Diagnosed with 4+3 decipher score .96 in July 2023. My urologist wanted to do a proctectomy immediately. Started watch this channel. Met with an oncologist. Went to UCSF and Stanford for second opinions. Four months later after conducting much research and watching every available video on this channel, I elected to have one round of HDR brachytherapy, followed by five weeks of IMRT, no ADT. My homework paid off, I am confident I made the right decision, so glad I didn't get a proctectomy, for being 66 I couldn't imagine having to endure all the related side effects, compared to the minimal side effects associated with my course of treatment. It's not exactly pleasant, but absolutely tolerable! My research made me believe that surgery is almost barbaric compared to available types of radiation treatments. As stated in this video, you must learn and understand the type of PC you have so you can make an informed decision. Lastly, I would not recommend making a final decision without getting a PSMA PET first. Wishing everyone watching this channel all the best!
Interesting, I am in the same situation as you. 70 years old and otherwise healthy with 4+3 diagnosed in October 2023. I have an appointment with a radiation oncologist and a chemo type doctor next week. I am still researching alternatives.
I've a very similar story, but with LDR and with ADT (I'm 12 months into a 18 month Orgovyx/Zytiga regimen)- my PSA has been undetectable since June, my gleason was 9, with no evidence of spread outside of the capsule with PSMA/bone scan,
Be sure to thoroughly research LDR and HDR brachytherapy following the results of a PSMA/PET scan. There are some excellent videos on this channel and others on UA-cam regarding the advancement of this technology. You'll be blown away when you learn that this type of therapy isn't pushed as heavily as other forms because it isn't as lucrative. This is billion dollar industry and sadly, it's all about the money. @@bvschledt
I had Gleason 4+3 as well opted for 40 rounds of proton therapy after much research. 6months out PSA went from 14pre treatment to 1.14 one year out PSA .4. Next psa test upcoming April 2024. I experienced no urinary or rectal sexual issues, I’m 69years old, no metastasis. I also declined ADT, might have saved myself the horrendous side effects.
I'm a 56-year-old Air Force with Gleason 4+3 =7 and used PCRI and Dr. Scholz advice to help me make the decision to get radiation treatment and not prostate removal surgery. My doctors said both were an option for me. My PSA has dropped from 13.7 to 2.7; 8 months past my radiation treatments. I have very few side effects, feeling good physically and mentally, missed very few days of work, was able to travel, exercise, ride my Harley and enjoy time with my wife and grandkids, very happy with my choice of treatment. Thank you PCRI, bless you for the help you give us!!
I am right in the same boat as you…55, veteran (Army) and 4 + 3, was having RP pushed pretty hard. Found this channel, and helped me make better choices. Still haven’t started treatments yet, but likely doing EBRT. Glad you’re on the road to recovery.
I'm in the same boat, definetly going with radiation....which method did you choose? My PSMA CT Pet was good. i will not go on ADT. Did you guys go on hormone therapy?
@@johnmchale8308 yeah, I think that my radiation oncologist wants to do 6 months of ADT. I also had a clear PSMA scan. He thinks that’s kind of a “double whammy” against the tumor cells. Not so happy about it (but maybe I will grow breasts? That could be fun 😅)
No one should go into any prostate treatment plan without coming here first and often. I am a year into this journey, am doing well and have confidence in my decisions. These two are wonderful and the information is pure gold. A big thanks to both of you.
@@DeathSentryCoH I was just diagnosed with cancer after my biopsy on August 1st, 2024. Waiting for the Gleason Score is killing me. Won't know until August 21st.
I am in love with #MarkScholzMD female presenter. She genuinely seems to care about male prostate issues. She asks excellent questions that help inform us. Big fan of Dr. Mark Schcolz, huge fan of his compadre. Say her name! I have prostate cancer 3+4. Admiration for the both of you. Thank you both for this invaluable source of information.
I am newly diagnosed with prostate cancer...Gleason score 7 (3+4). Still trying to figure it out. This channel is an absolute must. Thank you for existing❤
Please read my post above. I strongly suggest giving Proton Beam Therapy serious consideration. However, there are a few issues that make choosing it as a treatment. For one, it is only available in a few locations. Another is that many health insurance companies may not want to cover it. Finally, it typically involves 45 treatments (5 days a week) so you will need to stay near the treatment location. Since I was retired, the 9 week treatment--commonly referred to as the "radiation vacation" because of the lack of side effects, wasn't an issue. I was also on Medicare, and fortunately Medicare covers PBT.
@@robertbrazeau7049 Hi Robert, I have just been diagnosed with 3+4 gleason and my doctor is pushing me to have surgery. I would really love to chat to you offline about PBT therapy. Please let me know if this is possible and ill forward contact details. Thanks.
I was diagnosed 3 years ago with (3+4)=7 PC. Researched extensively all treatments. Went to Mayo Clinic in Rochester,Mn and had 5 High Dose Treatments of PROTON therapy over 2 weeks . PSA now .27 with minimal side effects…………..
I was diagnosed with prostate cancer in November. They gave me a choice between RP and radiation. After doing a lot of research and watching many of the videos on this channel and others, I decided to go with SBRT and hormone therapy. Out of 12 cores 2 came back positive - 4+3 and 4+4 with cribriform growth present (more aggressive form of cancer). Got Lupron injections 3 weeks ago and taking bicalutamide daily. So far no side effects. 5 Radiation treatments will be done in March. Hoping for the best.
@@joemaxwell1044 Stereotactic body radiotherapy. It's only 5 treatments of radiation instead of the usual 25-40. It uses 3D or 4D imaging and highly focused radiation beams to send high doses of radiation to the area to be treated. This results in the least amount of damage to the healthy tissues around the area.
