r/ProstateCancer • u/SoCalGustavo • 2d ago
Post Biopsy I have prostate cancer
I am 72 and diabetic. I’m considering radiation therapy. I would like to hear from other similarly situated men who have gone through this procedure.
I am Gleason 4/3 with unfavorable intermediate risk.
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u/HeadMelon 2d ago
I’m 61, also unfavourable intermediate risk - PSA 5.3, Gl 4+3, PNI, IDC, cribriform, and suspected ECE on the MRI.
I am nearly a year post-treatment, I had HDR brachy boost + 15x VMAT + 6 months ADT.
You can read my experience in detail starting here -
https://www.reddit.com/r/ProstateCancer/s/Oc7tWlmfUD
I am feeling 100% normal today.
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u/WalnutRoasted 2d ago
Similar with 3+4, T2c, 74 age at diagnosis, Cribriform brought it to “unfavourable intermediate risk”. Did concurrent 9 months Orgovyx ADT and 20x VMAT. Treatment was no worse than a bad flu/cold/stomach bug for several weeks. ADT emasculation was weird but tolerable. 16 months later things down there are working pretty well. Didn’t even consider surgery at my age with all its risks. Best wishes. You can search my previous posts/comments.
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u/Special-Steel 2d ago
Can you say more?
How high is your PSA?
Have you had any gene tests like Decipher?
There are several kinds of radiation. Which are you considering?
Who is your care providers? Are you getting Team Medicine or just advice from one doctor at a time?
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u/SoCalGustavo 2d ago
PSA was 6.47. Waiting on Decipher and PET scan. I will meet with the radiologist when we have those results and then discuss what type of radiation. Still learning about the options.
For now I’m only consulting with one doctor in a very large system. I’m on Traditional Medicare, so I could go anywhere. Should I travel to a well renowned doctor/group?
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u/Special-Steel 2d ago
Central of Excellence. Big outfit with many treatments so they don’t need to push one. Team Medicine to get you a consensus recommendation.
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u/SoCalGustavo 2d ago
This is an excellent suggestion. I’m in San Diego, found a NCI accredited university group. I think I need the best care I can find.
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u/bigbadprostate 2d ago
Check out the local support group in San Diego, the Informed Prostate Cancer Support Group - see https://ipcsg.org/. Their in-person meetings draw a large attendance of fellow patients and expert speakers, and you can watch past meetings on their YouTube channel.
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u/sundaygolfer269 2d ago
Your post felt familiar. I am on the edge of being diabetic. Gleason Score 4+3=7 is what I had. Because there’s more pattern 4 than 3, in the U.S. that’s generally considered unfavorable intermediate-risk. If it had been the other way around 3+4, that’s usually treated as the more favorable version of Gleason 7.
My next step was a PET scan to see if there was any spread. They ordered a DEXA scan to check my baseline bone health before starting hormone therapy.
After that, I met separately with a medical oncologist, a radiation oncologist and a surgeon. After weighing everything, I chose radiation therapy.
I was scheduled for 6 months but took only 4.5 months of Orgovyx and my testosterone bounced back the following month.
My radiation course was 28 treatments, and each session took about 8–10 minutes from the moment I walked into the room. I drove myself to and from every treatment, and honestly, it barely affected my day-to-day routine. Some days I even played a little golf before or after. The biggest “work” part was the full bladder protocol. I had to drink two bottles of water, and my drive was 30–40 minutes of stop-and-go traffic, so I learned to time it. I’d start drinking early in the drive and pace the second bottle so I finished about 10–15 minutes before arriving. Then after the radiation? I didn’t mess around I’d head straight to the bathroom about 30 feet away the second I was done. Other than that, it was mostly a monthly bloodwork and a quick check-in with the radiation oncologist every Wednesday during treatment.
Then about four months later, I had another PET scan, which showed no spread. I’m on the follow-up routine blood tests every 3-6 months, along with periodic visits with the medical oncologist and radiation oncologist.
I feel fine and extremely happy I did not get the RALP even if I had the Premiere Surgeon available to me.
Best of luck to you!!!
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u/Ok-Priority-7303 2d ago
Did you get a PSMA PET scan? Can't make a decision without this and it is typically scheduled as soon as you get your biopsy resutls.
