so agree that alcohol is bad and may have contributed to my prostate cancer. Tobacco is also really bad. I have definitely quit the strict plant based diet and now include a very small amount of eggs and dairy. I eat seafood and chicken and lots of beans for my protein. I also eat a lot of fruit which I know has a lot of sugar. But I don’t think there is evidence that sugar or eggs feed prostate cancer since prostate cancer is fueled by testosterone. So I believe a balanced diet with exercise is an important part of a cancer fighting lifestyle. Sorry I didn’t see your response until now. Best of luck! Michael
@@BravoEstrada-un5yy Definitely watch videos with Mark Shultz and Alex on PCRI. There you will find a wealth of accurate, up-to-date information on prostate cancer. New research is coming out all the time. Also find the best doctors possible because not all of them are current and may not be receptive to the most current research. This has been my experience. Best of luck. Michael
I love this channel and the superb information it presents, but my one criticism is that it focuses so much on the newly diagnosed patients and not those of us who are navigating recurrent prostate cancer. I was diagnosed in November 2010 at the age of 52 with a PSA of 5.0 and a Gleason of 3+3. In retrospect, I probably rushed my decision to have surgery, but I went ahead anyway. The post-surgery pathology upgraded my Gleason to 3+4. My PSA was undetectable for 54 months after surgery, when it came back at 0.05 ng/mL in September 2015. Of course, having a detectable PSA sent me into a full panic. Once I had a detectable PSA again, we applied many of the concepts in this video, and we took a much more measured approach with managing the recurrence. It took over two years for my PSA to go from 0.05 ng/mL in September 2015 to 0.10 ng/mL in December 2017. It took another three years and seven months for my PSA to go from 0.10 ng/mL to 0.21 ng/mL in July 2021. So for nearly six years, my medical team and I were okay with regular monitoring, doing our best to avoid salvage radiation therapy. But it took only 9 months for my PSA to go from 0.21 ng/mL in July 2021 to 0.36 ng/mL in April 2022. Given the rapid acceleration in the growth of my PSA, we decided it was time to act. We agreed to do concurrent androgen deprivation therapy (ADT) and salvage radiation therapy (SRT). I had a six-month dose of Eligard two months before having 35 sessions of SRT over 7 weeks ending in August 2022. The ADT knocked my PSA down to 0.05 ng/mL in November 2022, but the dose has worn off and my PSA was 0.13 ng/mL in March 2023 and 0.11 ng/mL in May 2023. Two data points don't make a reliable trend, but we're cautiously optimistic that the SRT is taking hold. (My radiation oncologist said it could take 18 to 24 months to see the impact of SRT.) Time will tell whether waiting over six years to start SRT with a rising PSA was the wise choice. But I believe that you could make a separate video on this same topic aimed at recurrent prostate cancer patients. Thanks for all your hard work!
@@schmingusss I can understand that thought process. As an update, my salvage radiation therapy failed, too, and my PSA is now 0.52 ng/mL, the highest it's been since my diagnosis. In retrospect, I wish I had done more research and better educated myself before opting for surgery. I was diagnosed on 11 November 2010 and had surgery 4 January 2011. I don't know that I would have come to a different decision, but I would have been much smarter about the disease, how it behaves, and treatment options.
@@1958zed What is your treatment plan now? Did you get any scans to detect any new cancer? I was just diagnosed with Gleason 6 cancer. My PSA was 9, but my free PSA was .9%, which was very low (not good). My MRI showed Pi-Rad 4 lesions. I had a transrectal biopsy and they found high volume cancer in 1 core (55%) and also cancer in all of the right side cores. I am scheduled for a PSMA PET CT scan -- I hope my insurance covers it. You never know. I also hope to get a Decipher test before I make a decision on treatment. I also need to know the tumor location. The high volume scares me.
Thank you, thank you, thank you. I’ve been diagnosed with prostate cancer in August after having my biopsy. My PSA level was 3.65. Every year I’ve had my pcp check my prostate when I get my physical. It did rise to 1.65 in 2020 and 2021. Last year 2022 my Dr didn’t have my PSA checked but did do the exam and felt nothing. May 2023 during my normal checkup he had my PSA checked and that’s when he noticed the numbers doubled since 2021. I then saw a urologist who checked me and felt a nodule. That led to an MRI in July which on a scale from 1-5 the matter of concern was a 5 and it looked like cancer. In August I had the biopsy and on my birthday in late August it was confirmed I have cancer. I met with the Oncologist in September and he was telling me about the Robotic Surgery and went over what it details. I have up to February 2024 to get myself either in surgery or Radiation. I’ve been researching and talking to guys who’ve had both treatments. The horror of hearing I have cancer surfaces daily but I don’t breakout in tears as much as I did when I was first told. The medical team I’m dealing with are good and are checking on me to see how I’m dealing with it all. I will tell male friends and my son get yourselves checked. Thank u again for all the information I can grab onto within this video.
@@Gary65437 I chose radiation and didn't miss a beat with continuing living my life. I had minimal side effects only the urgency to urinate often. I did gain weight for I am on the ADT shots but still tightening my diet including more green veggies and less sugar and of course dairy. I just had my second shot of ADT (Hormone Therapy) recently which is a monster dealing with the hot flashes but i do exercise but need to up it some more with lots of walking and including my weights again. I just had my blood work regarding my PSA so I'll be ready to see how I'm doing with that. Keeping my fingers crossed. Overall my life is still good, I'm working and enjoying each day God lets me see. I'll be 69 in August but we have to take the bull by the horns and win this fight.
I had surgery and radiation. I thought I had done so much research that I thought my head was going to explode. I thought I was well informed. Knowing now what I have read since along with what I have been hearing here, I would have not gotten surgery. I was told that if I did radiation and had BCR then it is unlikely that I would find a surgeon to perform surgery because of all the scar tissue. My surgery took place in 2019 and 3 months later I had an elevated PSA then Rad. I had Gleason 9. My body is not and will never be the same although I am enjoying life. I would never recommend to anyone to have surgery again. I think surgery for this disease unless absolutely necessary should be outlawed. Just my 2 cents and THANIK YOU so much for this information. It is SOOOO helpful and I wish I had seen something like this in 2019. Keep up the good work.
If you would of had radiation first then needed to have your prostate removed it would of been hard to find a surgeon to do the surgery because of the scar tissue they say. So you probably done the wright thing having your prostate removed because you probably wouldn't be here today if you hadn't had the surgery first.
Be sure to research hormone therapy and pick the right drug. Hormone therapy can have some nasty long lasting side effects. Surgery even for a 3+4 can have great results if done properly.
Thanks so much for this I've just been diagnosed with prostate cancer gleason score 3 +4=7 I feel a lot calmer now because I've time to do some research. 👍
Same. And just got a 2nd reading on my biopsy slides by John Hopkins. It came back as a 3+3=6!! And I also highly recommend reading: You Can Beat Prostate Cancer" by Robert Marckini 2nd edition. Excellent resource.
What an amazingly clear, concise articulation of how to proceed with treatment planning decisions. Recent diagnosis of unfavorable intermediate Gleason 3+4. Urologist was kind, but brutally un-sparing in describing my postoperative quality of life with surgery. Told me both nerves have to go, and post-op ADT, referred me to a radiation oncologist. I'm 65. Nothing matters more to me, at this stage in life, than the quality of life I may have left remaining. I absolutely cannot imagine living any longer without sexual function or urinary continence, but those are the choices I face. It seems to me like the cure is worse than the disease. I've never been so devastated by any loss I have ever faced in life. People who minimize the trauma of prostate cancer (Oh, just have it removed! You'll be fine!") have surely never faced it. Time in making my decision r.e. surgery vs. radiation seems like the greatest luxury. Thank you for this erudite elucidation. ❤
John you need to find a new urologist. A 3+4 gleason score is better than a 4+3. Both equal 7 but the 4+3 is more aggressive. Not sure where you live but if you are in a rural area find a urologist. In my area the surgery is via robots controlled by the doctor of course and patients are home the day after. I am a bit older than you at 73 and on my last biopsy one core had a Gleason score of 4+3 indicating nerve involvement. I requested a PSMA Pet Scan and will be setting that up next week. That scan should show if the cancer has spread beyond the prostate. If it has my conversation with my doctor will take a different path. Good luck to you.
I was just diagnosed with a prostate MRI. A multi sequence, multi planar imaging of the pelvis was performed by California Imaging institute. Two lesions were found. One lesion was .5 x .3 cm and one was .5 x .4 x .4 cm. PSA density was .09 ng/ml. T2 for both was 3/5, DWI/ADC for both 3/5. IMPRESSION: 1. Benign prostatic hyperplasia 2. Two PI-RADS cat 3 nodules are identified, one within the right apical medial peripheral zone and the second within the right apical lateral peripheral zone. These are intermediate lesions with the presence of clinically significant prostate cancer equivocal. 77 yr old Appreciate any feedback and is Dr Scholz excepting new pts. Medicare insurance and tricare for life insurance PSA HISTORY Feb 2021. 6.1 May 2021 8.4 Jul. 2021. 5.6 Aug. 2021. 4.5 Nov 2021. 4.3 Feb 2023. 5.5 Mar. 2024. 7.8
I’m presently getting treatment at Dana Farber Cancer Center at Mass General in Boston. I’m on active surveillance where I’m monitoring my PSA and FREE PSA on a regular basis. If my PSA goes crazy then we will talk about a MRI targeted trans perineal biopsy.
Hi. I was just diagnosed with Gleason 6 cancer. My PSA was 9, but my free PSA was .9%, which was very low (not good). My MRI showed Pi-Rad 4 lesions. I had a transrectal biopsy and they found high volume cancer in 1 core (55%) and also cancer in all of the right side cores. I am scheduled for a PSMA PET CT scan -- I hope my insurance covers it. You never know. I also hope to get a Decipher test before I make a decision on treatment. It all really depends. I am 54, so the risks of future more serious cancer are higher for me than you at age 77. With your PSA levels and lesions, you should probably get a biopsy if you have not had one. That way you can get a Gleason score and maybe a Decipher test. The biopsy isn't fun, but its a lot better than surgery, radiation, or any other treatment if you find out you have Gleason 6 now, but later get a Gleason 7, 8, 9 or 10.
As a recently diagnosed Gleason 6 78 year old who has other information to consider I’m not hurrying to treatment. I’m intermediate risk on Decipher. I have good quality of life and want to preserve it. My doctors are recommending that I proceed with radiation. I’ m pursuing other input from MSK in NY but may seek to avoid treatment related side effects as long as possible regardless. It all comes down to risk assessment/ tolerance in this rapidly advancing field. This series of videos is an enormous help. Kudos to the providers.
Thank you for the video I finished Pluvicto and it came back within 3 months after I finished. Taking more than a month just to get a zoom call to talk to the radiation doctor to do 4 new spots it’s hard to remain calm especially after failing all the treatments I have had. I have been going through all of this for almost 5 years and have learned allot but it’s nice to hear a little encouragement that at the moment I don’t need to feel anxious at this point that emotion always comes the week before check ups. Keeping sane isn’t always that easy. Good luck to everyone going through this.
Great video.! My 3+4, grade two prostate cancer has returned after active surveillance and later cryoablation. I was concerned about the time line that my surgeon has offered to do another ablation. Seven weeks away seemed too long. Now I have a better sense of an acceptable time frame . Thanks so much
Gn I was on active surveillance since 2015 having done a TURP to relieve challenges due to bph. My Jamaican Urologist referred me to UM Sylvester and a biopsy revealed a Gleason 6. I continued surveillance and transferred to a US HMO. My PSA climbed from 4.7 to 9.7 in 5 months and a 3 tesla mri was done and a biopsy in February 2023 with 23% of one sample Gleason 4+4=8. Having reviewed my status, risks and options with my Urologist and viewed several of your videos I opted for targetted radiation ( completed in August/September) and hormone therapy. I will continue hormone therapy ( Eliguard) for 6 months. My PSA has fallen from 9.7 to 1.06 ( November). I have the videos very informative and helpful. I still have fairly good libido and occasionally use 10mg Cialis 1 hr before sex.
I can’t tell you how grateful I am to have found the PCRI. Knowledge is power and you are providing so much valuable information so that I can make good decisions. I am in the investigation process and proceeding with my biopsy. I feel you have educated me enough to discuss which procedure I should discuss with my doctor. I will definitely be watching all of your content so I can advocate for myself with as much information as possible. After I receive the results from my biopsy I will probably want reassurance from PCRI on my best treatment options if in fact they are necessary. You have really comforted my concerns and reinforced the fact I can continue to live an active normal lifestyle. Thank you for your brilliant work and I have learned a tremendous amount in a short amount of time by watching you and Alex during your weekly content on TH-cam.🙏🙏❤️
Waiting for a PET. I n the meantime finding PCRI and Alex is really helping me deal with this. Alex you are so economical and clear, your questions are exactly those us blokes have rattling around in our heads. Thanks so much. X
I've had two biopsies, the second after an MRI showed a spot, and nothing was found. Age 68, and my PSA bounces around with a high of 10 ( only once 4 years ago ) but now down to 4. Just took the The ExoDx™ Prostate Test with a score of 44. Still monitoring with PSA and an second MRI in the fall.