I'm 71 and sought out a very experienced, highly regarded Doctor to perform my Brachytherapy at the Cleveland Clinic about a month ago ( Gleason 7 4+3, psa 5.7). I was told by my initial Uro who did the biopsy (Surgeon) that Brachytherapy was obsolete. Was told similar by a Radiation Oncologist who wanted me to start EBRT and ADT right away. Glad I looked further
I had a 4+3 w psa 8+. I considered prostatectomy vs. radiation. I decided to go with radiation because the long term outcomes looked the same with less consequence. My original treatment was going to be a mix of ADT, EBRT, and a single HDR Brachytherapy (not the LDR Brachy/seeds - worth googling the difference). I also had a PSMA PET CT scan to assess if it had spread and a Decipher genomic test to assess the aggressiveness of the cancer. The PSMA PET CT showed no spread. The Decipher test indicated low risk in aggressiveness. Based on those outcomes, my Dr recommended a switch to 2 sessions of HDR Brachy. Each takes a full day via outpatient session - 1 week apart. Relatively painless procedure with about 3-6 weeks of recovery to be back 100% (very low impact recovery). I was happy to avoid the ADT/EBRT which can be challenging (esp ADT). My outcome has been excellent so far - PSA went from 8+ to 1.1 in three months. No side effects from the procedure at all (really). I'm fully back to cycling, working out, hiking, and everything I could do before. The HDR Brachy tech has been around but the precision technology (machines & visualization during the procedure to guide the treatment) has dramatically improved to where the side effects and potential impact outside the target area are extremely limited. For me, I could not have asked for a better outcome. I was lucky to get a very experienced forward thinking, cutting edge oncologist who has done a large number of these procedures at an NCI Cancer Center. Just sharing another possible treatment path. Good luck!!
@skinfiddler I’m in a situation close to yours, Gleason 7 3+4 in three cores and 3+3 in two cores psa 5.7, I’m looking at the Cleveland Clinic also. Can you advise who the Doctor was that performed your procedure?
When I was diagnosed with prostate cancer for years ago. They gave me a book and told me to go home and take my time and make the decision what I wanted to do.
I was diagnosed in Early 2009 with PSA levels that were in the 2-4 range. Given a family history of the disease and the decades they had lived with it, I was not pleased but not anxious to try surgery or brachytherapy. I was directed to Summit in Oakland, where I was basically sold on High Dose brachytherapy on the grounds that it was precise, and didn’t leave radioactive pellets behind. What wasn’t discussed was side effects. Two years after the procedure, I developed interstitial cystitis leading to urinary interruption, and several trips to the ER. Months of hyperbaric therapy alleviated most of the problem, though ED became progressively worse. Finally, during a endoscopy procedure, my urologist saw what turned out to be a stage 4 tumor in the interface of the bladder and prostate. Metastases were present. Chemotherapy and immunotherapy have extended life for almost two years now, but I’m living with a permanent Foley. I share this to caution others to proactively question caregivers about side effects, and longer term care prospects. Doctors generally want to help, but they also want to publish and advance their careers. Be aware.
I'am so sorry for your Issues that occurred after Treatment. These are the things that are extremely frustrating and in my Opinion "might/Should" be caught and or Eliminated with more precise diagnosis. I wish you the Very best. Thank you for your Post, these things need to be out there for others to read and get the Important Information needed to be proactive rather than reactive. Thank you so much. 🙏🏻..
@@Ron-n4j1l My husband also had a normal PSA that result in a diagnosis of Prostate cancer. He is an avid bike rider sometimes going over 200 miles a week. He would get intermittent prostatitis, and his urologist said it was caused by his bike riding. Because of this he always would get PSA testing. Well he had one PSA result that was 2 point higher that the PSA 6 months prior. This result is a big red flag if it jumps that quickly. His PSA results was also in normal limits, He has never got a PSA results over the normal range. MRI prostate showed highlighted areas .Biopsy showed Gleason 4+3, also had a decipher test. He then did a PSMA Pet Scan. That showed only highlighted areas in the prostate. He is now on his treatment journey.
I stumbled upon these videos very early on in my journey, and as my diagnosis became clearer, hearing my doctors suggest the precise treatments for my condition as have been outlined by Dr. Scholz, has allowed me to have confidence in the process. Put differently, Dr. Scholz is my second opinion, and since it matches the first, I feel good about the direction.
recently dx in Nov. My local prostate cancer support group suggested I check this site out and am now a subscriber + made a small donation. Back to my story, I have 3+4 gleason; no metastasis; localized only, last PSA was 8.6. I don't want to do surgery; leaning towards beam+ brechy; part of the conversation was adding hormone tx; but I rather not go this route. I'm 50 otherwise healthy, within my range weight for height and don't take any meds, no alcohol or drugs, plus stopped drinking dairy milk and all processed and red meat, with reduced chicken and fish, mostly veggie type diet but not exclusively. I find these videos extremely helpful. Am wondering what other considerations am I missing before I make a decision. Thank you!! P.S. It was also suggested I read the Key To Prostate Cancer by Dr. Scholz, excellent book and highly suggest it.
Im 70. I've had a Gleason 6 for about 10 years. Active surveillance awaiting biopsy results. Highly considering taking my chances with the disease.symtoms are mild.
I am just starting on my journey. Truly glad I found Dr. Sholz and Alex and the wealth of information I have consumed. I hope I make the correct decision for my health and well-being. Thank you for the vast array of knowledge that I can turn to.
@@jaybrown2182 you should get a second opinion from Dr Scholtz. He might be able to cure you of your cancer. He have been keeping me undetectable since 2011.