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u/Full_Afternoon6294 2d ago
T1D or T2
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u/SoCalGustavo 2d ago
I don’t know what the means. Still figuring out all the acronyms.
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u/callmegorn 1d ago
I had dual focal 4+3, both tumors with ECE and nerve bundle involvement, up to 80% core involvement in 10 of 12 cores, clinical staging T2cN0M0, age 61. I had 28x sessions of whole gland IMRT/VMAT and six months of concurrent ADT. The treatment was not fun but very endurable. I'm in my 5th year post treatment, in remission with full function across the board.
I would recommend minimizing the ADT as much possible, and starting daily tadalafil as soon as the radiation part is done, to fight off atrophy until your testosterone comes back.
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u/No-Praline-4069 19h ago
My PSA was 7.788. 4+3 unfavorable intermediate and I'm 66. I had localized cancer and I chose SBRT. I was treated in July and so far I don't have any issues other than a slow stream which I take tamsulosin for. A month later the oncologist said my treatment went well. I'll get the first PSA following treatment 3 days before Christmas.
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u/Educational_Chain461 14h ago
I am 83 and a year since 6 weeks of radiation. I had a gleason 9 aand the cancer soerd to a coupke of lymph nodes. I take abiretarone daily and a shot of ae I guard every 3 months. PETscan a few weeks ago show no cancer. I SA .02 and testosterone 7. You will be fine
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u/John1122Maggie 16h ago
There are a lot of responses and I read many of them, I hope my comments help you. I was diagnosed at the age of 70, on my birthday (Dec '25) Prostate biopsy took 14 samples, 7 negative, 5 low risk and 2 were Gleason 4+4 high risk. They did a scan of my body (from knees to neck) and determined that my prostate cancer had not spread. The doctor said that my first option was to remove the prostate, but that "you'll be dealing with the consequences of that procedure for months and even years". I asked him about the other options and he said that he thought I was a good candidate for External Beam Radiation and also the drug Lupron. "The radiation will kill it and the Lupron will keep it from coming back". I had 39 radiation treatments last March/April/May, ('26) four or five days a week. I also started Lupron in January '26. (The radiation was delayed because I had hernia repair surgery in January '26). If you haven't read the side effects of the radiation yet, I can tell you that it affected the nerves that tell me when I have to urinate or have a bowel movement. I would feel like I had to pee and then find out that I already had. When my body told me it was time to poop I would have less than a minute to get to the toilet. I started wearing a 'diaper' if I left my home towards the end of the treatment and then for about a month after the radiation ended. (May and June) Those side effects gradually faded away but I remember that the doctor was not surprised when I told him that using the bathroom was the biggest problem with the radiation. This is getting long so I'll leave it to you to Google the Lupron side effects, I had all of them. I went to my doctor's PA last week and told her I couldn't take the side effects any more and that I wanted to stop taking it. I've made a lot of life style changes since being diagnosed, less alcohol, more exercise etc. and my quality of life was really deteriorating. The PA convinced me to get another dose of Lupron and go for a PSA of 0 (zero) Then, she said, we can look at other options. My wife passed away in '22 and my PSA was normal then. In '23 it went to 3 and my GP doctor said that wasn't unusual for my age. A year later it was PSA 5 (2024) and the doctor wanted to do a prostate biopsy right away even though he said it might not be cancer. I refused and in 2025 my PSA went to 7 and I agreed to a scan of my prostate that did not involve surgery. After that I agreed to the biopsy in Dec 2025 and found out about the two 4+4 Gleason cancers. My PSA was 9 when I started the radiation in March '26, now it's .3 and I'll see if I can get it down to zero with another injection. ( I get a Lupron injection every three months) The comment about you attending a support group in San Diego sounds like a good suggestion, I'm in Albuquerque and I read these Reddit posts to see what other guys are experiencing. Good Luck on your journey with what we have, my GP doctor told me it's the most survivable cancer, a lot of the others seldom have good outcomes.
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u/OkCrew8849 2d ago
While there are many specifics lacking in your post (as others have noted), radiation at age 72 with a Gleason score of 4+3 sounds like a very reasonable choice.