I am 71 with prostate cancer, with gleason score over 6 and have no anxiety. I am in for surgery on 9/27/2023. Pet Scan and Bone Scan show it is just in the prostate. I have pushed my surgery off a month, so I can get things done before hand.
I was 72 when diagnosed, Gleason score 3+4. It took three months to get a medical clearance from my heart doctor. He was convinced I had heart issues, but ran every test and passed them all. July 18 the surgery was done. I was walking around the ward four hours later. The incision above the naval was very tender. I was sent home the next day, with a catheter. Six days later, I went back to have the catheter removed, painless by the way, and had bladder control about 98% of the time. Lifting anything heavy caused leaks, but getting better. The pathology came back Gleason 10, and ready to spread. Six weeks after surgery, PSA was .1.
🎯 Key points for quick navigation: 00:00:20 *🕒 Anxiety from prostate cancer diagnosis often stems from a lack of time and information provided by doctors.* 00:01:32 *🧠 Even with a Gleason 10 diagnosis, a treatment delay of 2-3 months is unlikely to significantly impact prognosis.* 00:02:26 *🧪 Delaying hormone treatment allows for more accurate staging and diagnostic scans.* 00:03:21 *❄️ Hormone treatment can effectively manage certain high-grade prostate cancers for many years.* 00:04:19 *📅 Historically, delays in treatment did not worsen long-term outcomes, even with Gleason 7 or 8 cancers.* 00:05:26 *🏥 Immediate treatment is often pushed due to patient anxiety and the financial incentives of the healthcare system.* 00:06:36 *🏃♂️ Prostate cancer is generally less aggressive compared to other forms of cancer, allowing more time for decision-making.* 00:07:59 *📚 Patients are encouraged to conduct their own research and seek second opinions due to rapid advancements in prostate cancer care.* 00:09:11 *⏳ Gleason 6 patients have ample time to consider treatment options due to the non-metastatic nature of their cancer.* 00:10:07 *🔍 Continuous monitoring is vital to catch more serious cancers, even if Gleason 6 is initially diagnosed.* 00:11:04 *🕰️ Gleason 7 patients can safely delay treatment for up to six months without impacting cure rates.* 00:12:38 *💬 Patients should prioritize informed decision-making over fear when choosing treatment options.* 00:13:19 *🌎 Prostate cancer patients are encouraged to get multiple expert opinions to understand all treatment impacts and options.* 00:14:00 *🗣️ Joining support groups and researching doctors can lead to more informed and confident medical conversations.* Made with HARPA AI
My father had a precautionary prostate surgical removal owing to family history of cancer. This resulted in impotence and many subsequent years of frustration which, if tbings weren't already bad enough, resulted in more violence and abuse within the family unit with us children bearing the brunt. Medicine has to be about more than body parts.
Well your Channel is great. Many thanks. I have just been told by my private specialist that my PSA is high around 9. And he is already talking about robotic surgery. This seems bizarre after watching your video. Thanks for educating me it gives some reassurance in a difficult time.
i was diagnosed with Gleason 8 in Aug of 2022 and PSMA showed nothing outside of my prostate. I was scheduled for surgery at the end of November but I got the flu 2 days before and surgery was postponed until Jan 31st of this year. Tumor was all contained within prostate, margins and lymph nodes were clear. Gleason was downgraded to 7 and I've had 2 PSA tests since and it's been undetectable
I’m researching for my hubbie as he’s a bit in denial. He’s Gleason score 8 as well and recently diagnosed and trying to decide what is best for him. I’m interested to hear why you’d be downgraded and how that can happen? You’ve had no treatment at all then? Are you being monitored as surely the cancer is still there? Thanks for sharing… very helpful.
@@RhondaMcL1I was diagnosed with Gleason 7 , after my surgery it showed I had Gleason 9,my urologist said he was surprised,try to get psma scan too be sure.
@@RhondaMcL1doctor told me biosy does not catch everything so when prostate is out they send it to the lab and disect it and get a more precise diagnostic or gleason number
Hubby had RALP procedure in the end. Just last week! We will get results in around 6 weeks. Hopefully, if it ever returned he has other options like hormone treatment. 🙏
This channel has been and is a great source of information I trust. In this video you spoke of a PCRI test. Can you explain what that is please, I was diagnosed with what the dr said he was 54% sure it was cancer. A fushion mri showed two - 2mm spots and one further 2mm spot on the wall of my prostate. He ordered a biopsy immediately as many other doctors had suggested earlier, just based on my psa of 10 once after I’d had a catheter for several days. A retest with the VA urologist showed a 5.5. I have not gotten the biopsy as I’d heard on your channel about the EXODx test. In the waiting time since last October since cutting out 98% of all animal products & coffee, & waiting to get in to a dr who would order it this urine test, I hardly ever have any discomfort when urinating where before it was most always painful.
In August 2007 I got a private health check and my PSA was 5.64. Early this year 2023 I went ot the doctor for frequent visits to the toilet during the night and the doctor took a blood sample for a PSA test which was foun to be over 10 at 11.5. So my PSA went from 5.64 to 11.5 over a period of 15 to 16 years during which I have been very healthy other than the frequent visits to the toilet during the night for a wee. Anyway this was followed up from early this year ...scans, biopsy etc to find that I have Gleeson 4/3 and now I am on Hormone therapy for 6 months during which I will receive radiation therapy over 3 weeks. My testostorone level is going down and I feel aged, body sweats and fatigued. I read that my PSA should come down to near zero after Ratiation Therapy, but if it goes up slightly, I could be back to square one as it indictes that the cancer could still be present. Is there no escape for this nightmare?
1) Twelve years ago, a Urologist decided that I have prostate cancer and I should schedule a surgery. But I did nothing. 2) Two years later, I went to another urologist who told me that I just have a large prostate and gave me some medications. 3) Two years later, I went to another Urologist who told me that I have a low-grade prostate cancer, and I need to go to him a couple of times a year for monitoring. 4) Four years after that another Urologist told me that my prostate cancer has become aggressive and I should schedule a surgery. 5) Two years after that another Urologist advised that I should at least have Hormon Therapy. I finally gave in and started on Hormon therapy. 6) Last year, another urologist advised that I should have radiation but not hormon therapy. 7) This year an Oncologist tells me that I should have radiation together with hormon therapy... I am now on Hormon therapy - because my wife insisted that I should do it - and am hesitant about Radiation therapy. Except for going to bathroom, 2 or 3 times a night, I have not seen any other symptoms or problems. I am now 84 and do not want to live beyond the age of 90. I am told my Gleason score is 9. With this background, should I do a) surgery, b) radiation, c) Hormon therapy, or d) none of the above - because there is no clear-cut answers plus I do not want to live beyond my 90th birthday?! My PSA ranged between 3 to 9 during these years, but it went back to less than 1 since I began the Hormon therapy.
You’ve done well hanging in after 12 years. I started with Gleason 9 (5+4) Sept 2023 with PSA at 310. Starred with immediate HT, followed by Chemotherapy and Darolutamide. PSA at January 25, 2024 now down to 0.44. Given 4-6 years. So, if it works for you, that should take you to 90 +.
I'm in a bind. First off, thank God for these Prostate Cancer Research videos and Dr Scholz' unbiased insights. Which leads me to my predicament - something I think many reading will find themselves in a similar situation. I just turned 54, never needed to take any medications (why do all these doctors look at me strange when i say that?), and very active, workout at least 4 days a week and eat well. In 2019 an annual physical blood test showed a 1.7 PSA. Then in 2022 it was 4.2. So, my doc referred me to a urologist, which I said I thought was possibly raised due to my avid cycling and especially since I did a 40 mile ride a day before blood test (I didn't know it mattered). So he said we'd wait 6 months to do another one. Well, it went down at 3.7. So, we waited again another 6 months. It rose back up to 4.3. That led to an MRI (2t) which showed a single left side lesion Pirade 5 that then led to a biopsy (yay, fun). That showed only G6 primarily in that single lesion - nothing on right side - but a few cores of 3+4. So even though a majority is 3, there is a tad 4 which basically means I am intermediate risk 2b. Okay, fine. So now what? My urologist is a straight shooter and seems to have no bias in this. The doc that did the biopsy suggested if they find anything to just get it taken out and that since I'm so young still it will be fine. My urologist sent me to 3 different specialists to evaluate my options. The doc I saw today is a radiologist and was clear to me was pushing me into SBRT/EBRT and actually even leaning toward removal with his recommendation doc. Same thing said as the biopsy doc. But I know 2 people who've had theirs removed years ago and regret it bigtime due to the inconstancy. I can't imagine pads for life. But I've watched every video from PCRI here on TH-cam and Dr Scholz very clearly implies someone in my situation to NOT do a removal because the tech is so good now. The question that keeps coming up is with HIFU/TULSA the failure rate after 5 years or so. But I'm even getting conflicting answers on that due to new tech. (Focal 1 machine?) Since I'm in such a low grade situation, I don't have a gun to my head on this yet. I'm hoping the tech advances fast enough to make this decision much easier, but I really don't want to do a removal for all the reasons we know. These docs who are pushing it - and I'm wondering if there is some vested interest in that the places I'm going to are pretty much set up for that - don't have to live with the consequences of it like I will. Seriously, are these TULSA/HIFU options really that good and worth it? And the failure rate? What issue is that with today's tech? Thanks!!
My urologist told me he would never consider removing my prostate. I got radiation and everything turned out fine. It really wasn't even that bad. My PSA was 60. Took about seven weeks
It’s a gamble but I’m leaning towards Hifu (3+4=7, 63 yrs , 6 positive on one side, PSA 7.2/ 4.5/6.2 & last week 5 since last Dec. Still waiting to see an oncologist/radiologist as I was not interested in RP. Now my Dr has retired & waiting again to see who replaces him (Canadian, so stand in line in this regards) My hope is that even with only 5 years until a possible repeat after Hifu the way AI is advancing (I’ve checked multiple sources regarding where the money in cancer research is going, this in the millions of dollars) there may well be something on the horizon that’s worth this treatment & as it were just kicking the ball down the road… Right now I’m making dietary changes & keeping up on my PSA checks. Cheers
Here's some first hand results I've had while I'm in practically your same boat. I spent an hour with a doc here who does HIFU. She swears by it, but admits its limitations. Tulsa Pro I think is going to end up the gold standard due to it extreme flexibility in its ability to reach the entire gland and ablate at much higher degree the cancer without the surgery problems. Dr. Scholz says as much regarding surgery. My doc jumped right to that suggestion because that's what he does. His practice isn't set up for this new cutting edge stuff. I'm switching networks because of it. But I also changed my diet. And boy oh boy the results! I might not have to do anything. After a solid 6 months everything appears to be subsiding. My doc doesn't believe it. I'll post if you're interested. @@Jack-2day
@@smoknvader9127 I totally agree with the way you are making changes regarding what you’re eating. Low carbs & the proper begs & fuits. For information regarding Tulsa pro/Hifu there are some recent reports on Pub Med Cheers
I was told Gleason 6 “you have lots of time, active surveillance will be just fine”. I said no I want it gone, by the time I got the referral and an appointment with the doctor it had been six months. He wanted an MRI biopsy, in that time I had gone from “mass” the size of a dime, to two. One the size of a nickel and the other about the size of a quarter. And the doctors said “that shouldn’t happen, you don’t have small cell carcinoma”. Had I listened to the first doctor it could have catastrophic. Do research, remember most doctors want to protect their own interests. Radiologist want you to do radiation, surgeons want to do surgery etc. The radiologist for example may not go in-depth on the chance that radiation could lead to another cancer (bladder,colon) in 10 years or so. I mention this because two friends that I met during my journey did radiation, and one ended up developing bladder cancer, and the other colon cancer.
Diagnosed June ‘21 - Gleason 9. Started ADT end of August, IMRT early September for 5 weeks. Brachytherapy 2 days after radiation ended. Ended ADT Aug ‘22. Took this approach /timing after consulting with Radiation Oncologist, Urologist, and Primary Care. Do your research, listen to Drs you trust but, gain a good understanding, on your own, of latest studies and therapies. Always appreciate your videos. Thanks.
How are you now? I’m Gleason high 9 - 5+4 advanced but localized (psma pet negative) ADT last month, imrt now - just completed first week. Want the least ADT as possible still looking for cure not only managing.
Thank you for this info. This really helps caregivers that care for a family member with cancer. We deal with so much stress waiting for the next dr apt or test results.
