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- เผยแพร่เมื่อ 1 มิ.ย. 2024
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0:17 Can you address paralysis and how it relates to metastatic disease
1:55 PSA started at 3500, 6 months ADT dropped to 0.6. What about triple therapy now?
4:33 Patient had surgery, PSA rose, then radiation with ADT, 2 years later rising again. What now?
7:08 RP in 2021. Recent doubling rate, PSMA scan shows 2 lymph nodes. ADT/radiation?
8:50 Would a Gleason 9 patient need to get both focal and hormone therapy?
11:20 What about a Gleason 9 patient with a low PSA, below 2.5?
13:59 Gleason 9 hasn't spread - do chemo first as opposed to surgery or radiation?
15:58 60 year old with 12 lymph nodes, reactions to certain drug, can't do BAT. What options?
17:58 Alex's conclusions
18:32 If you need more help
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Thank God I found this channel a couple years ago. I was diagnosed Gleason nine I had a low PSA no nodules. My biopsy showed nine, but there were some areas that were affected at all. It wasn’t like heavy. I was dealing with a urologist of course he wanted to do surgery thank God I didn’t get that done, the radiation and hormone therapy ,particularly the therapy, was really very difficult to deal with. I got through it OK but with the reduction of testosterone really knocks you out.
Thanks for another great video. I had a test in June 2022 I was told I had stage 3 prostate cancer with a Gleason score of 9. I had a PSA 9.4. I was offered 3 types of treatment to deal with my results. I email you from the UK with my details asking for advice for best treatment for my best outcome. I was emailed back with a very helpful advice for my best treatment. I had brachy (HDR) in Feb 2023 plus 15 IMRT(external beam radiation) I have also been on ADT for 21 months now my PSA is below 0.1 July this year will be my last ADT implant injection. Many thanks for your help and very good videos you put out. I am 66 in this year and i feel really good after all my treatment.
Hi Steve, I’m recently diagnosed and want to mail Dr Schulz as you did; can you please provide me the email address you used. I’m pleased to hear your doing well. Thanks Ian
When my husband was 51 (almost 2 years ago) he had a Gleason’s score 9, the prostate cancer spread to his lymph nodes just outside the pelvis area. 28 rounds of radiation 3 years of lupron and two years of abiraterone and a steroid. We have been told they won’t do any scans at this time to see if the cancer has spread anywhere else because his PSA is down to under .1. . His hip hurts nonstop in the bone type of pain and they don’t seem concerned. We want a scan but have been told insurance won’t cover. Would you suggest we keep pushing for one or stay on the path. We are almost two years into treatment now. Thank you. I listen to all your episodes you have been so helpful since we received his diagnosis
Sorry to know about your husband situation. Every cancer patient they have the right to be treated whether theres insurance or not. My dad suffer a lot untill he past away because he got no good treatment.
You will need a Dr. prescription and then it should be preapproved depending on your insurance. You didn’t say who said that the insurance wouldn’t pay. You can call the prostate cancer research number and try to understand how your psa may still place a risk for metastatic cancer to the hip given the treatment he received in your husband’s case. If the current doctor doesn’t prescribe, maybe get another doctor to do this. The other option is to go to an orthopedic doctor and have the hip pain evaluated totally apart from the cancer issue. Just say you have nonstop hip pain. My understanding an xray shows bone abnormalities as well… Maybe it is a different issue. Good luck. Aside from this a family member with the same stage diagnosis received chemotherapy, first and second generation ADT from the getgo but had bone mets also, not just in the lymph nodes.
You can appeal a denial to cover the desired treatment that you feel is imperative for his current care plan. Google request for a scan appeal letter. There are many sample letters which will help you to draft an appeal letter. You will find that once a formal appeal is completed, the insurance company will change its mind .
Ask your oncologist to review your appeal letter for his/her recommendations.
I have watched every video PCRi and this is one of the very best!!!