I had a TURP procedure 2 weeks ago, 6 of 133 chips are malignant 4+4=8. Waiting for my surgery follow up to determine next steps. Thank you so much for the information you are providing to help me make treatment decisions!
This series is incredibly important and supportive. I have 4+3 encapsulated and this series of videos has helped me navigate all the options and acted as the 3rd and 4th opinions, as well as the baseline of being your own advocate. I have opted for proton therapy at the Mayo clinic and you two have even helped pick where to do it. Subscriber for life (a long life).
Dear Dr. Scholz, I appreciate the valuable insights provided in your videos. As I continue to undergo radiation therapy in Italy for my prostate tumor (4=3), I am mindful of the collaborative nature of the treatment process. I have observed the dedicated team of technicians who operate the equipment and support me during each session. Additionally, there is a pivotal role played by the doctor (whom I see 1time x week) in determining the treatment frequency, potency, and overall plan tailored to my specific needs. In light of this, I am keen to gain a clearer understanding of the division of responsibilities within this team-based approach. Given the presence of varying technicians (and sometime technician in training) during my sessions, I am eager to know if I can place my complete trust in them. Furthermore, I seek your perspective on the allocation of greater responsibility -does it predominantly rest with the treating doctor or the technicians? I am grateful for your guidance on this matter. Sincerely, Marco Biancardi
Great info and advice. Thank you! Eight years after imrt I have recurrence, psa went from 1.4 to 3.6. Had the PSMA Pet and MRI, had the biopsy, small area with 4+3=7, confined to prostrate. At 76 really looking at the options carefully, did not go to my oncologyst referral. Been doing a lot of research, maybe too much. No, never too much. The newer ablations seemed very interesting, however now more focused on SBRT, MRI guided. Can't recall seeing one of these video sessions focusing on recurrence.
I’m 67. Like you, 7-years after my SBRT, my PSA went from about 1.5 or less to 6. Had PMSA. Cancer confined to prostate. At 67, like you, I’m researching like a mad man. Never can do too much research. Doc wanted me to start Eligard 3-month injection. I don’t want the side effects of ADT. Would like to see something also on recurrence after radiation therapy. Praying you have a successful outcome.
Big Thank You to PCRI After PC diagnosis 7 months ago, Gleason 7a with PSA10. I did intense research with lots of help from this Channel, excellent !!! Today I got inserted my gold fiducials and in 2 weeks, cyberknife/SBRT will start. Thank you so much Dr Schulz and Alex !! Fun fact: My german Urologist had to google SBRT, unbelievable. His advice was clearly radical ectomy.
I'd Have to Look up the acronym myself. SBRT??? Ya, I don't off the top of my head know what it is either, But a Dr. not knowing???? Hmmmmmmm????? Really.
nice work Dr. Scholz & Alex. if it wasn't for your my urologist would have my prostate removed 4 years ago. with prostate MRI and active surveillance i would have let them overtreat me. thank you for all you do
Husband was on Hormone treatment for 5 yrs (worst ever sleep & urination). PSA rose, so Taxotere for 5 treatments (1x/ev 3 wks) when PSA rose again. Offered to switch chemo treatments (1x/wk for 2+ yrs). In 8/2023, MRI noted 3 lesions behind kidneys/in front of spine. Interestingly, PSMA noted 3 lesions in bone only. So apparently patients need both scans. If still eligible, after next MRI 1/2024, Husband is moving on to Proton Radiation (20+ spot treatments).
These video's are very helpful. I made a small donation and had a phone call with the PCRI organization last month. With a high PSA I just received my MRI results as a PIRADS 2. In 2024 I need to be a student and learn more to make the right choices.
I had Gleason score 3+4=7. I am 53 yrs now. It was localised at Right Lob of Prostate Gland. My doctor suggested Robotic HIFU treatment & accordingly I undergone it on 21st Feb 2024. I Have been discharged next day. Let see what Will be the result.
I second that in its entirety. Very well put. The information contained in this channel has been incredibly valuable, and I urge that you keep the flow of new information & and procedures coming. Thank you
Thank you. I am having difficulties with my treatment team at Kaiser. I had a 4/4 Gleason 4 plus years ago and had radiation and Lupron. I am asking them to get another PSMA Pet Scan to determine whether or not the spot on my C3 spine is cancerous because it can now determine if my spot decreased in size after my Lupron shot. If it has, then it can be eliminated by radiation. It there was no change, then it is benign. My team has denied this test at this time. I am afraid it will metastasize. Radiation plus hormonal treatment to me is best. Thanks Dr. Scholz
In Britain you see the surgeon your given and are told what treatment you will have. I was only given 2 options surgery or radiotherapy i had surgery and my PSA has gone from 0.0 to 0.18 in 5 years
I am on the road to recovery from a Gleason score of 4+3. I just wish sometimes that you would focus on some older technologies that still work because not all of us have access to or can afford to use a modern cancer center. We are dealing with regional hospitals that may have limited access to super modern stuff or not the leaders in their fields. The best they could offer me was 25 radiation sessions rather then SBRT. Did it work? So far I can say yes? Thanks to you both for these videos. They are always informative and professionally well produced.
That was a piece of excellent information much needed for me at the moment. After having an MRI done I've been told there is a high possibility of prostate cancer and was suggested to make a biopsy which I refused, wanting to have more time on research. Thank you.