An MRI Feb 22nd 2023 showed I had a small area (anterior apex of the prostate) with cancer. I was scheduled for a minor op March 1st and the anesthesiologist refused it due to heart problems. That ended up with a heart ablation April 22. About a month later targeted biopsies showed I had Gleason 4+4 with 5% abnormal cells in the biopsies. No cancer in the 12 random biopsies. The genetics of the cancer put me on the low end of intermediate risk. My own genetics has no mutations that encourage prostate cancer. A PSMA PET scan showed cancer only in the area indicated by the MRI, with no metastasis. I have a large prostate due to BPH (149 mL). Researching I hit a roadblock. My urologist thought me a candidate for focal treatment and referred me to the Mayo Clinic. They do not accept Medicare Advantage so I have not been able to schedule a consultation. I can change to straight Medicare, but cannot get a Medigap plan because I have a pre-existing condition. So to change to insurance Mayo will accept I have to pay 20% of all future medical bills (this year just the heart ablation and PSMA PET scan would have cost me $30K if I just had straight Medicare and no Medigap). What if I switch and cannot get the focal treatment? Another complication is I self cath (CIC) due to bladder injury. This is likely to cause problems during EBRT. A supra pubic catheter would probably lead to sepsis. I would need hundreds of seeds for brachytherapy so that is not an option. I feel like I am stuck in a loop, wanting to protect my quality of life (I am 75 so not much longer to live) but not ignore the cancer with roadbocks to getting the information I need. This video was very helpful because it suggested ADT might help (maybe I will get a soprano voice and regrow my hair to compensate for the lack of sexual interest).
They’re watching this video. I feel a heck of a lot calmer. Thank you. It’s good to know that I have time to make a decision. I’ve had a MRI and they found a lesion. Next thing is to get a biopsy. But they’re so backed up I’m gonna have to wait at least two months. Now I know that that’s OK. The cancer doesn’t spread that fast. Thanks again again great video.
This Site (She and Dr.) asked ALL the Right/Focused questions! PSMA PET Scan is Key today. Know your Urologist and how CURRENT they are. Mine saw my .3 PSA for 8 years jump to 2.5 and then Immediately Ordered a 1) PSMA Scan. 2) Biopsy 3) Cryo ... because my first prostate cancer treatment.was Radiation. 2nd Opinions greatly appreciated. BTW Dr.... Love that Tie!
I was diagnosed with non invasive bladder cancer in 2015 and had TURBT then and again in 2017 after a regular schedule cystoscopy show new tumor. I had a course of BCG in 2017. In Jan 2019 due to a high (8.3) jump in PSA that was always under 2.5 I had a random biopsy and was diagnosed with 3+3 Gleason 6. 7 positive cores with less than 5% of core malignant. In March 2019 I had a T3 Multiple Parametric MRI and a small tumor 3mmx5mm lit up on this test. A targeted biopsy was indicated but never happened and I stayed on active surveillance along with bladder cystoscopy. PSA went back down to under 2.5 every 3 months at the lab. In Dec 2022 I was diagnosed with bladder cancer CIS with very aggressive pathology and after 3 consultations, all recommended cystectomy. They all said my case involved BCG failure and did not recommend any other treatment than surgery to remove the bladder and at the same time take out the prostate. I am 76 years old living alone with no assistance and by the way I had a total R lung pneumonectomy in 1988 and never had chemo or radiation and lung cancer did not recur. The 3 doctors all said as well, I did not have to have the surgery in a week or 2 but take only a couple of months to decide and only having one lung with COPD they all said I would need a workup by many specialties to see if I can safely withstand 5-6 hours of general anesthesia. For the removal of the prostate and bladder and additional time to construct an Ileal conduit ending in a right side stoma. I am a veteran and they authorized community care to have this done and I had my choice of of hospitals and surgeons, outside as long as they would take payment from VA, which is about same as Medicare would pay. I decided quickly on the surgery, within a matter of weeks but had to find and Elite high experience urology robotic surgery. I ended up going to the smallest hospital of the 3 I visited. It was an hour from home. The 2 hospitals I did not got to were the larger cancer centers. I chose the surgeon over the modernity of the hospital facility. The surgeon I picked had more than cystectomy operations. Men from all over the world come to him for the treatment. He had been at the Cleveland Clinic for over 20 years before moving down to a smaller hospital to start a new program a few years back. I had the surgery May 12th 2023 and today I am doing fine and again living without assistance. The home health company ended their contract a month early due to my speedy recovery and ability to change urostomy pouching system on my own. So this was a long story BACK TO THE PROSTATE. My cancer was confined to the organs and there was no evidence of spread but the prostate tumor and grown significantly since 2019, but contained in the capsule and my Gleason score went from 6 to 7, a 4+3 on post surgery pathology. I had T2N0M0. My first PSA since was 0.01. Thanks to PCRI. I watched since 2019 and still watch.
Such good information, it has really been helpful for me. I am at the beginning of this journey, I am scheduled for a biopsy next week for what appears on MRI to be a PI-RADS 4 lesion. Thanks to your channel and some others, I am well armed with information and I am quite confident that I will make a treatment decision, if I need to, that will be the best decision for me and for my spouse. THANK YOU BOTH for your wonderful videos!! ❤❤😊😊
I’m curious to know how your treatment turned out and what you chose. I just was diagnosed with a four lesion as well. I am very scared but would love some information.
@@troyelam8978 fortunately my 26 core biopsy was negative in spite of how it looked on MRI. If I had had to choose treatment, I was leaning towards either TULSA-pro HIFU (if I was a candidate) or HDR brachytherapy, my goal being to try to preserve my sexual function as best I could and minimize the urinary side effects also. Fear I completely understand, but prostate cancer is NOT like other cancers for the most part. Take your time, because you HAVE time, and don't let ANYONE talk you into a treatment that will have dramatic and irreversible side effects. Best of luck to you, please keep us posted on your progress.
@troyelam8978 my biopsy was negative in spite of the MRI so I fortunately did not have to have treatment. If I had had to choose I was leaning towards TULSA-Pro, or HDR brachytherapy. Fear I completely understand but, as the above video shows, you HAVE time. Don't let anyone talk you into a treatment with severe and irreversible side effects unless you decide that is what's best for you.
12 years ago,I underwent robotic prostatectomy for recalcitrant prostatitis and recurrent obstruction after a TURP. Multiple biopsies were negative or just carcinoma in situ. The path showed that I had a 1.5 cm carcinoma that was undetected. Biopsies completely missed it, even under MRI guidance. The last 12 years have been spectacular. No obstruction. No prostatitis pain. Complete continence. Meanwhile, my 52 year old neighbor is in the last innings. His PSA is climbing despite hormonal deprivation RX, with Mets to his spine and pelvis. If you have a cancer, treat it.
@@stevequinones6640 Between age 50-55, I had severe prostatitis and progressive obstruction. My PSAs were in the 5-8 range and biopsies were negative. The TURP was a disaster- had to return to surgery for profuse bleeding, and I bled for 6 weeks intermittently. It did give me relief from the obstruction and pain for 3 years until the prostate regrew to tennis ball size, and the scenario repeated itself.
While working Kuala Lumper I was diagnosed with prostate cancer after bloodwork was done to check immunity cover. Went through numerous tests having scans etc., and a surgeon was chosen to carry out the operation using instrument surgery. Then came a complication with my company's insurance cover. Though being able to return to work quick have this type of surgery the insurance company did not to cover the operation cost yet would stand the extra cost of a longer recovery stay in hospital. Doing the math's, one cancelled the other out plus taking the extra charge operation would have me back to work earlier. On check in day this still had not been settled but I was prepared to pay the extra but would challenge the extra stay in hospital against the insurance company. They then agreed to pay the extra operation charge. The cancer had shown on the wall of the prostrate and so radiation treatment was needed. The insurance company again did not want to pay, but I claimed that there delay in OK ing the operation could have caused this. I suggested my company change insurers as they were not working for the good of the company employees. Thankfully all tuned out fine for me HealthWise, the company did get a rewrite of insurance cover because of my case.
My husband was diagnosed with Gleason 6 last year. Went in for his annual prostate MRI and it had 3 liaisons on the left hip bone.... he then had a PSMA scan and only one of the liaisons lit up and nothing anywhere else in his body. He has appointments with both a Medical Oncologist and Radiation Oncologist Sept 20th. He goes to the Mayo Clinic, Phoenix. Oh and by the way he had a heart transplant 2 years ago this August, so is on some major anti-rejection medicines.
Dear Alex, Well done discussion and evenly weighted. As a lifestlye med physician, I have seen an almost universal reversal of trends when patients add stress reduction, diet and exercise to their treatment protocols. Keep up the good work,. Cheers from New Zealand
I am wondering what part of NZ you practise in. My husband had RP using robotic surgery privately in the Sth Island in 2022 and now has a rising PSA. I am researching the things you mention- dietary changes, exercise and stress reduction. I want him to have a second opinion from a Dr who will at least discuss the lifestyle changes as his current consultant dismissed anything I suggested as apparently 'no evidence' apparently yet lots online. Observational and convincing. The consultant did say some men in my husband's situation their PSA level plateaus but he did not know what they did if anything for this to happen. It is documented that people don't tell their Dr if they are using alternative treatments, lifestyle changes taking supplements etc. Research is needed but ? funding comes from. It is a waiting game until his PSA rises to 4 before he gets a PET scan. From what I listen to online a PSMA PET scan is now being done at the same time as a high grade MRI. No biopsies as can seed the cancer.
Very informative video. Sir in 2022 i was dignosed prostate cancer on the basis of biopsy reprt with gleason score 8. Doctor prescribed harmone treatment eith tablet cslutamide one daily a d one injection pamorlene once in three months..Now in April 2023 i hve been operated with procedure TURP. Presenltly i have been advised to get the injection once in three months only. My PSA reprt is 0.36 Please advise how long i should go with treatment a d what will be the side effects
My dr was angry that i had any questions about prostate cancer when i came in with the knowledge i learned with this channel..pushing for biopsy..she knew my mri showed a 60cc prostate and my psa was only 4.8 wellv within the psa density range that she didnt seem to know about when i told her
I was 3+4 and waited 8 months before going with radiation. My psa was a little above 8 when diagnosed, and went a little above 9 while waiting 8 months.
For me with Gleason 9, I wanted to get going. By the time I was able to start the Lupron injections and radiation, five months past by. So if one waits say three months then add other delays for scheduling etc to fall in place.
It took over three months to get all my medical clearances after the biopsy came back 3+4. Intermediate cancer. My holdup was the cardiologist. I just needed a clearance, but he was convinced I had heart issues, and ran every test in the book, and found nothing. I have great insurance, and I think he was taking advantage of the coverage. Even after he signed the clearance, he wants to more follow ups. I will cancel before I will go back to him.
@@johnthompson9441 good luck with everything ,my confirmation biopsy came back as gleason 6 with 3 cores out of 13 ,1 had 5% the other 2 had 1%,this was a lot less than my first biopsy which showed 9 out of 17 had gleason 6 and they were 50%
@@MyFrank71 Interesting! My first (only) biopsy found high volume Gleason 6 cancer in 1 core (55%) and also cancer in all of the right side cores. I am scheduled for a PSMA PET CT scan. My PSA was 9, but my free PSA was .9%, which was very low (not good). My MRI showed Pi-Rad 4 lesions. I would like to get a Decipher test before making a decision on treatment. Maybe another biopsy would also be useful.
I was diagnosed with a Gleason 6(3+3) about six months ago,I have a PSA level 3.79 on my last blood test. My doctor's recommendation was HIFU.I choose an active surveillance for now. What do you think? Did I make the right decision to stay on A/S? I am 73 years old. Thank you for any advice you can give me.
You definitely made the right decision. The PSA is low, the Gleason 6 means "nothing". Your cancer will not harm you in the long run, let alone killing you. I quote this, and you can search for it: "Currently, such abnormalities are classified as “Gleason 6” in the scoring scale of prostate cancer grades. However, some urologists believe they shouldn't be classified as a cancer at all because, though highly unlikely to kill, the label causes distress and influences patient decision making."
I was a 15.5 PSA with a Gleason 9 four (?) months ago and was shocked at how glacially slow everything was going. But I just kept telling myself, "Just because this is your first rodeo, cowpoke, doesn't mean it's theirs!" For example, my first check-up after completion of radiation treatment is a full two months down the road after we're done. Today was my first radiation treatment. Went very smoothly. They know their business. "Wow!" I said when I first saw the machine. "That must be worth at least $750,000!" It made an MRI look antiquaited. "It's $3 million," said my attendant. "Your figure barely covers the upkeep."
My husband psa level was 3.1 ten years ago. But recently it shows 16.57* Now, he is 73 years old. MRI reveals Pirads - nodules in the transitional zone bilaterally as described. Apical region of the transitional zone representing Pirads-3 lesion. Here what's your suggestion for our further action please?
Is it possible for you to cover the rare prostate cancer and are there any clinical trials or research on the rare form of prostate cancer? My step father is out of options and running from one clinical trial to another at Stanford University.
I was really not told much about my prostate cancer. Blood test showed a PSA of 5000. Then a CT 4:36 and bone scan. byopsie in my back. Just told there was nothing that could be done. Did start me on a hormone treatment the ssme day they said I had "terminal" cancer. Not told how long I might live. Never tell me snything. At 75 the hour or day long sweats are killing me as I have a bad heart and pacemaker.