Thank you Dr. Scholz. I was diagnosed with Gleason 9 in 2023, confirmed by biopsies and PMSA-Pet scan. Only the gland itself, and two pelvic lymph nodes and a small seminal vesicle involved. They did radiation in June thru July, and also Aberaterone Acetate, which I will take for 18-24 months. Your discussion seems to confirm the steps my oncologists have taken are the correct ones. I also get a Lupron shot every six months. So far my PSA has been under point [.] one. Last one being 0.35. I’m believing for a cure…my radiologist oncologist seem to think I have a great chance at a cure. The radiation scans were state of the art, as our cancer center spent over 4 million dollars to upgrade to the latest and most advanced radiation machine. I’m blessed!
Isn’t 0.35 above 0.1?
I went back and checked my test results, and found I left out a 0 . It should have read 0.035, not 0.35, so I think I’m good. Thanks for bringing my mistake to my attention! @@truthseeker1959
@@truthseeker1959 he corrected that in a separate post; 0.035.
Great information on all the videos ! This is my go to source for educating myself on
Prostate cancer, the treatments, and resources. Thank you!
I had a psma pet scan Jan 30, 2024. Results were unremarkable. I was injection with 3 month Lupron shot 3 weeks following the scan, psa was rising. I had another psma pet scan May 24, 2024, results were the same unremarkable, following the scan I received a 6 month Lupron injection. My oncologist referred me to a radiologist. He wants to do 39 treatments of prostate bed & surrounding lymph nodes. I'm very concerned. Should have radiation or have a Axumin psma pet before undergoing radiation. Thx Freddie McDonald
P.s. I'm 13 years out since my prostatectomy.
I have metastatic bone (original PSA 3465 in 2019) I now have bone pain to L3 and told by my radiologist that I have to wait until I have neurological symptoms before treatment. Surely this isn't right
Had surgery in 2015 psa 3.9 Gleason 9 , 2 years later psa went up to .2 , did 37 rounds of radiation 6 months Lupron , 2019 psa started going back up , 2020 pas went up to 6.8 been on Lupron every since, psa .004
Hi can I ask you if youve ever had a psma scan or decipher test? Im gleason 9 also..thanks
I feel like his PSA was rather low?
.2? .... 37 ROUNDS of ...RADIATION!?!?!?!! .2?? I don't un get it.
@@ricknowak4582 After having a radical prostatectomy, the post-op PSA levels should essentially be 0 and remain at 0. Generally if the PSA remains below a 0.1 it's not a concern. However, if the PSA reaches 0.1ng or greater and increasing, the concern is great for the return of cancer cells. Even though 0.2 seems like it's not high in general, it is a significant change/increase after RP and especially if the Gleason is 8 or above, whether it's an aggressive cancer, what stage it was, etc. It warrants radiation in most cases.
I mistakenly left out a zero in the other post. The latest PSA reading was 0.035.
i am on medicare, will only pay for 3 lifetime pet scans, will not do first till psa 0f 2
Thanks for the video. Can you discuss about the treatment strategy for high Decipher number in the future? My Gleason is 9. PSMA shows it is localized, but my Decipher number is 0.98, very high. I had 26 radiation treatments, 1 Formagon, 5 Lupron, 7 month Xtandi, PSA < 0.1 now. I want to know how many more Lupron and Xtandi I need to take. Thanks.
My husband 55, diagnosed in January with Stage 4 prostate cancer due to wide spread disease to all bones and pelvic lymph. His alk phos was almost 900 and his PSA was 1358. After 6 doses of chemo, Lupron and Nubeqa, his PSA is now 0.2. They will not do another PSMA scan because they say that his PSA is too low for the scan. How do we know if more treatment is needed?
