Arbiraterone +Brachytherapy

Hello RichE 

I would trust your team - and make sure when you have your Radiotherapy it's including your pelvic lymph nodes.

Abiraterone etc is there for you should you need it in the future - I have had almost 4 years of Decapeptyl - once the side effects kick in that will be enough thank you! 

Gleason 8 with cribriform pattern and your team are looking after you - stick with them, if they are confident of a "curitive pathway" then happy days.

Best wishes - Brian.

Thanks Brian. Im feeling quite positive atm taking every side effect free day as a bonus. 

Hi Rich, I think at least you should discuss the addition of Abi/Pred with your oncologist. You are probably eligible. I am T3a, Gleason 9, and chose to add it after looking at the results of the STAMPEDE trial, which are conclusively better if added. It is not a 'free lunch', I have fatigue SE (only) which is inconvenient but not debilitating. Worth it in my opinion..Unclear what is the additive effect of Abi but probably some. I have been o this for 7 months (on top of Orgyovix) and am 'undetectable '. Great news and because of this rapid progress, my onco has agreed to reduce the 3 year sentence to 2 years. Very welcome.

Brachy boost not offered to me, but also worth asking.

Hope this helps.

David

I would ask about Abiraterone/prednisalone and Brachytherapy boost (not brachytherapy by itself).

As mentioned, you should be entitled to the Abiraterone.

They probably wouldn't offer Brachytherapy boost if they don't do it, but (in England at least), you're entitled to go somewhere which does do it (which they never think to mention), although that might mean more travel. Even if you do have to go somewhere else, they should be able to plan the external beam part so your local hospital can deliver that part.

That’s exactly what I did: I asked about BBoost and the MDT agreed that was the best way forward. Aggressive features in my biopsy report (4/3 with Cribriform / atypical intra ductal proliferation (AIP), suspicious of IDC-P).  The normal ADT was enough to drive my testosterone & PSA  down so I didn’t have Abi).   AW

Leave the Abiraterone/Prednisolone until your oncologist thinks you need it.
You haven't had any side effects from Triptorelin yet and maybe you will be lucky and not get any

I've been on Abiraterone/Pred for nearly 2 years. Started off at 1000mg a day but they dropped it to 500 mg as the side effects were too much.  It's still bad but better than the alternative 
PSA is below 0.03 and has been for some time so it obviously works but it is debilitating and the fatigue is bad.
I'm not curable so this is 'it' until it stops working but it's not a walk in the park, actually a walk in the park would be nice if I had the energy ;-)