On 1/11/24, my PSA was 11.65, referred for MRI and Biopsy. MRI on 2/4/24 yielded Impression results, "No multi-parametric MRI evidence of clinically significant prostate carcinoma." PI-RADS Assessment: "Very Low (Clinically significant cancer is highly unlikely to be present)." Biopsy on 2/13/24 provided a "Gleason Score of 4+3=7" with 2 of 18 cores showing 3% and 10% "Adenocarcinoma of the prostrate" and "Grade Group 3." Decipher test results, "High risk - .67." Next on my agenda is a PSMA-PET scheduled for 3/18/24.
I am diagnosed with a 3+4 Gleason score. 25 samples were taken with 18 showing cancer. The discussion I have had with my urologist and radiation oncologist resulted in wanting to remove my prostate because of the bad BPH I have . I am in the 73% on BPH and both doctors stated that seeds, radiation will swell the prostate more causing a complete block of urine flow. Have you ever addressed prostate cancer with bad BPH? M level of cancer was a 2. 1 being best and 5 being worse. I am scheduled for removal for March 6th but watching your videos is making me question that surgery. The big thing is the size of my prostate.
@@DeathSentryCoH I got 3 plus 4 for 4 years, I am 64 now. I have an enlarge prostate but can pee well. I get a biopsy in Dec, I hope to stay on AS. No spreaD AND psa UNDER 5 . I will remain on AS is no change
I was diagnosed with prostate cancer from an biopsy on August 1st of this year. I will not know my Gleason score until the 21st. of this month. I can't believe I have to wait this long. It was in the Anterior portion of the prostate glands. Sleepless in 29 Palms California.
Overview +7 The Decipher test is a genomic test that assesses the risk of prostate cancer spreading and death. It analyzes the activity of 22 genes in prostate tumors to calculate a score from 0 to 1. The score is then categorized into three groups
I was diagnosed withGleason six I was on active surveillance for six months. I decided to have the robotic surgery. I do not want to live with this disease I’m 56 years old I have a very supportive spouse my PSA drop from 2.13to 1.63 i’m doing great, but I made my decision
I like Alex, she seems to genuinely care about PC patients. Dr Shill however is obviously biased against surgery and never seems to acknowledge that radiation has its fair share of risks and side effects. There is no perfect treatment option and cool names like Cyberknife don't reflect what their name implies. Make the choice that is right for YOU and your cancer based on your research. I wish you well in your journey.
You can look up quercetin phytosomes and curcumin phytosomes on the NIH. This high absorption/bioavailable form of plant compounds is spoken of highly for prevention in many clinical papers.
I have a CA : 5+4=9 . In 6 Cores Gleason 9. Group 5.. PSA, above 80. Very Aggressive. I Had a Cryoabolation ( Freezing) of the Prostate. My Tumor was Locally, in a PET Scan.. What is my Chances, it has been Cured.?? Its been 7 weeks. Going to checky PSA. Level. Going to take PSMA PET Scan, in 2 months, to see images, hopefully it has not Spread.
I had a Gleason score 3+4 cancer in the prostate and lymph node in pelvic cam after radiation of prostate went back to cyberknife miami and treated again and 6months of hormones now they tell me every 3 months PSA test last psma scan said no visible cancer where it was in previous scan
My husband 65 years old with a Gleason of 4+3,/Decipher/MRI/PSMA confirmed his diagnosis of cancer He has never had an abnormal PSA. Just an abnormal 2 point rise within 6 months, and intermittent prostatitis from biking riding. His treatment is 1 injection of Lupron(last 6 months,) Then waits 2.5 months and will do the Low-Dose Brachytherapy by an oncologist that does 500+ of these a year. Then wait a month or so, then do 5 weeks of daily 5 min of radiation treatments, with a SpaceOar(rectal spacer). This protects the rectum from the radiation. There are several different hormone treatments. The Lupron knocks down the testosterone which feeds the cancer, essentially putting the cancer on ice hopefully stopping/slowing it down. This gives the low-dose radiation seeds and the following low-dose radiation the best knock down punch at the cancer. Then active surveillance afterward.
I was diagnosed 4+3 gleason score (intermediate non- favourable) in multiple cores. A low score Decipher test helped me choose radiation w/o ADT. Can you pls cover role of decipher test to establish metastasis risks in future and helping patients choose the correct treatment for themselves.
@@jamesrhoades1524 Decipher, SelectMDx, and 4K Score in Active Surveillance & Intermediate Prostate Cancer | PCRI ua-cam.com/video/k811g78YRQE/v-deo.html
Spouse was just diagnosed with a G7 score. Urologist recommended removal straight off and not even radiation or other options. We're also being scheduled for a bone scan. I wonder why he didn't offer any other options besides surgery?
My guess is the reason he only offered surgery as an option is because he is a surgeon. That's not a negative comment. Whatever the doctor's chosen field (surgery, radiation) will typically be his/her recommendation. That's why it is so critical to do your own homework. For me, Proton Beam Therapy was my choice. My doctor didn't include it as a treatment choice but when I told him that it was my preferred treatment he commented that it was a very good treatment choice and we went from there. Turned out to be one of the best life decisions I've ever made! I highly recommend looking into it as an option
@@rodneykahn6927 4+3 =7 and really 19 of 21 cores were adenoma cancer. Only 2 cores were listed as totally benign on the Left. Of the 7 Left cores, 5 cores in the left were HGPIN or Low grade adenocarcinoma. 11 of 14 cores on the right ranged 4+3, 3+4, and 3+3.
I wonder what treatment plan for radiation would be best for those patients who have an additional complication with another diagnosis that prevents them from being able to empty their bowels every day for 45 days regardless of investing things like miralax and milk of magnesia or tye use of enemas that a prove ineffective on a daily basis, and maybe helping to produce results once a week at best.
