Husband diagnosed today - we need to decide on treatment

It may be the position of the 4+3 in the prostate gland, along with aggressive features such as cribriform, that are driving the need to ensure HT is administered (endured!) for sufficient time.  Richard’s Dad may have 5-4, but it may be completely confined in the gland with less chance of escape. However, I’m not sure that such a logical explanation applies.  I agree that different consultants have differing ideas on how to treat the cancer and for how long.   AW

You are suffering I see that but are you on any other treatments? I’m on HT for life for my continued challenges to the cancer. I’m a Gleason 8 and when I was on aberiterone acetate and my arms were hairless but that wasn’t the HT in my case.

Sadly I can’t drop the HT or my very limited prognosis would shrink and that’s not something I would swap sex or stamina for. But that’s me not you.

I feel for you, but be careful what you wish for.

Good luck 

It doesn’t make sense. Richards Dad had symptoms, Gleason 5-4, brachytherapy boost and his first PSA check afterwards was 0.22. He’s been told 12 months HT.
JPMJIG had no symptoms, Gleason 4-3, brachytherapy boost and your first PSA check afterwards was 0.01.  He has been told 18 months HT!
What are we missing? I am certain grade 4 with cribriform is still better than grade 5: pictures of cell structure bear that out.
AW

Dr Mark Sholtz (PCRI) explains cribriform very well, as an indication that active surveillance is not appropriate.  Hence my conclusion that 4 plus cribriform is not as bad as 5.  That’s also why cribriform is never mentioned on a grade 5 diagnosis, because treatment is necessary with no chance of AS.

Hi Mr U I wish you had a profile to read, will you consider doing one? When I come across someone that seems similar to Mr BW (HT for life) I will trawl over the profile looking at the treatments, original PSA, journey etc. for comparison. I feel Mr BW and I are always on standby waiting for what’s next. I also find that the higher the level- the less information is shared. We have been pushing to come off HT for a break after 2 years and applying “intermittent use”. Reason = hoping that it will elongate the use of Abiraterone before BW becomes resistant to it and to see if the cancer is still active and where it is.  But now, Mr BW has adjusted to life on HT; he manages the side effects and the cancer is controlled and asleep, we are concerned that we will wake it up and it will be hard to get it back under control if we stop HT.  His consultant originally said “no point in stopping”, but after two years he seems more open to considering having a monitored break and we are now too (scared?) to go for it.  So I hope you don’t mind me asking some questions as it would be very helpful to get your take on things ; you say you had Abiraterone, why did you stop it and what are your drugs now? What was your original PSA and what is it now? Have you had RT or Chemo? Have you discussed what’s next on your treatment plan? 

(also I agree with you about not stopping HT too early after RT. We thought Mr BW had hit his Nadir a while back right after year one. It was at 0.05 and reasonably steady for almost a year.  Now into year three after a whole year steady, the PSA has suddenly started moving down again without HT changes.) 

Best wishes L

Hi,  you mentioned.

My husband was diagnosed with advanced metastatic prostate cancer 4+ years ago so at a different end of the scale but thanks to the treatments available we still have a good quality of life. 

Did your husband undergo the Triplet therapy ?  Is he now just on daily Darolutamide tablets and 3 monthly ADT injections?  Or is he having different treatment?  Thanks

Brief history:

2.5 years ago, age 58 surprised to have a blood test showing PSA 90. I have BRCA2 and CHK2 malformations in my DNA. Prognosis 5 years

HT Zoladex administered initially and after scans and biopsy found to have lesions in bones (only) with a Gleason score of 8. PSA immediately went down to <1

Started Abeiterone Acetate (chemo pills) which was great for 14 months until the PSA rose to 15. Whereby that treatment ended.

Started Olaparib pills (which I’ll stop Monday) a year ago. Initially it took a couple of months to knock back the PSA but seemed to be a good 2nd treatment till now.

Two months ago the PSA doubled to 26 then last month trebled to 80.

I had a consultation about next step a choice between Docataxel and Carboplatin. The later was chosen as it is more specifically aimed at my DNA mutation prostate cancer.

From the start RT was of no use because of the metastatic bone lesions. First IV chemo starts April 15th 2025.

Hi all - lots of interesting reading here on my thread - just thinking (as we are at the start of the journey) - what are peoples thoughts on getting a private 2nd opinion before we start treatment ? Husband has private med cover through work and it will only cost the excess of £200 - do you think it might be worth it ? Also as hubby has not been offered a bone scan they may do one as a matter of course ?

HiRedrose25 Quite simply , if you have it use it. The more information and opinions the better. Sorry we've flooded your feed. It's been very interesting following it. 

Best wishes for you both 

Lorraine x

 Mr U Thank you so much for sharing your journey it's really helpful. Very similar to Mr BW =age/level/prognosis (though we were told could go to 10 plus with treatment options) except The BRCA and CHK2 of course which is pretty full on and I don't really know much about it. More aggressive? but at the same time allows precision with treatment options? "Carboplatin” I will follow you if that's ok. And you've filled in your Profile, I'm so glad you've come out of the shadows. 

Lorraine