I had cancer on my prostate and my lungs I started taking Myrrh gum capsule and the cancers where surrounded by the myrrh and dried up that has been over eight years ago I'll be 91 next month , you can't let the cancer get to large .
Last year my Gleason score was 3-3 but this years biopsy it was 3-4. So it seems it's getting worse and not staying the same. Any guess in how long out I might need surgery or radiation?
That’s something you and your doctor need to decide. I was diagnosed last year with cancer went through all the different things had a biopsy came back 4+3 aggressive caught it in time that I had a choice between surgery or IRMT radiation and hormonal therapy . I chose radiation. Went for my check up a few months ago and it’s in remission and I don’t have that weight on me anymore. Good luck with your decision you’ll do what’s right for you .
My experience with a score of 3+4 was that it is best suited for Cyberknife treatment from a reputed radiation oncologist. A PSMA PET scan can confirm if it is localized and that should make it easier to decide the treatment plan.
I had a 3+4 intermediate cancer biopsy. At 72 years of age, my radiologists said he thinks he can treat it, and it should work. Not the words I wanted to hear. Also due to the size of my prostrate, they would not be able to protect the colon. I decided to have it removed, and pathology came back that it was bulging and getting ready to spread. I have not regretted having it removed.
Remember there is some subjectivity to biopsy tests. My first reading was a Gleason 6, but then they looked at the same test results in Jacksonville Proton Clinic, and they said I was a 3+4, so it can vary depending on who analyses the biopsy results. I decided on Active Surveillance for now. So far my PSA has been staying below 4.0. Will make a decision if it rises (testing every 3 months).
i was diagnosed 6 months after my first biopsy because they missed the cancer , the first psa was 5 then the second was 10 , my gleason was 9 , I had seed implants , radiation and hormone deprivation therapy for 2 years , its 2 years now after completion of the treatment but over the last 6 months my psa rose to 0.05 , then down to 0.04 and now up to 0.06 , the doctor wants to wait for another 6 months to see where it goes before considering any further treatment , the first time around i was nervous and just went with what they said but i've come to accept things now and am fine with waiting to see where the psa goes , im just hoping it a radiation bounce and not recurrence
In 2005 my health check showed -psa =7. I . At that Time the superbugs were prominent and a highly advertised died after a biopsy. I was concerned and asked my doctor for an alternative to biopsy. He must have thought I meant I did not want any treatment. My psa rose while watchful waiting ro 12,15, 21,29 with me not understanding the importance. I had no symptoms for 10 years until I started to getting so,e minor back aches. After 11 years it was bad and I had CT scan which showed psa of 9000, extensive bone metastases and lymph nodes and I was referred to an Oncologist. I refused Chemo and was given ADT-Zoladex and Casodex. after 4 month I felt much better and cancer in Lymph nodes were resolved. bone metastases were less obvious. Psa was
4 years ago a doctor told me I had prostate cancer. He was going to do the random biopsy. I refused and fought for the MPMRI. Good thing, over the years where I had, had hernia surgeries, the mesh had come out and migrated into the prostate, uretha tube and the sigmoid colon. After a 6 hour surgery to remove and repair all this, psa levels came down, I got well. Lesson, ALWAYS ask questions, and do your own research. You are the only person living in the body you got, and you know it better than any doctor.
Interesting! I told my Drs I had hernia mesh in my abdomen 20 yrs ago. I had sudden onset bleeding with clots and they said it's just BPH thus far with a CT scan pending for my bladder. I do have an upcoming MRI with the VA. Any specific questions, would be appreciated. I had two lower inguinal hernias, second was a repair too but no mesh use there if I recall. Thanks for sharing!
@@Frogman214and ko ji❤
In November 1995 a doctor told me to get ready for death because of prostate cancer.
Four months later I ran the 100th running of the Boston marathon.
Are there any studies being made on exercise and the effect on psa testing?
They do advise no bike riding, extreme exercise, even sex two days Before, if I recall a PSA test is conducted. Don't know about any specific exercise studies conducted. @@jcolumbiap
@@jcolumbiap+ Look up MCP.
Dr. Scholz is the only Urologist I've met that I respect. Diamond in fields of rough.
Hello. He is an oncologist not a urologist as far as l know. With my regards.
Another timely and compassionate discussion....thanks
This channel is invaluable! After my PSA went from 4-6-7 over two years I went in for the 3T MRI. ONLY after that showed a lesion (tumor) did I get the Biopsy. The Biopsy came back as a 3+4=7. The urologist recommended surgery in 2 weeks. (They are surgeons, so of course that's what they recommend!) I took the advice of THIS channel and got a 2nd reading on the biopsy. (That's right guys, reading a biopsy slide is subjective NOT objective). I sent it to John Hopkins: It came back as a 3+3=6. THANK the Good LORD, I didn't listen to the urologist!! Then the radiologist I met with, recommended Radiation. (Of course he did! Lol...) BUT he doesn't do Proton-Beam because that's a completely different type of radiation and he's not trained in it. So, off I went to consult w/ a Proton-Beam specialist. The point is this: We have time! SLOW-Down~~~~ The Proton-Beam staff has me scheduled for another 3T MRI AND they want to read my Biopsy slides also. They aren't rushing me into anything....I like that.
As I know, a Gleason 6 "cancer" never advancing enough to cause any harm during patient's lifetime. Some doctors even wanted to reclassify Gleason 6 to some kinds of irregularity than cancer as I quote here and you can search for it: "Currently, such abnormalities are classified as “Gleason 6” in the scoring scale of prostate cancer grades. However, some urologists believe they shouldn't be classified as a cancer at all because, though highly unlikely to kill, the label causes distress and influences patient decision-making."
So, IMO, you should not get treatment at all, active surveillance is all you need.
You should read other comments below to see people with Gleason 6 went with active surveillance for 12 yrs already, and it is still okay, as Dr. Scholz said clearly: Gleason 6 patients can postpone treatment indefinitely
How long is the recovery if you get surgery for Prostate?
Everyone is different. And from what I've read, 35% of patients who do the surgery, THEN require radiation down the road too. Dr. Scholz no longer recommends surgery and I'm not doing it. Radiation (both standard and Proton Beam have made HUGE strides in the last few years. My recommendation is to read: "You Can Beat Prostate Cancer: And You Don't Need Surgery to Do It" by Robert J. Marckini BUT get the updated 2nd edition! It's much more current from the 1st edition. Hope this helps~~@@ricardoabella1436
I had gleason 6 and one year later went to 7 I had surgery then. My psa is still undectable 7 months later
By far, the most credible source of information on prostate cancer. I've watched numerous TH-cam videos on the subject, but I can't recall any other website. Both Alex and Dr. Scholz are incredibly enthusiastic, dedicating substantial effort to providing global awareness. Cheers from Sydney, Australia!
I watch a lot of TH-cam videos.I prostate cancer by learning one thing. Most of these videos are sponsored byesterday by the medical profession. Different medical groups. So they will always be positive. You have to find the ones that are individually posted. And not sponsored by a medical group.
This Lady Presenter is truly excellent ❤
I’m an internist. This guy is spot on. I’m going to save this for my patients.
My urologist is pushing real hard for surgery, right now. Go on some hormone therapy and radiation and scaringvme that "it's probably already in my bones." Of course: I have a PSA of 69, and the mri is showing some "lesions" inside the prostate. Should I get another opinion? I don't even know what a Gleason score-is. Your thoughts..
@@allenvaughan1 This is old, but always get a 2nd opinion from a valued facility. Maybe even a third opinion.
😊@@allenvaughan1
I was diagnosed with Gleason 6 in 2011 when I was 61. First biopsy showed cancer in one plug out of 12 and second biopsy showed no cancer in any of the 12 plugs. I was ready to pull the trigger on seeds, but then my primary physician told me to cool my jets and explained active surveillance to me. It has now been 12 years since my diagnosis and my last PSA reading in June was 5.3. It has brought me a great feeling of relief to hear Dr. Scholz's opinion on not needing immediate treatment on Gleason 6 and the benefits of active surveillance.
I have a friend who was diagnosed at 60 with prostate cancer. He had nothing done…He died at 86 from pneumonia.
Are there any symptoms of prostate cancer ?
@@jamescalifornia2964 none, other than the slightly elevated PSA. I do have an enlarged prostate, but that's common among 73-year-old men.
No. That's the "problem". It's a silent killer. BUT it's a SLOW cancer. Very/VERY Slow. Watch ur PSA. If it gets over 10....or you see it consistently "jumping" like mine did. (4, 6, 7---over 2 years) then you schedule a 3T MRI. (NOT a standard MRI...must be 3T). ONLY if that shows a tumor (IMO) do you go for a biopsy. @@jamescalifornia2964
@@jamescalifornia2964 Symptoms are mostly as BPH symptoms if there are any. Many patients have no symptoms.
Thank you so much! I can't tell you how much bad information I have received from urologists over the years. I am so happy that I didn't pull the trigger on treatment with Gleason 6. You are doing a true service to humanity.
I quote here and you can search for it: "Currently, such abnormalities are classified as “Gleason 6” in the scoring scale of prostate cancer grades. However, some urologists believe they shouldn't be classified as a cancer at all because, though highly unlikely to kill, the label causes distress and influences patient decision-making."
I was just diagnosed with Gleason six what should I do
@@VictorDeLaCruz536 Definitely choose "active surveillance" and get on with your life. Choose treatment is not wise in your case.
I too have a Gleason 6 and was directed towards robotic surgery. Having stumbled across this amazing channel I am now doing more research and asking more questions. The biggest worry to me is that my report says I have 90% in one chamber. I definitely need to do more research.
What does it mean "pull the trigger" please clarify.
I just went for my Biopsy today, It went well a bit painfull. Now I can talk about it with first hand knoledge, My psa 8.75 it was 3.5 in 2019. I didnt know I had growing psa untill February this year I have a small prostate. I waited to get the biopsy . DRE in February was indicative of a small nodule on the right side. I feel mostly very good, except for today. Every one have a blessed day
I want to thank you so much for these videos. I was diagnosed with Gleason 4 + 3 last week and I went into full panic mode. Your wisdom and expertise have helped me tremendously
Gleason 4+3 isn’t a death sentence but it does require treatment. I hope you won’t ignore what’s happening in your prostate on the basis of what is posted on the internet.
Edward. What treatment did you decide to have?
I have spoken to three radiation oncologists and two surgeons. Every one of them have said “do surgery.” So, going to have the surgery (not scheduled yet)
@@edwardreiller6269
Hi. I was just diagnosed with Gleason 6 (3+3) cancer. My PSA was 9, but my free PSA was .9%, which was very low (not good).
My MRI showed Pi-Rad 4 lesions.
I had a transrectal biopsy and they found high volume cancer in 1 core (55%) and also cancer in all of the right side cores.
I am scheduled for a PSMA PET CT scan -- I hope my insurance covers it. You never know.
I also hope to get a Decipher test before I make a decision on treatment.
I am 54, so the risks are higher for me than older patients.
I haven't decided a treatment yet. If I had 4+3, I would be more inclined to get surgery than 3+3. But I need to know more about my high volume cancer, where the tumor(s) are located, and maybe the Decipher test.
I think volume, location, and age are also factors.
@@edwardreiller6269 Edward I hope you r doing ok. How was your surgery? How are you?
Doc’s got some great ties! I went to Moffitt Cancer Center in Tampa today, Gleason 7. However they’re looking at my slides again to be sure my biopsy was interpreted and graded correctly. If it downgrades to Gleason 6 I’ll likely go to Active Observation. If not I’ll be treating with SBRT, no rush into it, and they’re the third oncologist I’ve spoken to! @Prostate Cancer Research Institute has been a tremendous resource for me!
I did my biopsy in Moffitt Cancer Center recently, and my Gleason is 7. I am in the process of evaluation what kind treatment I should take. Your sharing here is great help and I hope can get more from your experience.
@@NancyNie-ri6gq if you have any questions at all, I’m nearly four months out from treatment and my numbers are right where they need to be! I’ll be happy to try to answer any questions that might come up with you.
I had a psa of 9.5. Tests showed a small but aggressive type of cancer. The surgeon was very pushy. So, I went for radiation and no hormone treatment. After treatment, I was 1.9, 12 months, 2.7, and 18 months, 3.5. So, I have been a bit worried at the rise in PSA. However, after watching this session, I feel so very much relaxed with the future. I am an active and busy 71 year old. Thank you.