Have 4+3 Gleason score, with previous robotic surgery, radiation and 2 times recurring psa and now just had Pet scan. I basically have given up and am counting my days, months , etc
My issue is, My PSA is going up and I am being told NOT TO WORRY we have not seen Cancer with that LOW of a PSA #. Of which mine is Now 2.11??? Confused, you might ask??? YES I AM.
I’m not a medical professional, I do believe you have some time to watch and evaluate. My PSA was 2.03 on 11/15/2021 2.17 on 11/21/2022 4.07 on 9/8/2023 I think the key is to watch for doubling on the lower PSA numbers. The one thing I wish I would have done is the DRE along with the PSA. I thought my information from PSA were all I needed but if I had requested the DRE more, mine might have been detected earlier. Newly diagnosed G9 with lymph node invasion 5 cores positive. Last PSA 10/9/2023 was 4.63. Get that DRE done in case the PSA stays low and don’t tell the whole story.
Thanks animalhouse972. I have to go look up All these acronyms every time I read these Posts 🤪, I do believe that the DRE is the Digital Rectal Exam??? I assume?? I always have the Digital Rectal Exam every Year. The G9, I'am just guessing is the "Gleason" Score #??? And as much as I watch this channel, I really don't totally Understand just exactly (Without Looking it Up) What GLEASON Refers to or actually is?? Again, Sorry, my Bad. So Yes, My Dr. says my DRE was "NORMAL" Whatever that means (To Him)?? And that he watches for a "Doubling" of the PSA # B 4 "he" gets Alarmed??? I just don't want to have any Dr. MISS Something and then say, "O" GOSH it appears as tho we should do some testing now, I felt something abnormal. And this Core thing, I know a guy that just went through that, 😳, had 12 Cores and tested + on a few of them, went through the Treatment process and his PSA just came back at 1.15 last week. He's doing fine. But watching this Channel, I'am under the Impression that Digging out core samples is old school, (ya still done) but that 3TMRI's and Color Doppler Ultrasounds are Non Invasive, and Better Quality Diagnostic tools & More Accurate???
My PSA. has steadily risen over the years due to benign prostatitis . It is currently 3.8 (age 73 with family history)and I am tested twice a year, plus a digital exam. The PSA number bounces around the 4 number. The PSA free info seems to indicate that the possibility of cancer is really never zero; but I was told that, absent a significant and sudden increase in the score , no biopsy (or treatment) is recommended.
Ya, that's what I Been Told Also. Just Scary to even think that CANCER "could" Be Missed. I'am 70 (this Feb) Just had the Digital Exam, PSA is @ 2.11, Up from 1.94 Last year.
@@kendavis1198 Keep in mind that the test itself is not that accurate. The hundredths digit is probably useless and I was told that test results could vary 20 percent depending on proximity of sexual activity and other factors. Several years ago , my PSA rose to 4.5. The doctor had me get a second test at a different lab and it came back as 3.7. Just like the treatment options, this ain't a perfect science. My brother had PC. almost 30 years ago. His PSA was 15 when they operated and he didn't die from that 25 years later. I had one friend die of it when he was 81. They implanted seeds in lieu of radial removal which I gather they don't do anymore.
>>Undetectable levels of Prostate Specific Antigen (PSA) have been reported from the first patient with metastatic castrate-resistant prostate cancer (mCRPC) to ever receive two cycles of Clarity’s 67Cu-SAR-bisPSMA at the 8GBq dose level. PSA is a marker of tumour burden, clinical response to treatment and an indicator of the recurrence of disease for prostate cancer.
@@rodneykahn6927 for me, i have 10 out of 13 cores which were 3+3 =6. Urologist recommends prostate removal. Im trying to determine if this is too aggressive.
I've got to say, I listened to this and now I'm more confused. You threw a lot of variables out there but gave no basis to choose from. You were ambiguous as to side effects and outcomes but affirmed that once done you have to live with it.
What do you do if you’ve been diagnosed with a 3+3 at 40 but also have severe BPH symptoms. Treating the BPH through surgery, could result in poorer outcomes if radical prostectomy is ever needed. But medication has sexual side effects. This combination seems to be a grey area with not a lot of detail on how to approach. Physio and medication isn’t really treating the symptoms, but the risks of full removal mean it’s hard to know what to do
I am listening regularly thank you so much but recent sudden death of a famous and great singer from PC at age 55 in India frightens me. He had a cerebral stroke then things deteriorated . Wondering if stroke was from hormone or something in treatment can you explore?😊
I believe i am in a very gray area. I only have Gleason 6, but there are other things to consider. Five cores on biopsy were positive and throughout both sides of the prostate. Two lesions present on MRI on opposite sides of the prostate with both abutting the wall. Decipher score was .1 asay from being intermediate risk, family hx of father and both grandfathers having prostate cancer, and dre observed hardness on one side where one of the lesions were present. Should I still do AS? Been to three reputable hospitals All leaning toward treatment. I will probably do SBRT five sessions. I believe saying Gleason 6 without all the facts could be a bit misleading. Maybe I’m wrong, as I am concerned about waiting too long.
I was in a similar situation with 4 or 5 (can't remember exact number) cores (Gleason 6) but only one side abutting the wall. Unfortunately I got a very bad urinary tract infection from the biopsy and from that point was not going to do active surveillance with annual biopsies. So I looked at my options. I decided on SBRT and went to Penn Medicine. I went through a procedure to get SpaceOar to protect the Colon, then a month later started SBRT (5 treatments). I'm now 1 year post treatment with relatively few side affects. The SBRT process is harder than it seems, though. You have to perform an enema before each treatment, and you have to drink about 20 ounces of water 45 minutes before, so if they are backed up on patient treatment appointments it does get a bit uncomfortable, especially since the treatment is about 45 minutes. They do perform CAT scans right on the treatment table before you get the radiation and check the results before you get the radiation. You do not really feel anything from the actual radiation treatment. Other than that no regrets on my choice at this point. My PSA at my last appointment was 1.95 down from a high of 4.2. It takes about 2 years to get to near zero PSA. I hope that helps and if you have any questions, let me know.
