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Gleason 9

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Prostate Cancer Research Institute

Prostate Cancer Research Institute

Күн бұрын

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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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Пікірлер: 58
@dennistichelkamp7327
@dennistichelkamp7327 Ай бұрын
I love this program. Totally genuine and you can tell they care.
@stevemarsh1584
@stevemarsh1584 2 ай бұрын
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.
@ianforsyth2090
@ianforsyth2090 2 ай бұрын
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
@SkipNormand-n7r
@SkipNormand-n7r 18 күн бұрын
Hi, Steve. I have some questions regarding your treatment schedule: 1) Did you get burns to your bladder and/or rectum from the radiation and/or have other side effects?, 2) Did you get to take any "holidays" from your ADT or was it 21 straight months of ADT?, 3) What were your major side effects from the ADT?, 4) Are you now taking Flomax?, 5) Do you occasionally have any blood in your stools or urine stream ?, 6) What is your PSA at this point? Your answers will be of great help in the decisions I am currently making. Kindest regards and best wishes for a complete cure.
@wayneredd6776
@wayneredd6776 2 ай бұрын
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.
@auggie7687
@auggie7687 2 ай бұрын
I have watched every video PCRi and this is one of the very best!!!
@woodartist2021
@woodartist2021 2 ай бұрын
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!
@truthseeker1959
@truthseeker1959 2 ай бұрын
Isn’t 0.35 above 0.1?
@woodartist2021
@woodartist2021 2 ай бұрын
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
@edg531
@edg531 2 ай бұрын
@@truthseeker1959 he corrected that in a separate post; 0.035.
@dennistichelkamp7327
@dennistichelkamp7327 Ай бұрын
Gleason 8, localized in se was 4+4 in 20% of core sample. Orig. in 12/22 was a 3+3 but in nine months went to 4+4 in Icy. At end of Sept 23 psa went to 6.8 had 3T mri and psma pet. After Oct biopsy at end of Nov 23 I had 6 month Lupron. Clinical at each doc was smooth, firm, no nodules nor perineural issue. Psma showed pnly in prostate no other involvement. In early Jan psa was 1.7 then in early Mar of 24 psa down to 1.4. Had 3T mri which said essentially no diff between from earlier 3ts. In Mar began five weeks of external beam then on 6/13/24 had permanent Brachy. At first urination much better but last few weeks slower and dribble and burning. No radiation to lymph nodes. As all 3ts showed no enlargement of lymph nodes nor perineural involvement or seminal vesicle. Located in right peripheral apex only. Sent 3ts and biopsies to Barnes and Mayo. Mayo was going to do every other day for five treatments and Lupron for 6 months and no lymph nodes. I wound up in Mar doing locally 5 weeks of external with no lymph nodes and had second 6 month of Lupron and psa was .02 at end of May. Plan is for 2 years of Lupron. These questions: 1. Should I start on 2nd gen of hormone. I am 72 ok on health. I have been only Lupron for 8 months now. Should I do 2nd gen now and I am not rich but make too much to get help so any ideas to help with cost. 2. I think 💭 should have done Lymph nodes but local doc did not and Mayo was not going to either but Barnes was. Can I now do lymph node radiation after first getting another 3t mri. See if ad oncologist tomorrow who will do minor Ct to check on placement of seeds. She am worried over decrease flow with dribbling and burning every time of urination. If you believe in doing 2nd gen and if either you or me figure how to pay I think I should do and should I also do Steroids. If you answer this how will I know? Just send to cdgnr@yahoo.com. This f a new 3T mri shows no enlargement of lymph I still think I should do rad of lymph. As far as bowel movements I have to take Miramax. Also is it ok to use any of the 2nd gen hormone drugs as only one, Zytiga has generic and still high. Our great American health care if you are rich?
@robertfemia4217
@robertfemia4217 2 ай бұрын
Great information on all the videos ! This is my go to source for educating myself on Prostate cancer, the treatments, and resources. Thank you!
@KimBoekholder
@KimBoekholder 2 ай бұрын
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
@nestordupo845
@nestordupo845 2 ай бұрын
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.
@terriblepainter7675
@terriblepainter7675 2 ай бұрын
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.
@MagnificentMurphy
@MagnificentMurphy 2 ай бұрын
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.
@kathyjohnson170
@kathyjohnson170 Ай бұрын
We were told 3t image & psma scan wouldn't be covered back when first getting from dr. , nurse. Really? Strange cause our ins. Approved it. What is going on with that. Radiation causes cancer. I asked the radiologist. He said yes.... but on down the road.... but consider how much a person has received over said amount of years.... like the buildup. Interesting to me. Doing both, holistic, catching up with deficiencies, & getting junk out.... bromides, mercury, flouride, metals, toxins, parasites.....junk. Just started lupron, my husband and deciding when to do radiation.
@imagequestful
@imagequestful 2 ай бұрын
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.
@rogerembry4777
@rogerembry4777 2 ай бұрын
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
@nelsonoliva2119