The average PSA for a 70-year-old ranges from 0 to 6.5. I'm 73 with a PSA of 5.33
I’am 68 was diagnosed a year ago with high PSA .had biopsy showed aggressive 4+3 Gleason had 43 rounds of radiation and hormonal therapy went for my check up PSA is almost undetectable. I’am living a life without the fear of cancer it’s in complete remission . Some people like to gamble or pretend they don’t have it,but it’s not going away if you don’t treat it properly. This video is telling you to research your options before making your decision,then make your decision based on your choice. Good luck to everyone who is going through this journey ,there is hope and great outcomes. 👍
At age 72, my Gleason score was 3+4 intermediate cancer. I chose surgery, and the pathology report showed it was bulging and ready to spread. It was removed just in time. PSA test now show a score of .1
One of the things that Dr. Scholz knows from his experience is that prostate cancer in the aging male is ubiquitous and most of the time it will not harm us in our life and we'll die of something else. He absolutely wants us working with our doctor on the issue, keep on top of it, and make good decisions. But, if you go to him or doctors like him, he's likely to also ask you about more dangerous aspects of your health. I've been to their office, I currently don't have prostate cancer (but if I live long enough I'll highly likely to get it), and their office ended up prescribing me a coronary calcium test... So, what's the lesson there: Yes, keep an eye on your prostate but don't be myopic about it. Losing track of other aspects of your health may be more dangerous for you than prostate cancer. Keep an eye on heart health!!
Prostatitis seems much more common ... 😩
@@jamescalifornia2964 Agreed!
Thank you very much for trying to help us sir!
Thanks a lot for sharing this aspect of Dr. Scholz office. Yes you are 100% correct. Best of Luck.
Indeed. I'm dealing with high blood pressure, diabetes 2, high tri glycerides and high cholestorl...also have genetic high ferritin. Focusing just on the prostate is not an option.
Great Great Video!! I'm Gleason 8. No spread. I'm on ADT last 10 days. Going to do Radiation in 3-4 weeks. These videos helped me a Lot. You guys deserve a lot a credit. I was scared to death 8 weeks ago. Now I know what to do. Thank you so much!!
Hi I was wondering if you had an update on you ADT treatment and how that is going? I had a prostatectomy in June 2023 followed by a related lymphocele infection that put me in the hospital for 6 days in September and set my recovery back. I'm doing fine now and feel well healed. They found metastatic disease once the prostate and adjacent lymph nodes were removed. My PSA seems to be increasing fairly quickly now. I was supposed to start ADT six weeks ago Abiraterone and Prednisone orally, and Lupron via injection. I haven't started yet because of the fear I have of the side effects and not having a good game plan in place to counter them.
@@steveschram575 I completely the 5.3 weeks of radiation in mid-November. Still on Lupron Depot till August. No complications. The shots do have side effects like hot flashes, etc., I’ve gotten use to it. My blood test was last week, it was
@@steveschram575 Yes, I finished the 5.3 weeks of IMRT. I went to Advent Health just 2 miles from me. Great experience there. Anyway I feel great, everything works good :). I have to continue the ADT until August 2024. Which I have no problem with. I really only have hot flashes with some fatigue. Still way better than surgery IMO. Too many risks.
@@9cyrus540 Thanks for your message. So your side effects from the ADT have been minimal over 6 months? I'm 58 yo. It seems like some of the older guys have severe side effects from the ADT. They want me to do the ADT for two years and six weeks (37) straight treatments of RT.
@@steveschram575 Sounds like you have a very aggressive cancer like mine. I got used the shot within 3-4 weeks. The hot flashes didn't last very long when I got one. But they will continue as long as you get the shots and probably 6 weeks after you stop. You will have no sex drive. But erections are possible as long as you had them before the shots. Now I'm a healthy 66 (my birthday was 6 weeks ago), I work out 3-4 a week, never smoked. I'm not slender, and losing weight is tough on the shots. Some other senior guys may not be that healthy and suffer worse or they are just unlucky. My doctor told me some men get no side effects and didn't think the shots even worked (but of course they do). So I guess I'm lucky. You will need to exercise once on the shots avoid losing muscle. I'm going stay on the shot as long as needed, I cannot take any chances. The trade-off is worth it. What is your Gleason score if I can ask?
Thank you, so reassuring, diagnosed April 22 Gleason 9 spread to bone and local lymphs, hormone treatment only for me, no radio no operations, psa almost zero, feel great, loads exercise, good diet, lifes good, grateful that the cancer I have is prostate and not something else, love your vlogs so educational Phil
Way to go Phil
I have Gleason 4+3=7 intermediate, brought my PSA down from 8 to 6 through Keto diet and exercise from December . Diagnosed w/ cancer in June no spreading serious fasting till radiation Sept 18. If PSA goes lower should I postpone and continue naturopathic healthy path? Also only had cat scan w/ dye should I have a PET SCAN? 3 of 14 biopsies had intermediate. Delay?
@@jameswpurviance7696
Radiation drops PSA slowly , could take years to bottom .
As long as PSA trend is down (could be a bounce up one time but then continues down) ,
Yeah , just do healthy stuff and monitor PSA .
it should eventually bottom below 1 .
If several rises occur , eventually doubling from lowest reading , then at that point definitely jump into the scans & biopsy world .
Keep track as the SPEED of the rises are an indicator of aggressiveness (I'm hoping that you have no rises!)
@@waldipup9010 hi, psa bounces after prostatectomy and radition normal?
my father got the lowest psa read at 0.06 and now 3 months later got 0.08, and last radiation session was in march
@@bradastra6111 Hi Brad . Did he get hormones with the radiation? If so , that's why its so low so quickly , and not definitive of anything . If not , great .
Yes , PSA bounce after radiation very common , and your levels are extremely low . If lowest reading more than doubles at that point new tests should be considered .
But keep in mind that if hormones were given PSA can rise as they wear off and not mean radiation failure .
Hormones temporary effects on PSA complicate the picture .
I was diagnosed with Gleason 6 (3 cores
Did you still eat any eggs, dairy, or sugar? Those still fuel prostate cancer. Alcohol is bad too.
Where did you find that information?
What is an ADT and IMRT? I am diagnosed with prostrate cancer Gleason 7 and now I am doing research on what is best for my condition. 63 yrs old.
@@truthseeker1959 I so agree that alcohol is bad and may have contributed to my prostate cancer. Tobacco is also really bad. I have definitely quit the strict plant based diet and now include a very small amount of eggs and dairy. I eat seafood and chicken and lots of beans for my protein. I also eat a lot of fruit which I know has a lot of sugar. But I don’t think there is evidence that sugar or eggs feed prostate cancer since prostate cancer is fueled by testosterone. So I believe a balanced diet with exercise is an important part of a cancer fighting lifestyle. Sorry I didn’t see your response until now. Best of luck! Michael
@@BravoEstrada-un5yy Definitely watch videos with Mark Shultz and Alex on PCRI. There you will find a wealth of accurate, up-to-date information on prostate cancer. New research is coming out all the time. Also find the best doctors possible because not all of them are current and may not be receptive to the most current research. This has been my experience. Best of luck. Michael
I love this channel and the superb information it presents, but my one criticism is that it focuses so much on the newly diagnosed patients and not those of us who are navigating recurrent prostate cancer.
I was diagnosed in November 2010 at the age of 52 with a PSA of 5.0 and a Gleason of 3+3. In retrospect, I probably rushed my decision to have surgery, but I went ahead anyway. The post-surgery pathology upgraded my Gleason to 3+4. My PSA was undetectable for 54 months after surgery, when it came back at 0.05 ng/mL in September 2015. Of course, having a detectable PSA sent me into a full panic.
Once I had a detectable PSA again, we applied many of the concepts in this video, and we took a much more measured approach with managing the recurrence.
It took over two years for my PSA to go from 0.05 ng/mL in September 2015 to 0.10 ng/mL in December 2017. It took another three years and seven months for my PSA to go from 0.10 ng/mL to 0.21 ng/mL in July 2021.
So for nearly six years, my medical team and I were okay with regular monitoring, doing our best to avoid salvage radiation therapy. But it took only 9 months for my PSA to go from 0.21 ng/mL in July 2021 to 0.36 ng/mL in April 2022. Given the rapid acceleration in the growth of my PSA, we decided it was time to act.
We agreed to do concurrent androgen deprivation therapy (ADT) and salvage radiation therapy (SRT). I had a six-month dose of Eligard two months before having 35 sessions of SRT over 7 weeks ending in August 2022. The ADT knocked my PSA down to 0.05 ng/mL in November 2022, but the dose has worn off and my PSA was 0.13 ng/mL in March 2023 and 0.11 ng/mL in May 2023. Two data points don't make a reliable trend, but we're cautiously optimistic that the SRT is taking hold. (My radiation oncologist said it could take 18 to 24 months to see the impact of SRT.)
Time will tell whether waiting over six years to start SRT with a rising PSA was the wise choice. But I believe that you could make a separate video on this same topic aimed at recurrent prostate cancer patients.
Thanks for all your hard work!
So the cancer had spread outside of the prostate even though you had it removed early. Why would someone with higher Gleason scores even bother?
@@schmingusss I can understand that thought process. As an update, my salvage radiation therapy failed, too, and my PSA is now 0.52 ng/mL, the highest it's been since my diagnosis.
In retrospect, I wish I had done more research and better educated myself before opting for surgery. I was diagnosed on 11 November 2010 and had surgery 4 January 2011. I don't know that I would have come to a different decision, but I would have been much smarter about the disease, how it behaves, and treatment options.
@@1958zed What is your treatment plan now? Did you get any scans to detect any new cancer?
I was just diagnosed with Gleason 6 cancer. My PSA was 9, but my free PSA was .9%, which was very low (not good).
My MRI showed Pi-Rad 4 lesions.
I had a transrectal biopsy and they found high volume cancer in 1 core (55%) and also cancer in all of the right side cores.
I am scheduled for a PSMA PET CT scan -- I hope my insurance covers it. You never know.
I also hope to get a Decipher test before I make a decision on treatment. I also need to know the tumor location.
The high volume scares me.
Thank you for this as the wife of a husband waiting for biopsy results.
Thank you, thank you, thank you. I’ve been diagnosed with prostate cancer in August after having my biopsy. My PSA level was 3.65. Every year I’ve had my pcp check my prostate when I get my physical. It did rise to 1.65 in 2020 and 2021. Last year 2022 my Dr didn’t have my PSA checked but did do the exam and felt nothing. May 2023 during my normal checkup he had my PSA checked and that’s when he noticed the numbers doubled since 2021. I then saw a urologist who checked me and felt a nodule. That led to an MRI in July which on a scale from 1-5 the matter of concern was a 5 and it looked like cancer. In August I had the biopsy and on my birthday in late August it was confirmed I have cancer. I met with the Oncologist in September and he was telling me about the Robotic Surgery and went over what it details. I have up to February 2024 to get myself either in surgery or Radiation. I’ve been researching and talking to guys who’ve had both treatments. The horror of hearing I have cancer surfaces daily but I don’t breakout in tears as much as I did when I was first told. The medical team I’m dealing with are good and are checking on me to see how I’m dealing with it all. I will tell male friends and my son get yourselves checked. Thank u again for all the information I can grab onto within this video.
What did you decide on surgery or radiation? How are you doing now? 68 yr with an MRI PIRADS 5 level and not even a biopsy yet.
@@Gary65437 I chose radiation and didn't miss a beat with continuing living my life. I had minimal side effects only the urgency to urinate often. I did gain weight for I am on the ADT shots but still tightening my diet including more green veggies and less sugar and of course dairy. I just had my second shot of ADT (Hormone Therapy) recently which is a monster dealing with the hot flashes but i do exercise but need to up it some more with lots of walking and including my weights again. I just had my blood work regarding my PSA so I'll be ready to see how I'm doing with that. Keeping my fingers crossed. Overall my life is still good, I'm working and enjoying each day God lets me see. I'll be 69 in August but we have to take the bull by the horns and win this fight.
I had surgery and radiation. I thought I had done so much research that I thought my head was going to explode. I thought I was well informed. Knowing now what I have read since along with what I have been hearing here, I would have not gotten surgery. I was told that if I did radiation and had BCR then it is unlikely that I would find a surgeon to perform surgery because of all the scar tissue. My surgery took place in 2019 and 3 months later I had an elevated PSA then Rad. I had Gleason 9. My body is not and will never be the same although I am enjoying life. I would never recommend to anyone to have surgery again. I think surgery for this disease unless absolutely necessary should be outlawed. Just my 2 cents and THANIK YOU so much for this information. It is SOOOO helpful and I wish I had seen something like this in 2019. Keep up the good work.
Why wouldn’t you do surgery again? What went wrong? 🤔
@@truthseeker1959Don’t you understand they cut out your prostate gland completely, side effects are impotence,loss of bladder control understand now .
Nothing went wrong. Since radiation is as effective as surgery now, I would just do Rad and Hormone therapy. Less side affects.
If you would of had radiation first then needed to have your prostate removed it would of been hard to find a surgeon to do the surgery because of the scar tissue they say. So you probably done the wright thing having your prostate removed because you probably wouldn't be here today if you hadn't had the surgery first.
Be sure to research hormone therapy and pick the right drug. Hormone therapy can have some nasty long lasting side effects. Surgery even for a 3+4 can have great results if done properly.