I found this.... poking around on the internet, and yes, this is real. >>First patient with metastatic prostate cancer to receive 2 doses of Cu-67 SAR-bisPSMA achieves undetectable PSA level
I have not been impressed with the urologist/s I have dealt with to date. My urologist office (only one in town) is extremely overwhelmed there and it's a 'herd like mentality' there. The two doctors ( both old-school urologists) there have been doing this a long time (maybe too long) and they are pretty set in there ways. Collectively they have not gained my confidence. In fact, I have a lack of confidence in them. Both urologists I have seen seem taken aback by my wanting to be the decision-maker in my treatment option. I have 11 of 12 cores that are 70-90% positive all 3+4 (20% on whole are 4's). The first urologist ordered a PSMA Pet Scan. Aside from confirming cancer in my prostate my PSMA Pet scan indicates one other statement ... "Equivocal for sub-5mm right internal iliac nodal metastasis." I took to be that it is ambiguous or not sure or uncertain finding. However, the urologist (2nd one that I've seen at the same place) says given my PSA of 81 he is certain I have micro metastasis and is wanting to treat me as if I have certain spread/metastasis and is pushing Hormone Therapy. He even said "I would not have even ordered a PSMA Pet Scan for you." I was taken aback by this statement and it just reinforces my lack of confidence in him. I am now being referred to radiation oncologist that the urologist works with. Not sure how my consult will go with the oncologist. I would like the least aggressive approach possible and am hoping for brachytherapy or Proton Beam Therapy and hope that I will be a candidate. Would like to avoid hormone therapy and standard/typical radiation treatment but not sure what options I will have available.
I share your frustration. Imagine living in a small town in the US not near any major centers and having little to no resources with a bad Medicare Advantage HMO plan and having to deal with all of this, not to mention the trust issue from urologists.
My radiologist told me I should welcome a penile implant..said it so flippantly.. also told me i am on the internet too much because i asked some questions...sigh
I sm 4 months into adt with a starting psa of 121 rising to 230 while I waited for an appointment w ith a urologist. My psa has dropped but rate of dropping is decreasing. My mental health has never been worse. I cannot find a reason to live. I feel that the best outcome available will leave me in a level of misery where i will wish evrn harder to die. What to do?
hi I have bee with prostate cancer metasised to my bones for 3 years now ... first my PSA was 275 3 years ago and I was on hormon pills and elegard I had Chemo 3 times radiation now I am on lynparza and my spa is start going up after it it did went down to 3.9 and now it is 7.8 and still on lymparza my dr. said I have to go back to chemo one the PSA is going up to 16 or more what is you advise to me shall I do chemo or not.... thanks dr.
There is something called modified citrus pectin, I don't know if it is for someone in your position or not... however you can research it, it was said to reduce PSA but again, where you are at matters a great deal. There is a urology center in Omaha that is involved with the Cu67 trial that seems to be showing stellar results. You can search for it.
Hello, we are not able to answer case questions on our comment section but we can help you through our Helpline who can speak with you either by phone or email. Here is the link to contact them: pcri.org/helpline
Who would consider prostatectomy it is so froth with all kinds of risks and dire post surgery issues, there is potential for severed nerves, damage to the intestines, just look at lloyd Austin's complications probably nicked his intestine during surgery. Then after surgery one needs a catheter and most likely will have bladder leakage for the rest of life, necessitating the need to wear adult diapers.
You know, this is very disheartening. Why do WE have to do the research? What ever happened to "First do no harm"? Outcomes are terrible for Prostate Cancer treatments. Where are the therapies to control it? It's all about the fuckin $$$.
Don’t know what your experience was but, all of my doctors presented my “numbers” and I decided treatment based on what side effects I was willing to endure and confidence that the approach would be effective. If you have doctors pushing towards a specific treatment without a “by the numbers” discussion. Get a new doctor. Sure, every doc has a bias based on how they were trained and what speciality they are in - every body has biases. It’s up to the individual to make the final call…it is very tough but ultimate the individual is in control. Don’t be so quick to go down the $$$$ hole conspiracy theory.
it is a shame that the urologists that are profit driven only consider revenue over their patient's needs. the UK seems to be light years ahead of the US on prostate cancer treatment since they are not profit driven
@@dondgc2298I disagree with you. I could not have received better treatment from my local hospital - my doctor was the failure in initially refusing me a PSA test. ( AGE 79 with PSA 310 )
Diagnosed with 4+3 decipher score .96 in July 2023. My urologist wanted to do a proctectomy immediately. Started watch this channel. Met with an oncologist. Went to UCSF and Stanford for second opinions. Four months later after conducting much research and watching every available video on this channel, I elected to have one round of HDR brachytherapy, followed by five weeks of IMRT, no ADT. My homework paid off, I am confident I made the right decision, so glad I didn't get a proctectomy, for being 66 I couldn't imagine having to endure all the related side effects, compared to the minimal side effects associated with my course of treatment. It's not exactly pleasant, but absolutely tolerable! My research made me believe that surgery is almost barbaric compared to available types of radiation treatments. As stated in this video, you must learn and understand the type of PC you have so you can make an informed decision. Lastly, I would not recommend making a final decision without getting a PSMA PET first. Wishing everyone watching this channel all the best!
