I was diagnosed with a gleason 7 (3+4) and PSA 5 which was biopsied twice and several MRIs and then HIFU last december when PSA was 8 - very unusually I am told a previously twice negative biopsy lesion on the clear side suddenly comes up as gleason 9 (4+5) after a PSA of 7.
I am now on bicalutimide 150mg and as i had polio which has left me with lots of muscle loss from that as well as affecting my respiratory muscles the idea of using bicalutimide (casodex) as a mono-therapy alone to shrink the cancer and lower PSA prior to radiotherapy without risking the LHRH hormmes such as zoladex seems an a reasonable option choice.
I am aware that the usual treatment would be to use both or at least start with the bicalutimide,and then add the zoladex LHRH this impacting both paths of testosterone. The PSMA scan shows no evidence of spread outside the prostate, which i think is not absolute evidence but perhaps 85% accurate even with a gleason 9.
I wondered if anyone had experience of this and what the outcome was, obviously its not easy to make decisions but I am reluctant to compromise my walking and functioning by adding the zolodex if ut the relative benefits are marginal - obviously if i were 80+ i might be less concerned but at 71 and still working part-time it is less clear given a 10 year plus horizon.