Thanks so much for this I've just been diagnosed with prostate cancer gleason score 3 +4=7 I feel a lot calmer now because I've time to do some research. 👍
Same. And just got a 2nd reading on my biopsy slides by John Hopkins. It came back as a 3+3=6!! And I also highly recommend reading: You Can Beat Prostate Cancer" by Robert Marckini 2nd edition. Excellent resource.
@@peterb2346what does he recommend?
What an amazingly clear, concise articulation of how to proceed with treatment planning decisions. Recent diagnosis of unfavorable intermediate Gleason 3+4. Urologist was kind, but brutally un-sparing in describing my postoperative quality of life with surgery. Told me both nerves have to go, and post-op ADT, referred me to a radiation oncologist. I'm 65. Nothing matters more to me, at this stage in life, than the quality of life I may have left remaining. I absolutely cannot imagine living any longer without sexual function or urinary continence, but those are the choices I face. It seems to me like the cure is worse than the disease. I've never been so devastated by any loss I have ever faced in life. People who minimize the trauma of prostate cancer (Oh, just have it removed! You'll be fine!") have surely never faced it. Time in making my decision r.e. surgery vs. radiation seems like the greatest luxury. Thank you for this erudite elucidation. ❤
John you need to find a new urologist. A 3+4 gleason score is better than a 4+3. Both equal 7 but the 4+3 is more aggressive. Not sure where you live but if you are in a rural area find a urologist. In my area the surgery is via robots controlled by the doctor of course and patients are home the day after. I am a bit older than you at 73 and on my last biopsy one core had a Gleason score of 4+3 indicating nerve involvement. I requested a PSMA Pet Scan and will be setting that up next week. That scan should show if the cancer has spread beyond the prostate. If it has my conversation with my doctor will take a different path. Good luck to you.
I was just diagnosed with a prostate MRI. A multi sequence, multi planar imaging of the pelvis was performed by California Imaging institute. Two lesions were found. One lesion was .5 x .3 cm and one was .5 x .4 x .4 cm. PSA density was .09 ng/ml. T2 for both was 3/5, DWI/ADC for both 3/5. IMPRESSION:
1. Benign prostatic hyperplasia
2. Two PI-RADS cat 3 nodules are identified, one within the right apical medial peripheral zone and the second within the right apical lateral peripheral zone. These are intermediate lesions with the presence of clinically significant prostate cancer equivocal.
77 yr old
Appreciate any feedback and is Dr Scholz excepting new pts. Medicare insurance and tricare for life insurance
PSA HISTORY
Feb 2021. 6.1
May 2021 8.4
Jul. 2021. 5.6
Aug. 2021. 4.5
Nov 2021. 4.3
Feb 2023. 5.5
Mar. 2024. 7.8
I’m presently getting treatment at Dana Farber Cancer Center at Mass General in Boston. I’m on active surveillance where I’m monitoring my PSA and FREE PSA on a regular basis. If my PSA goes crazy then we will talk about a MRI targeted trans perineal biopsy.
Hi. I was just diagnosed with Gleason 6 cancer. My PSA was 9, but my free PSA was .9%, which was very low (not good).
My MRI showed Pi-Rad 4 lesions.
I had a transrectal biopsy and they found high volume cancer in 1 core (55%) and also cancer in all of the right side cores.
I am scheduled for a PSMA PET CT scan -- I hope my insurance covers it. You never know.
I also hope to get a Decipher test before I make a decision on treatment.
It all really depends. I am 54, so the risks of future more serious cancer are higher for me than you at age 77.
With your PSA levels and lesions, you should probably get a biopsy if you have not had one.
That way you can get a Gleason score and maybe a Decipher test.
The biopsy isn't fun, but its a lot better than surgery, radiation, or any other treatment if you find out you have Gleason 6 now, but later get a Gleason 7, 8, 9 or 10.
Thank you so much. This clarifies a lot. This channel is so important
Thank you. Great information for Prostrate cancer patients.
As a recently diagnosed Gleason 6 78 year old who has other information to consider I’m not hurrying to treatment. I’m intermediate risk on Decipher.
I have good quality of life and want to preserve it.
My doctors are recommending that I proceed with radiation.
I’ m pursuing other input from MSK in NY but may seek to avoid treatment related side effects as long as possible regardless.
It all comes down to risk assessment/ tolerance in this rapidly advancing field.
This series of videos is an enormous help. Kudos to the providers.
Thank you for the video I finished Pluvicto and it came back within 3 months after I finished. Taking more than a month just to get a zoom call to talk to the radiation doctor to do 4 new spots it’s hard to remain calm especially after failing all the treatments I have had. I have been going through all of this for almost 5 years and have learned allot but it’s nice to hear a little encouragement that at the moment I don’t need to feel anxious at this point that emotion always comes the week before check ups. Keeping sane isn’t always that easy. Good luck to everyone going through this.
Great video.! My 3+4, grade two prostate cancer has returned after active surveillance and later cryoablation. I was concerned about the time line that my surgeon has offered to do another ablation. Seven weeks away seemed too long. Now I have a better sense of an acceptable time frame . Thanks so much
Gn I was on active surveillance since 2015 having done a TURP to relieve challenges due to bph. My Jamaican Urologist referred me to UM Sylvester and a biopsy revealed a Gleason 6. I continued surveillance and transferred to a US HMO. My PSA climbed from 4.7 to 9.7 in 5 months and a 3 tesla mri was done and a biopsy in February 2023 with 23% of one sample Gleason 4+4=8. Having reviewed my status, risks and options with my Urologist and viewed several of your videos I opted for targetted radiation ( completed in August/September) and hormone therapy. I will continue hormone therapy ( Eliguard) for 6 months. My PSA has fallen from 9.7 to 1.06 ( November). I have the videos very informative and helpful. I still have fairly good libido and occasionally use 10mg Cialis 1 hr before sex.
Thank you very much for your information. Very helpful.
@@richardreesesr6964 was the TURP helpful? Any incontinence issues post RAD? Glad you are doing well.
These are all fabulous videos. Thank you so much for making them. Very informative
Thanks ever so much for your videos, helping me cope with gleason score 9 metastatic aggressive prostate madness.
So glad you guy's are there for us.
I can’t tell you how grateful I am to have found the PCRI. Knowledge is power and you are providing so much valuable information so that I can make good decisions. I am in the investigation process and proceeding with my biopsy. I feel you have educated me enough to discuss which procedure I should discuss with my doctor. I will definitely be watching all of your content so I can advocate for myself with as much information as possible. After I receive the results from my biopsy I will probably want reassurance from PCRI on my best treatment options if in fact they are necessary. You have really comforted my concerns and reinforced the fact I can continue to live an active normal lifestyle. Thank you for your brilliant work and I have learned a tremendous amount in a short amount of time by watching you and Alex during your weekly content on TH-cam.🙏🙏❤️
Waiting for a PET. I n the meantime finding PCRI and Alex is really helping me deal with this. Alex you are so economical and clear, your questions are exactly those us blokes have rattling around in our heads. Thanks so much. X
So appreciate this channel and this interviewr is really awesome as is the doctor. So much useful information. Thank you.
I've had two biopsies, the second after an MRI showed a spot, and nothing was found. Age 68, and my PSA bounces around with a high of 10 ( only once 4 years ago ) but now down to 4. Just took the The ExoDx™ Prostate Test with a score of 44. Still monitoring with PSA and an second MRI in the fall.
I had the same ExoDX score, PiRads 4 one lesion, biopsy GL 7 found 2 lesions 3-4, 4-3 and 3x3-3
I am 71 with prostate cancer, with gleason score over 6 and have no anxiety. I am in for surgery on 9/27/2023. Pet Scan and Bone Scan show it is just in the prostate. I have pushed my surgery off a month, so I can get things done before hand.
I was 72 when diagnosed, Gleason score 3+4. It took three months to get a medical clearance from my heart doctor. He was convinced I had heart issues, but ran every test and passed them all. July 18 the surgery was done. I was walking around the ward four hours later. The incision above the naval was very tender. I was sent home the next day, with a catheter. Six days later, I went back to have the catheter removed, painless by the way, and had bladder control about 98% of the time. Lifting anything heavy caused leaks, but getting better. The pathology came back Gleason 10, and ready to spread. Six weeks after surgery, PSA was .1.
🎯 Key points for quick navigation:
00:00:20 *🕒 Anxiety from prostate cancer diagnosis often stems from a lack of time and information provided by doctors.*
00:01:32 *🧠 Even with a Gleason 10 diagnosis, a treatment delay of 2-3 months is unlikely to significantly impact prognosis.*
00:02:26 *🧪 Delaying hormone treatment allows for more accurate staging and diagnostic scans.*
00:03:21 *❄️ Hormone treatment can effectively manage certain high-grade prostate cancers for many years.*
00:04:19 *📅 Historically, delays in treatment did not worsen long-term outcomes, even with Gleason 7 or 8 cancers.*
00:05:26 *🏥 Immediate treatment is often pushed due to patient anxiety and the financial incentives of the healthcare system.*
00:06:36 *🏃♂️ Prostate cancer is generally less aggressive compared to other forms of cancer, allowing more time for decision-making.*
00:07:59 *📚 Patients are encouraged to conduct their own research and seek second opinions due to rapid advancements in prostate cancer care.*
00:09:11 *⏳ Gleason 6 patients have ample time to consider treatment options due to the non-metastatic nature of their cancer.*
00:10:07 *🔍 Continuous monitoring is vital to catch more serious cancers, even if Gleason 6 is initially diagnosed.*
00:11:04 *🕰️ Gleason 7 patients can safely delay treatment for up to six months without impacting cure rates.*
00:12:38 *💬 Patients should prioritize informed decision-making over fear when choosing treatment options.*
00:13:19 *🌎 Prostate cancer patients are encouraged to get multiple expert opinions to understand all treatment impacts and options.*
00:14:00 *🗣️ Joining support groups and researching doctors can lead to more informed and confident medical conversations.*
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My father had a precautionary prostate surgical removal owing to family history of cancer. This resulted in impotence and many subsequent years of frustration which, if tbings weren't already bad enough, resulted in more violence and abuse within the family unit with us children bearing the brunt. Medicine has to be about more than body parts.
Well your Channel is great. Many thanks. I have just been told by my private specialist that my PSA is high around 9. And he is already talking about robotic surgery. This seems bizarre after watching your video. Thanks for educating me it gives some reassurance in a difficult time.
i was diagnosed with Gleason 8 in Aug of 2022 and PSMA showed nothing outside of my prostate. I was scheduled for surgery at the end of November but I got the flu 2 days before and surgery was postponed until Jan 31st of this year. Tumor was all contained within prostate, margins and lymph nodes were clear. Gleason was downgraded to 7 and I've had 2 PSA tests since and it's been undetectable
I’m researching for my hubbie as he’s a bit in denial. He’s Gleason score 8 as well and recently diagnosed and trying to decide what is best for him. I’m interested to hear why you’d be downgraded and how that can happen? You’ve had no treatment at all then? Are you being monitored as surely the cancer is still there? Thanks for sharing… very helpful.
Highly recommend reading: You Can Beat Prostate Cancer" by Robert Marckini 2nd edition. Excellent resource.@@RhondaMcL1
@@RhondaMcL1I was diagnosed with Gleason 7 , after my surgery it showed I had Gleason 9,my urologist said he was surprised,try to get psma scan too be sure.
@@RhondaMcL1doctor told me biosy does not catch everything so when prostate is out they send it to the lab and disect it and get a more precise diagnostic or gleason number
Hubby had RALP procedure in the end. Just last week! We will get results in around 6 weeks. Hopefully, if it ever returned he has other options like hormone treatment. 🙏
These videos are very helpful. Just wish there was a way to get a listing of the most skilled practitioners or treatment centers.
Brilliant... I've a PSA of 8.4 but with a clear MRI... await biopsy results and this video is so helpful... Thank you!
These videos are a godsend.
This channel has been and is a great source of information I trust.
In this video you spoke of a PCRI test. Can you explain what that is please,
I was diagnosed with what the dr said he was 54% sure it was cancer. A fushion mri showed two - 2mm spots and one further 2mm spot on the wall of my prostate. He ordered a biopsy immediately as many other doctors had suggested earlier, just based on my psa of 10 once after I’d had a catheter for several days. A retest with the
VA urologist showed a 5.5.
I have not gotten the biopsy as I’d heard on your channel about the EXODx test. In the waiting time since last October since cutting out 98% of all animal products & coffee, & waiting to get in to a dr who would order it this urine test, I hardly ever have any discomfort when urinating where before it was most always painful.
In August 2007 I got a private health check and my PSA was 5.64.
Early this year 2023 I went ot the doctor for frequent visits to the toilet during the night and the doctor took a blood sample for a PSA test which was foun to be over 10 at 11.5.
So my PSA went from 5.64 to 11.5 over a period of 15 to 16 years during which I have been very healthy other than the frequent visits to the toilet during the night for a wee.