Interesting, I am in the same situation as you. 70 years old and otherwise healthy with 4+3 diagnosed in October 2023. I have an appointment with a radiation oncologist and a chemo type doctor next week. I am still researching alternatives.
I've a very similar story, but with LDR and with ADT (I'm 12 months into a 18 month Orgovyx/Zytiga regimen)- my PSA has been undetectable since June, my gleason was 9, with no evidence of spread outside of the capsule with PSMA/bone scan,
Be sure to thoroughly research LDR and HDR brachytherapy following the results of a PSMA/PET scan. There are some excellent videos on this channel and others on UA-cam regarding the advancement of this technology. You'll be blown away when you learn that this type of therapy isn't pushed as heavily as other forms because it isn't as lucrative. This is billion dollar industry and sadly, it's all about the money. @@bvschledt
I had Gleason 4+3 as well opted for 40 rounds of proton therapy after much research. 6months out PSA went from 14pre treatment to 1.14 one year out PSA .4. Next psa test upcoming April 2024. I experienced no urinary or rectal sexual issues, I’m 69years old, no metastasis. I also declined ADT, might have saved myself the horrendous side effects.
@@tomasso883 Great news that gives me optimism.
BTW, this has got to be in the top 10 channels as rated by importance and value. Thank you two for all the education you provide. It is priceless. ❤
I could not possibly agree more with you. This channel has brought peace to me throughout my process.
I'm a 56-year-old Air Force with Gleason 4+3 =7 and used PCRI and Dr. Scholz advice to help me make the decision to get radiation treatment and not prostate removal surgery. My doctors said both were an option for me. My PSA has dropped from 13.7 to 2.7; 8 months past my radiation treatments. I have very few side effects, feeling good physically and mentally, missed very few days of work, was able to travel, exercise, ride my Harley and enjoy time with my wife and grandkids, very happy with my choice of treatment. Thank you PCRI, bless you for the help you give us!!
I am right in the same boat as you…55, veteran (Army) and 4 + 3, was having RP pushed pretty hard. Found this channel, and helped me make better choices. Still haven’t started treatments yet, but likely doing EBRT. Glad you’re on the road to recovery.
I'm in the same boat, definetly going with radiation....which method did you choose? My PSMA CT Pet was good. i will not go on ADT. Did you guys go on hormone therapy?
@@johnmchale8308 yeah, I think that my radiation oncologist wants to do 6 months of ADT. I also had a clear PSMA scan. He thinks that’s kind of a “double whammy” against the tumor cells. Not so happy about it (but maybe I will grow breasts? That could be fun 😅)
@@edwardreiller6269 not much benefit if you look at the latest Landmark study the good Dr referenced
@@edwardreiller6269i
No one should go into any prostate treatment plan without coming here first and often. I am a year into this journey, am doing well and have confidence in my decisions. These two are wonderful and the information is pure gold. A big thanks to both of you.
YES, I Agree 7438! Great Channel and Fantastic Information here.
diagnosed last month and came across this channel today. It is very helpful.
Dr. Scholz saved my life when i first was diagnosed with Stage 4 in 2010. I've been undetectable since then till today. Thank you Dr. Scholz.
what treatment did you have?
@@DeathSentryCoH I had Lupron, chemotherapy, radiation, high dose seeds in the prostate, Zyytiga, Xtandi.
@@DeathSentryCoH I was just diagnosed with cancer after my biopsy on August 1st, 2024. Waiting for the Gleason Score is killing me. Won't know until August 21st.
I am in love with #MarkScholzMD female presenter. She genuinely seems to care about male prostate issues. She asks excellent questions that help inform us. Big fan of Dr. Mark Schcolz, huge fan of his compadre. Say her name! I have prostate cancer 3+4. Admiration for the both of you. Thank you both for this invaluable source of information.
Hi, I am 61 years old, and gleason 3+4...(PSA 10) what treatment did you follow and what results did you obtain? Thank you
I am newly diagnosed with prostate cancer...Gleason score 7 (3+4). Still trying to figure it out. This channel is an absolute must. Thank you for existing❤
Please read my post above. I strongly suggest giving Proton Beam Therapy serious consideration. However, there are a few issues that make choosing it as a treatment. For one, it is only available in a few locations. Another is that many health insurance companies may not want to cover it. Finally, it typically involves 45 treatments (5 days a week) so you will need to stay near the treatment location. Since I was retired, the 9 week treatment--commonly referred to as the "radiation vacation" because of the lack of side effects, wasn't an issue. I was also on Medicare, and fortunately Medicare covers PBT.
@@robertbrazeau7049 Hi Robert, I have just been diagnosed with 3+4 gleason and my doctor is pushing me to have surgery. I would really love to chat to you offline about PBT therapy. Please let me know if this is possible and ill forward contact details. Thanks.
I was diagnosed 3 years ago with (3+4)=7 PC. Researched extensively all treatments. Went to Mayo Clinic in Rochester,Mn and had 5 High Dose Treatments of PROTON therapy over 2 weeks . PSA now .27 with minimal side effects…………..
I was diagnosed with prostate cancer in November. They gave me a choice between RP and radiation. After doing a lot of research and watching many of the videos on this channel and others, I decided to go with SBRT and hormone therapy. Out of 12 cores 2 came back positive - 4+3 and 4+4 with cribriform growth present (more aggressive form of cancer). Got Lupron injections 3 weeks ago and taking bicalutamide daily. So far no side effects. 5 Radiation treatments will be done in March. Hoping for the best.
What is SBRT?