@nelsonoliva2119 2 ай бұрын
Hi can I ask you if youve ever had a psma scan or decipher test? Im gleason 9 also..thanks
@user-ig6hj5mr8g
@user-ig6hj5mr8g 2 ай бұрын
I feel like his PSA was rather low?
@ricknowak4582
@ricknowak4582 2 ай бұрын
.2? .... 37 ROUNDS of ...RADIATION!?!?!?!! .2?? I don't un get it.
@beachgirl468
@beachgirl468 2 ай бұрын
@@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.
@rogerembry4777
@rogerembry4777 Ай бұрын
@@ricknowak4582 i round
@dennistichelkamp7327
@dennistichelkamp7327 Ай бұрын
One thing that would be helpful if you did program on which 2nd generation hormone drugs to use and I did not know about steroids. The program should be focused (since these drugs are so expensive which means only the rich has access) on how to be able to buy the drugs. Whether you go out of country and how, or your income is too high for any assistance, so, mainly a step by step approach to getting the 2nd generation drugs.
@user-wu9oj4zp6m
@user-wu9oj4zp6m 2 ай бұрын
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
@j.jsjourneysouthafrica3806
@j.jsjourneysouthafrica3806 Ай бұрын
Same with my husband turned him away for chemotherapy and radiation we don't know what to do anymore we based in south Africa Cape Town
@daveheatherfridinger526
@daveheatherfridinger526 2 ай бұрын
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?
@skalbert12
@skalbert12 2 ай бұрын
i am on medicare, will only pay for 3 lifetime pet scans, will not do first till psa 0f 2
@4HisGlory07
@4HisGlory07 Ай бұрын
I had the fushion mri two years ago that showed 3 spots 3cm localized. I did not have a dr that I trusted. But when my psa went up from 5 to 10, he ordered another mri a few months ago. They said it is still not spread. I then went to UW in Sea & have a great dr & had a biopsy that showed the spots and am now a Gleason 9, and recommended for hormone & radiation. My concern is, I already have severe fatigue. How likely will I be able to even function if the therapy makes me more fatigued. It’s already very difficult to exercise or even walk around the house. Any suggestion from PCRI or viewers is appreciated
@WilliamDennis-d3i
@WilliamDennis-d3i 6 күн бұрын
I have recurrent prostate cancer. Of the 12 biopsied areas in 11/2022 11 were 4+4 and one was 4+5. I had external beam radiation in June of 2002 and brachytherapy in July 2002. Scar tissue has closed my urethra I have a super pubic catheter. I am on Telstar my last PSA was 7.3 (monthly check). Should I be doing anything else?
@woodartist2021
@woodartist2021 2 ай бұрын
I mistakenly left out a zero in the other post. The latest PSA reading was 0.035.
@srnath7104
@srnath7104 2 ай бұрын
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
@nelsonoliva2119
@nelsonoliva2119 2 ай бұрын
Hi Im not a doctor but I had rp wirh gleason 9 and was basically undetectable after a couple months ,
@georgerios7491
@georgerios7491 2 ай бұрын
Thanks very good 👍 advice to live longer keep fighting pc a cure is around the corner u are not alone 😻🙏
@user-ig6hj5mr8g
@user-ig6hj5mr8g 2 ай бұрын
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
@darylmcfarley9650
@darylmcfarley9650 2 ай бұрын
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.
@ricknowak4582
@ricknowak4582 2 ай бұрын
​@@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.
@mstechjonny8275
@mstechjonny8275 2 ай бұрын
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
@ianlaws3469
@ianlaws3469 2 ай бұрын
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?
@robertmonroe3678
@robertmonroe3678 2 ай бұрын
Not a Dr but some docs are suggesting post-prostatectomy salvage therapy at .1-ish (understanding PSMA won't be helpful at this point).
@ianlaws3469
@ianlaws3469 2 ай бұрын
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.
@robertmonroe3678
@robertmonroe3678 Ай бұрын
@@ianlaws3469 Unclear. Are you saying your PSA was actually UNDETECTABLE (meaning
@priya9372
@priya9372 2 ай бұрын
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
@piyushmaheshwari4824
@piyushmaheshwari4824 2 ай бұрын
.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.
@stitcheruk1150
@stitcheruk1150 2 ай бұрын
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
@Shiblee2000
@Shiblee2000 Ай бұрын
I have a prostate cancer that diagnosed back in the beginning of 2023 with a Gleason score 9 metastasized to two lymph nodes in pelvic region. Now I ham going through combination of 1st and 2nd gen Hormone therapy for 2 years and already radiated the affected area with 5 high beam radiation. Now the question is what are my chances for total cure?
@robertheath453
@robertheath453 Ай бұрын
Help! G9 LN MET. Had radiation and 2 years ADT and zytiga. STAMPEDE seems to suggest 3 years ADT. MO insist 2 years enough. Thoughts?
@jfc650
@jfc650 2 ай бұрын
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.
@NAVIN-rl3wg
@NAVIN-rl3wg Ай бұрын
What's the latest about the promises of a Cancer Vaccine seeing the day anytime soon? Tks.
@heartchakra2
@heartchakra2 2 ай бұрын
Is triple therapy also given to men over 80 years old ?
@robertheath453
@robertheath453 2 ай бұрын
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?
@MrGnEkiv
@MrGnEkiv 2 ай бұрын
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?
@patriciawarne
@patriciawarne 2 ай бұрын
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 😊
@leoregan3996
@leoregan3996 2 ай бұрын
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
@NAVIN-rl3wg
@NAVIN-rl3wg Ай бұрын
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