Anyway this was followed up from early this year ...scans, biopsy etc to find that I have Gleeson 4/3 and now I am on Hormone therapy for 6 months during which I will receive radiation therapy over 3 weeks.
My testostorone level is going down and I feel aged, body sweats and fatigued.
I read that my PSA should come down to near zero after Ratiation Therapy, but if it goes up slightly, I could be back to square one as it indictes that the cancer could still be present.
Is there no escape for this nightmare?
Dr Scholz would you please comment on focal laser therapy efficacy for prostate ca.
1) Twelve years ago, a Urologist decided that I have prostate cancer and I should schedule a surgery. But I did nothing. 2) Two years later, I went to another urologist who told me that I just have a large prostate and gave me some medications. 3) Two years later, I went to another Urologist who told me that I have a low-grade prostate cancer, and I need to go to him a couple of times a year for monitoring. 4) Four years after that another Urologist told me that my prostate cancer has become aggressive and I should schedule a surgery. 5) Two years after that another Urologist advised that I should at least have Hormon Therapy. I finally gave in and started on Hormon therapy. 6) Last year, another urologist advised that I should have radiation but not hormon therapy. 7) This year an Oncologist tells me that I should have radiation together with hormon therapy... I am now on Hormon therapy - because my wife insisted that I should do it - and am hesitant about Radiation therapy. Except for going to bathroom, 2 or 3 times a night, I have not seen any other symptoms or problems. I am now 84 and do not want to live beyond the age of 90. I am told my Gleason score is 9. With this background, should I do a) surgery, b) radiation, c) Hormon therapy, or d) none of the above - because there is no clear-cut answers plus I do not want to live beyond my 90th birthday?! My PSA ranged between 3 to 9 during these years, but it went back to less than 1 since I began the Hormon therapy.
You’ve done well hanging in after 12 years. I started with Gleason 9 (5+4) Sept 2023 with PSA at 310. Starred with immediate HT, followed by Chemotherapy and Darolutamide. PSA at January 25, 2024 now down to 0.44. Given 4-6 years. So, if it works for you, that should take you to 90 +.
Another awesome job communicating the great news of treating and defeating these diseases. Thanks for all you do and much love❤️
This is a very informative video. Thank you very much!
I'm in a bind. First off, thank God for these Prostate Cancer Research videos and Dr Scholz' unbiased insights. Which leads me to my predicament - something I think many reading will find themselves in a similar situation. I just turned 54, never needed to take any medications (why do all these doctors look at me strange when i say that?), and very active, workout at least 4 days a week and eat well. In 2019 an annual physical blood test showed a 1.7 PSA. Then in 2022 it was 4.2. So, my doc referred me to a urologist, which I said I thought was possibly raised due to my avid cycling and especially since I did a 40 mile ride a day before blood test (I didn't know it mattered). So he said we'd wait 6 months to do another one. Well, it went down at 3.7. So, we waited again another 6 months. It rose back up to 4.3. That led to an MRI (2t) which showed a single left side lesion Pirade 5 that then led to a biopsy (yay, fun). That showed only G6 primarily in that single lesion - nothing on right side - but a few cores of 3+4. So even though a majority is 3, there is a tad 4 which basically means I am intermediate risk 2b. Okay, fine. So now what? My urologist is a straight shooter and seems to have no bias in this. The doc that did the biopsy suggested if they find anything to just get it taken out and that since I'm so young still it will be fine. My urologist sent me to 3 different specialists to evaluate my options. The doc I saw today is a radiologist and was clear to me was pushing me into SBRT/EBRT and actually even leaning toward removal with his recommendation doc. Same thing said as the biopsy doc. But I know 2 people who've had theirs removed years ago and regret it bigtime due to the inconstancy. I can't imagine pads for life. But I've watched every video from PCRI here on TH-cam and Dr Scholz very clearly implies someone in my situation to NOT do a removal because the tech is so good now. The question that keeps coming up is with HIFU/TULSA the failure rate after 5 years or so. But I'm even getting conflicting answers on that due to new tech. (Focal 1 machine?) Since I'm in such a low grade situation, I don't have a gun to my head on this yet. I'm hoping the tech advances fast enough to make this decision much easier, but I really don't want to do a removal for all the reasons we know. These docs who are pushing it - and I'm wondering if there is some vested interest in that the places I'm going to are pretty much set up for that - don't have to live with the consequences of it like I will. Seriously, are these TULSA/HIFU options really that good and worth it? And the failure rate? What issue is that with today's tech?
Thanks!!
My urologist told me he would never consider removing my prostate. I got radiation and everything turned out fine. It really wasn't even that bad.
My PSA was 60. Took about seven weeks
Good luck to you bud and all the best!
It’s a gamble but I’m leaning towards Hifu (3+4=7, 63 yrs , 6 positive on one side, PSA 7.2/ 4.5/6.2 & last week 5 since last Dec. Still waiting to see an oncologist/radiologist as I was not interested in RP. Now my Dr has retired & waiting again to see who replaces him (Canadian, so stand in line in this regards) My hope is that even with only 5 years until a possible repeat after Hifu the way AI is advancing (I’ve checked multiple sources regarding where the money in cancer research is going, this in the millions of dollars) there may well be something on the horizon that’s worth this treatment & as it were just kicking the ball down the road… Right now I’m making dietary changes & keeping up on my PSA checks. Cheers
Here's some first hand results I've had while I'm in practically your same boat. I spent an hour with a doc here who does HIFU. She swears by it, but admits its limitations. Tulsa Pro I think is going to end up the gold standard due to it extreme flexibility in its ability to reach the entire gland and ablate at much higher degree the cancer without the surgery problems. Dr. Scholz says as much regarding surgery. My doc jumped right to that suggestion because that's what he does. His practice isn't set up for this new cutting edge stuff. I'm switching networks because of it. But I also changed my diet. And boy oh boy the results! I might not have to do anything. After a solid 6 months everything appears to be subsiding. My doc doesn't believe it. I'll post if you're interested. @@Jack-2day
@@smoknvader9127 I totally agree with the way you are making changes regarding what you’re eating. Low carbs & the proper begs & fuits. For information regarding Tulsa pro/Hifu there are some recent reports on Pub Med Cheers
Thank you for all the educational information. I also must say I like Doctor Scholz's tie.
Thank you for this. Very reassuring and helpful.
These PCRI videos are gold.
I was told Gleason 6 “you have lots of time, active surveillance will be just fine”. I said no I want it gone, by the time I got the referral and an appointment with the doctor it had been six months. He wanted an MRI biopsy, in that time I had gone from “mass” the size of a dime, to two. One the size of a nickel and the other about the size of a quarter. And the doctors said “that shouldn’t happen, you don’t have small cell carcinoma”. Had I listened to the first doctor it could have catastrophic.
Do research, remember most doctors want to protect their own interests. Radiologist want you to do radiation, surgeons want to do surgery etc. The radiologist for example may not go in-depth on the chance that radiation could lead to another cancer (bladder,colon) in 10 years or so. I mention this because two friends that I met during my journey did radiation, and one ended up developing bladder cancer, and the other colon cancer.
Diagnosed June ‘21 - Gleason 9. Started ADT end of August, IMRT early September for 5 weeks. Brachytherapy 2 days after radiation ended. Ended ADT Aug ‘22. Took this approach /timing after consulting with Radiation Oncologist, Urologist, and Primary Care. Do your research, listen to Drs you trust but, gain a good understanding, on your own, of latest studies and therapies. Always appreciate your videos. Thanks.
How are you now?
I’m Gleason high 9 - 5+4 advanced but localized (psma pet negative)
ADT last month, imrt now - just completed first week.
Want the least ADT as possible still looking for cure not only managing.
I very much appreciate what you are doing as this is a difficult journey and you make it easier to understand what to do. Thank you!
we watched your video was interesting.we was diagonosed with prostate early stage very slow growing.two spots one was 2 mm. thanks for video..
Thank you for this info. This really helps caregivers that care for a family member with cancer. We deal with so much stress waiting for the next dr apt or test results.
@@salsamink same here !!
An MRI Feb 22nd 2023 showed I had a small area (anterior apex of the prostate) with cancer. I was scheduled for a minor op March 1st and the anesthesiologist refused it due to heart problems. That ended up with a heart ablation April 22. About a month later targeted biopsies showed I had Gleason 4+4 with 5% abnormal cells in the biopsies. No cancer in the 12 random biopsies. The genetics of the cancer put me on the low end of intermediate risk. My own genetics has no mutations that encourage prostate cancer. A PSMA PET scan showed cancer only in the area indicated by the MRI, with no metastasis. I have a large prostate due to BPH (149 mL). Researching I hit a roadblock. My urologist thought me a candidate for focal treatment and referred me to the Mayo Clinic. They do not accept Medicare Advantage so I have not been able to schedule a consultation. I can change to straight Medicare, but cannot get a Medigap plan because I have a pre-existing condition. So to change to insurance Mayo will accept I have to pay 20% of all future medical bills (this year just the heart ablation and PSMA PET scan would have cost me $30K if I just had straight Medicare and no Medigap). What if I switch and cannot get the focal treatment? Another complication is I self cath (CIC) due to bladder injury. This is likely to cause problems during EBRT. A supra pubic catheter would probably lead to sepsis. I would need hundreds of seeds for brachytherapy so that is not an option. I feel like I am stuck in a loop, wanting to protect my quality of life (I am 75 so not much longer to live) but not ignore the cancer with roadbocks to getting the information I need. This video was very helpful because it suggested ADT might help (maybe I will get a soprano voice and regrow my hair to compensate for the lack of sexual interest).
They’re watching this video. I feel a heck of a lot calmer. Thank you. It’s good to know that I have time to make a decision. I’ve had a MRI and they found a lesion. Next thing is to get a biopsy. But they’re so backed up I’m gonna have to wait at least two months. Now I know that that’s OK. The cancer doesn’t spread that fast. Thanks again again great video.
We are both at the same place in this journey. I wish you all the best and I as well feel calm with the knowledge I have from Dr. Scholz
Any news what pirad was it ?
This Site (She and Dr.) asked ALL the Right/Focused questions! PSMA PET Scan is Key today. Know your Urologist and how CURRENT they are. Mine saw my .3 PSA for 8 years jump to 2.5 and then Immediately Ordered a 1) PSMA Scan. 2) Biopsy 3) Cryo ... because my first prostate cancer treatment.was Radiation. 2nd Opinions greatly appreciated. BTW Dr.... Love that Tie!
I was diagnosed with non invasive bladder cancer in 2015 and had TURBT then and again in 2017 after a regular schedule cystoscopy show new tumor. I had a course of BCG in 2017. In Jan 2019 due to a high (8.3) jump in PSA that was always under 2.5 I had a random biopsy and was diagnosed with 3+3 Gleason 6. 7 positive cores with less than 5% of core malignant. In March 2019 I had a T3 Multiple Parametric MRI and a small tumor 3mmx5mm lit up on this test. A targeted biopsy was indicated but never happened and I stayed on active surveillance along with bladder cystoscopy. PSA went back down to under 2.5 every 3 months at the lab. In Dec 2022 I was diagnosed with bladder cancer CIS with very aggressive pathology and after 3 consultations, all recommended cystectomy. They all said my case involved BCG failure and did not recommend any other treatment than surgery to remove the bladder and at the same time take out the prostate. I am 76 years old living alone with no assistance and by the way I had a total R lung pneumonectomy in 1988 and never had chemo or radiation and lung cancer did not recur. The 3 doctors all said as well, I did not have to have the surgery in a week or 2 but take only a couple of months to decide and only having one lung with COPD they all said I would need a workup by many specialties to see if I can safely withstand 5-6 hours of general anesthesia. For the removal of the prostate and bladder and additional time to construct an Ileal conduit ending in a right side stoma. I am a veteran and they authorized community care to have this done and I had my choice of of hospitals and surgeons, outside as long as they would take payment from VA, which is about same as Medicare would pay. I decided quickly on the surgery, within a matter of weeks but had to find and Elite high experience urology robotic surgery. I ended up going to the smallest hospital of the 3 I visited. It was an hour from home. The 2 hospitals I did not got to were the larger cancer centers. I chose the surgeon over the modernity of the hospital facility. The surgeon I picked had more than cystectomy operations. Men from all over the world come to him for the treatment. He had been at the Cleveland Clinic for over 20 years before moving down to a smaller hospital to start a new program a few years back. I had the surgery May 12th 2023 and today I am doing fine and again living without assistance. The home health company ended their contract a month early due to my speedy recovery and ability to change urostomy pouching system on my own. So this was a long story BACK TO THE PROSTATE. My cancer was confined to the organs and there was no evidence of spread but the prostate tumor and grown significantly since 2019, but contained in the capsule and my Gleason score went from 6 to 7, a 4+3 on post surgery pathology. I had T2N0M0. My first PSA since was 0.01. Thanks to PCRI. I watched since 2019 and still watch.