My father is 68, had bypass surgery 5 years back , bp, diabetes and weak, felt extreme pain in spine and legs for around 7 to 8 months, earlier in small city doctors didn't detected. Then we admit him to hospital as hb was 6 and difficult breathing and extreme pain . After tests found Gleason 9 and metastatic to lymph nodes and 3 in bones . Found in thyroid gland. Been on 6 month hormone therapy, psa is .17 . What treatment will you suggest for a weak person and lots of other issues. He shows positive attitude even in these all hard circumstances. Please suggest. thanks
.17 is good PSA. This means the treatment is effective. Since the patient has BP and Sugar, he needs to keep in check his reports (fasting and non fasting sugar, HbA1c (3 monthly reports), he probably is on insulin. Regular diabetologist visits are required. For the main disease treatment, I believe if the disease gets localized, talk to your doctor about radiation and if the PSA rises with further spread of metastasis spots, ask your doctor about Chemotharapy... Hormone therapy must go on and must not be stopped.
Prostatectomy 8 years ago, PSA rose to 0.17 in September 2023, now my PSA IS 0.18 in June 2024. Negative margins and estraular extension, Gleason 8, could this be benign prostate tissue generating PSA?
Not a Dr but some docs are suggesting post-prostatectomy salvage therapy at .1-ish (understanding PSMA won't be helpful at this point).
Thanks, I agree. PSMA scan seems unreliable under 0.5 and BCR is considered as being 0.2 by most bodies and my consultant. However it was him who brought up the question of benign tissue growth as my PSA had not risen for 8 years and has been at .17 for 7 months, he was concerned at potentially over treating with all the potential side effects.
Just complete PET scan on 21Arp 24 as localize prostate cancel and my PSA are 19.92 and Gleason 4+5= 9. 2 week ago at psa 14.36 and now waiting for surgery. Could I ask for hormonal therapy if its the microscope start spreading?
I had prostrate removed in June 23 Gleason score 9 spread to bottom of my spine and sixth rib I am on hormone injections and chemotherapy psa is low I am 70 years old can I have radiation as well as I have not been offered it 😊
Thanks, for great video, Just wondering if not taking radiation therapy is option for me, I am 48 years with Gleason score 9 (5+4) and lymph node involvement. I am on ADT treatment Lupron + Xtandi and PSA has come down from 77 to 0.77 and feeling pretty well and all my symptoms has improved greatly.
Just don't want short term side effects from radiation. Thanks
Is triple therapy also given to men over 80 years old ?
Gleason 9 treated surgically followed 10 months later 37 radiation treatments. Started lupron and zytiga then and just completed 2 years of it. Was told 86% chance of cure? If not, whats next?
HI I had hifu treatment 5 years ago the cancer has come back and they want me to do radiation and I dont want to psi 7 3+4 =7
stresseds out to the max can you give me any advice had an mri its in the same place not that big
My husband diagnosed prostrate cancer in jan 2024 … no spread in pet scan done robotic surgery in feb 2024 in biopsy Gleason score 9 after surgery … follow up in May 2024 psa is 0.030 repeat follow up in august 24 dr suggest radiation when urine is under control … am I am going right path please reply
Hi Im not a doctor but I had rp wirh gleason 9 and was basically undetectable after a couple months ,
Thanks very good 👍 advice to live longer keep fighting pc a cure is around the corner u are not alone 😻🙏
Three years remission for my husband… chemotherapy was not too bad, plant based diet and daily exercise! I believe he is healthy now than ever. Stay positive
I opted for Brachky therapy and IMRT PSA was 5.8 last check it was at 0.827. I turned down ADT with my PSA score what's my prognosis. I do not want ADT it would destroy my quality of life.
@@darylmcfarley9650I agree brother. I plan on refusing all hormone treatments also. I am leaning towards proton therapy. I have a Gleason of 3 + 4 equals 7. But waiting for a third opinion. 5 Coors out of 10. Lower volume fou on the first biopsy in a high volume on the second that's why I'm going for a third opinion. It will be the tiebreaker I figure. But currently I am leaning towards active surveillance with the metabolic therapy approach.
Alex, I started with Gleason 5+4 and a PSA of 320 in 10/2023 which is now down to .10 after six rounds of chemotherapy, ADT and taking Nubeqa. How long should I wait before having a follow up CT scan to check progress of my many skeleton metastases, including spine ? Age 79 - living in the UK. Thank you