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Cancer: Prostate Message Board

Cancer: Prostate Board Index

I'm so sorry to hear about the disappointing biopsy upgrade. I know that feeling when bad news like that arrives, like a cold wind freezing your heart. Thank God that you have taken the steps and found out what you are really dealing with -- you may have saved his life by doing that. Epstein is pretty much definitive.

I hope you understand that a Gleason 9 is still potentially very curable if you act quickly. Maybe some numbers will provide some comfort.

At Memorial Sloan Kettering, 93% of high risk men treated with IMRT+HDR brachy boost had no detectable disease progression 5 years later.

Among 958 high-risk men treated with a combination of androgen-deprivation, LDR brachy & IMRT, 86% had no detectable disease 8 years later:

I know that you wanted to avoid adding IMRT to the brachy to keep the side effects lower, and with a Gleason 9, you may not be able to do that. The only monotherapy I've seen for high risk was with SBRT, but the number of men treated this way are small. Among 88 men who were Gleason score 8-10 and treated with SBRT monotherapy, 78% had no detectable disease progression 5 years later. I know that Dr. King at UCLA, Dr. Katz in NY are doing this. Possibly Dr. Meier in Seattle -- you'd have to call and check. A really good MRI would be essential to check if there is evidence of extension beyond the prostate.

- Allen

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