Such good information, it has really been helpful for me. I am at the beginning of this journey, I am scheduled for a biopsy next week for what appears on MRI to be a PI-RADS 4 lesion. Thanks to your channel and some others, I am well armed with information and I am quite confident that I will make a treatment decision, if I need to, that will be the best decision for me and for my spouse. THANK YOU BOTH for your wonderful videos!! ❤❤😊😊
I’m curious to know how your treatment turned out and what you chose. I just was diagnosed with a four lesion as well. I am very scared but would love some information.
@@troyelam8978 fortunately my 26 core biopsy was negative in spite of how it looked on MRI. If I had had to choose treatment, I was leaning towards either TULSA-pro HIFU (if I was a candidate) or HDR brachytherapy, my goal being to try to preserve my sexual function as best I could and minimize the urinary side effects also. Fear I completely understand, but prostate cancer is NOT like other cancers for the most part. Take your time, because you HAVE time, and don't let ANYONE talk you into a treatment that will have dramatic and irreversible side effects. Best of luck to you, please keep us posted on your progress.
@troyelam8978 my biopsy was negative in spite of the MRI so I fortunately did not have to have treatment. If I had had to choose I was leaning towards TULSA-Pro, or HDR brachytherapy. Fear I completely understand but, as the above video shows, you HAVE time. Don't let anyone talk you into a treatment with severe and irreversible side effects unless you decide that is what's best for you.
Thank you for your honesty. Bless you.
thank you !!! I just got diagnosed with prostate cancer.. geason 3.. I'm waiting on cat scan, then decide on treatment
What did your ct show
12 years ago,I underwent robotic prostatectomy for recalcitrant prostatitis and recurrent obstruction after a TURP. Multiple biopsies were negative or just carcinoma in situ. The path showed that I had a 1.5 cm carcinoma that was undetected. Biopsies completely missed it, even under MRI guidance. The last 12 years have been spectacular. No obstruction. No prostatitis pain. Complete continence. Meanwhile, my 52 year old neighbor is in the last innings. His PSA is climbing despite hormonal deprivation RX, with Mets to his spine and pelvis.
If you have a cancer, treat it.
Hello. In your scenario, what were the benefits of a TURP? Thank you.
@@stevequinones6640 Between age 50-55, I had severe prostatitis and progressive obstruction. My PSAs were in the 5-8 range and biopsies were negative. The TURP was a disaster- had to return to surgery for profuse bleeding, and I bled for 6 weeks intermittently. It did give me relief from the obstruction and pain for 3 years until the prostate regrew to tennis ball size, and the scenario repeated itself.
These people are vert important. I thank them very much.
this is a great channel / resource - thank you for all your posts
While working Kuala Lumper I was diagnosed with prostate cancer after bloodwork was done to check immunity cover. Went through numerous tests having scans etc., and a surgeon was chosen to carry out the operation using instrument surgery. Then came a complication with my company's insurance cover. Though being able to return to work quick have this type of surgery the insurance company did not to cover the operation cost yet would stand the extra cost of a longer recovery stay in hospital. Doing the math's, one cancelled the other out plus taking the extra charge operation would have me back to work earlier. On check in day this still had not been settled but I was prepared to pay the extra but would challenge the extra stay in hospital against the insurance company. They then agreed to pay the extra operation charge.
The cancer had shown on the wall of the prostrate and so radiation treatment was needed. The insurance company again did not want to pay, but I claimed that there delay in OK ing the operation could have caused this.
I suggested my company change insurers as they were not working for the good of the company employees.
Thankfully all tuned out fine for me HealthWise, the company did get a rewrite of insurance cover because of my case.
My big concern is ADT. It has SO many side effects. How long do you have to be on it?
My husband was diagnosed with Gleason 6 last year. Went in for his annual prostate MRI and it had 3 liaisons on the left hip bone.... he then had a PSMA scan and only one of the liaisons lit up and nothing anywhere else in his body. He has appointments with both a Medical Oncologist and Radiation Oncologist Sept 20th. He goes to the Mayo Clinic, Phoenix. Oh and by the way he had a heart transplant 2 years ago this August, so is on some major anti-rejection medicines.
Good luck with the treatments.
Thank u both for great information 🇨🇮❤️🌹🙏
Dear Alex, Well done discussion and evenly weighted. As a lifestlye med physician, I have seen an almost universal reversal of trends when patients add stress reduction, diet and exercise to their treatment protocols. Keep up the good work,. Cheers from New Zealand
I am wondering what part of NZ you practise in. My husband had RP using robotic surgery privately in the Sth Island in 2022 and now has a rising PSA. I am researching the things you mention- dietary changes, exercise and stress reduction. I want him to have a second opinion from a Dr who will at least discuss the lifestyle changes as his current consultant dismissed anything I suggested as apparently 'no evidence' apparently yet lots online. Observational and convincing. The consultant did say some men in my husband's situation their PSA level plateaus but he did not know what they did if anything for this to happen. It is documented that people don't tell their Dr if they are using alternative treatments, lifestyle changes taking supplements etc. Research is needed but ? funding comes from. It is a waiting game until his PSA rises to 4 before he gets a PET scan. From what I listen to online a PSMA PET scan is now being done at the same time as a high grade MRI. No biopsies as can seed the cancer.
Thank you! So much for this information I have a 3+4=7 and 4+4=8 Gleason score
Very informative video.
Sir in 2022 i was dignosed prostate cancer on the basis of biopsy reprt with gleason score 8. Doctor prescribed harmone treatment eith tablet cslutamide one daily a d one injection pamorlene once in three months..Now in April 2023 i hve been operated with procedure TURP.
Presenltly i have been advised to get the injection once in three months only. My PSA reprt is 0.36 Please advise how long i should go with treatment a d what will be the side effects
Any advice on HIFU or Cryro instead of radiation for Gleason 6?
Thank you this was very helpful. Michael
My dr was angry that i had any questions about prostate cancer when i came in with the knowledge i learned with this channel..pushing for biopsy..she knew my mri showed a 60cc prostate and my psa was only 4.8 wellv within the psa density range that she didnt seem to know about when i told her
I was 3+4 and waited 8 months before going with radiation. My psa was a little above 8 when diagnosed, and went a little above 9 while waiting 8 months.
For me with Gleason 9, I wanted to get going. By the time I was able to start the Lupron injections and radiation, five months past by. So if one waits say three months then add other delays for scheduling etc to fall in place.
It took over three months to get all my medical clearances after the biopsy came back 3+4. Intermediate cancer. My holdup was the cardiologist. I just needed a clearance, but he was convinced I had heart issues, and ran every test in the book, and found nothing. I have great insurance, and I think he was taking advantage of the coverage. Even after he signed the clearance, he wants to more follow ups. I will cancel before I will go back to him.
Great video ,iam gleason 6 since last year ive just had a second confirmation biopsy please god it comes back at gleason 6
Frank get a PSMA PET SCAN listen to Dr Scholz tape on this
Am with ya Frank, go to Cleveland clinic next week for a second opinion and of course a look at everything….👍🏽🤞🏻
@@johnthompson9441 good luck with everything ,my confirmation biopsy came back as gleason 6 with 3 cores out of 13 ,1 had 5% the other 2 had 1%,this was a lot less than my first biopsy which showed 9 out of 17 had gleason 6 and they were 50%
@@MyFrank71 Interesting! My first (only) biopsy found high volume Gleason 6 cancer in 1 core (55%) and also cancer in all of the right side cores.
I am scheduled for a PSMA PET CT scan.
My PSA was 9, but my free PSA was .9%, which was very low (not good). My MRI showed Pi-Rad 4 lesions.
I would like to get a Decipher test before making a decision on treatment. Maybe another biopsy would also be useful.
Thank you so much.
I was diagnosed with a Gleason 6(3+3) about six months ago,I have a PSA level 3.79 on my last blood test. My doctor's recommendation was HIFU.I choose an active surveillance for now. What do you think? Did I make the right decision to stay on A/S? I am 73 years old. Thank you for any advice you can give me.
You definitely made the right decision. The PSA is low, the Gleason 6 means "nothing". Your cancer will not harm you in the long run, let alone killing you. I quote this, and you can search for it: "Currently, such abnormalities are classified as “Gleason 6” in the scoring scale of prostate cancer grades. However, some urologists believe they shouldn't be classified as a cancer at all because, though highly unlikely to kill, the label causes distress and influences patient decision making."
I was a 15.5 PSA with a Gleason 9 four (?) months ago and was shocked at how glacially slow everything was going. But I just kept telling myself, "Just because this is your first rodeo, cowpoke, doesn't mean it's theirs!" For example, my first check-up after completion of radiation treatment is a full two months down the road after we're done. Today was my first radiation treatment. Went very smoothly. They know their business. "Wow!" I said when I first saw the machine. "That must be worth at least $750,000!" It made an MRI look antiquaited. "It's $3 million," said my attendant. "Your figure barely covers the upkeep."
I'm starting radiation therapy tomorrow...currently on nubeca as part of a study at Dana Farber
Good luck! Also G9 and finished 44 sessions of IMRT in May.
THANK YOU FOR YOUR OPINION ON THIS VIDEO ❤
You both are fantastic! Thank you!
My husband psa level was 3.1 ten years ago. But recently it shows 16.57*
Now, he is 73 years old.
MRI reveals Pirads - nodules in the transitional zone bilaterally as described.
Apical region of the transitional zone representing Pirads-3 lesion.
Here what's your suggestion for our further action please?
What is your view of Tookad treatment. I hear it has been approved in many countries.
Is it possible for you to cover the rare prostate cancer and are there any clinical trials or research on the rare form of prostate cancer? My step father is out of options and running from one clinical trial to another at Stanford University.
I was really not told much about my prostate cancer. Blood test showed a PSA of 5000. Then a CT 4:36 and bone scan. byopsie in my back.
Just told there was nothing that could be done. Did start me on a hormone treatment the ssme day they said I had "terminal" cancer. Not told how long I might live. Never tell me snything. At 75 the hour or day long sweats are killing me as I have a bad heart and pacemaker.
Praying for you 🙏🏽
Very helpful video!!!!
I had cancer on my prostate and my lungs I started taking Myrrh gum capsule and the cancers where surrounded by the myrrh and dried up that has been over eight years ago I'll be 91 next month , you can't let the cancer get to large .
Thank you! Great information as always.
Great information!
Last year my Gleason score was 3-3 but this years biopsy it was 3-4. So it seems it's getting worse and not staying the same. Any guess in how long out I might need surgery or radiation?
That’s something you and your doctor need to decide. I was diagnosed last year with cancer went through all the different things had a biopsy came back 4+3 aggressive caught it in time that I had a choice between surgery or IRMT radiation and hormonal therapy . I chose radiation. Went for my check up a few months ago and it’s in remission and I don’t have that weight on me anymore. Good luck with your decision you’ll do what’s right for you .
My experience with a score of 3+4 was that it is best suited for Cyberknife treatment from a reputed radiation oncologist. A PSMA PET scan can confirm if it is localized and that should make it easier to decide the treatment plan.
I had a 3+4 intermediate cancer biopsy. At 72 years of age, my radiologists said he thinks he can treat it, and it should work. Not the words I wanted to hear. Also due to the size of my prostrate, they would not be able to protect the colon. I decided to have it removed, and pathology came back that it was bulging and getting ready to spread. I have not regretted having it removed.
Remember there is some subjectivity to biopsy tests. My first reading was a Gleason 6, but then they looked at the same test results in Jacksonville Proton Clinic, and they said I was a 3+4, so it can vary depending on who analyses the biopsy results. I decided on Active Surveillance for now. So far my PSA has been staying below 4.0. Will make a decision if it rises (testing every 3 months).
i was diagnosed 6 months after my first biopsy because they missed the cancer , the first psa was 5 then the second was 10 , my gleason was 9 , I had seed implants , radiation and hormone deprivation therapy for 2 years , its 2 years now after completion of the treatment but over the last 6 months my psa rose to 0.05 , then down to 0.04 and now up to 0.06 , the doctor wants to wait for another 6 months to see where it goes before considering any further treatment , the first time around i was nervous and just went with what they said but i've come to accept things now and am fine with waiting to see where the psa goes , im just hoping it a radiation bounce and not recurrence
these are awesome videos ...
In 2005 my health check showed -psa =7. I . At that Time the superbugs were prominent and a highly advertised died after a biopsy. I was concerned and asked my doctor for an alternative to biopsy. He must have thought I meant I did not want any treatment. My psa rose while watchful waiting ro 12,15, 21,29 with me not understanding the importance. I had no symptoms for 10 years until I started to getting so,e minor back aches. After 11 years it was bad and I had CT scan which showed psa of 9000, extensive bone metastases and lymph nodes and I was referred to an Oncologist. I refused Chemo and was given ADT-Zoladex and Casodex. after 4 month I felt much better and cancer in Lymph nodes were resolved. bone metastases were less obvious. Psa was
How did ADT go and how long did they have you do it?
& your insurance paid for your treatment with no biopsy? I was told they won't cover it without proof in the form of a biopsy !
Thanks for posting