@@joemaxwell1044 Stereotactic body radiotherapy. It's only 5 treatments of radiation instead of the usual 25-40. It uses 3D or 4D imaging and highly focused radiation beams to send high doses of radiation to the area to be treated. This results in the least amount of damage to the healthy tissues around the area.
@@JimArmstrongField I have no access to it.
I'm 71 and sought out a very experienced, highly regarded Doctor to perform my Brachytherapy at the Cleveland Clinic about a month ago ( Gleason 7 4+3, psa 5.7). I was told by my initial Uro who did the biopsy (Surgeon) that Brachytherapy was obsolete. Was told similar by a Radiation Oncologist who wanted me to start EBRT and ADT right away. Glad I looked further
I had a 4+3 w psa 8+. I considered prostatectomy vs. radiation. I decided to go with radiation because the long term outcomes looked the same with less consequence. My original treatment was going to be a mix of ADT, EBRT, and a single HDR Brachytherapy (not the LDR Brachy/seeds - worth googling the difference). I also had a PSMA PET CT scan to assess if it had spread and a Decipher genomic test to assess the aggressiveness of the cancer. The PSMA PET CT showed no spread. The Decipher test indicated low risk in aggressiveness. Based on those outcomes, my Dr recommended a switch to 2 sessions of HDR Brachy. Each takes a full day via outpatient session - 1 week apart. Relatively painless procedure with about 3-6 weeks of recovery to be back 100% (very low impact recovery). I was happy to avoid the ADT/EBRT which can be challenging (esp ADT). My outcome has been excellent so far - PSA went from 8+ to 1.1 in three months. No side effects from the procedure at all (really). I'm fully back to cycling, working out, hiking, and everything I could do before. The HDR Brachy tech has been around but the precision technology (machines & visualization during the procedure to guide the treatment) has dramatically improved to where the side effects and potential impact outside the target area are extremely limited. For me, I could not have asked for a better outcome. I was lucky to get a very experienced forward thinking, cutting edge oncologist who has done a large number of these procedures at an NCI Cancer Center. Just sharing another possible treatment path. Good luck!!
I have very similar PSA and gleason. may i ask what treatment modality you decided on? right now i am on a track for surgery. thank you!
They both had brachytherapy - a type of radiotherapy.@@MrPete-pe6uk
@skinfiddler I’m in a situation close to yours, Gleason 7 3+4 in three cores and 3+3 in two cores psa 5.7, I’m looking at the Cleveland Clinic also. Can you advise who the Doctor was that performed your procedure?
Yes I am talking to the Cleveland clinic but surgeon wants to perform surgery of course. May I ask who your Dr was at the Cleveland Clinic?
I really appreciate how honest and direct Dr. Scholz is.
Alex just asks the most pertinent questions. These two are just brilliant ❤
I have thought the same: she asks the questions I would ask. They are awesome together.
When I was diagnosed with prostate cancer for years ago. They gave me a book and told me to go home and take my time and make the decision what I wanted to do.
You got a book😮, I got a pamphlet, one on surgery and one on HRT, told to come back with my decision. Note: I had three 3+4, 40%. Whatever that means.
Absolutely love their knowledge base, and their caring, easy going personalities.
I was diagnosed in Early 2009 with PSA levels that were in the 2-4 range. Given a family history of the disease and the decades they had lived with it, I was not pleased but not anxious to try surgery or brachytherapy. I was directed to Summit in Oakland, where I was basically sold on High Dose brachytherapy on the grounds that it was precise, and didn’t leave radioactive pellets behind. What wasn’t discussed was side effects. Two years after the procedure, I developed interstitial cystitis leading to urinary interruption, and several trips to the ER. Months of hyperbaric therapy alleviated most of the problem, though ED became progressively worse. Finally, during a endoscopy procedure, my urologist saw what turned out to be a stage 4 tumor in the interface of the bladder and prostate. Metastases were present. Chemotherapy and immunotherapy have extended life for almost two years now, but I’m living with a permanent Foley. I share this to caution others to proactively question caregivers about side effects, and longer term care prospects. Doctors generally want to help, but they also want to publish and advance their careers. Be aware.
I'am so sorry for your Issues that occurred after Treatment. These are the things that are extremely frustrating and in my Opinion "might/Should" be caught and or Eliminated with more precise diagnosis. I wish you the Very best. Thank you for your Post, these things need to be out there for others to read and get the Important Information needed to be proactive rather than reactive. Thank you so much. 🙏🏻..
You had prostate cancer and your PSA was within range?
@@dappa311 As I recall, PSA level had increased from ~2 to ~4 ng/mL. A biopsy came back positive, and the journey began.
@@Ron-n4j1l My husband also had a normal PSA that result in a diagnosis of Prostate cancer.
He is an avid bike rider sometimes going over 200 miles a week. He would get intermittent prostatitis, and his urologist said it was caused by his bike riding. Because of this he always would get PSA testing.
Well he had one PSA result that was 2 point higher that the PSA 6 months prior. This result is a big red flag if it jumps that quickly. His PSA results was also in normal limits, He has never got a PSA results over the normal range.
MRI prostate showed highlighted areas .Biopsy showed Gleason 4+3, also had a decipher test. He then did a PSMA Pet Scan. That showed only highlighted areas in the prostate. He is now on his treatment journey.
@@Ron-n4j1l Sorry to hear about your diagnosis.....evidently you had treatment back in 2009-2010?
I stumbled upon these videos very early on in my journey, and as my diagnosis became clearer, hearing my doctors suggest the precise treatments for my condition as have been outlined by Dr. Scholz, has allowed me to have confidence in the process. Put differently, Dr. Scholz is my second opinion, and since it matches the first, I feel good about the direction.
recently dx in Nov. My local prostate cancer support group suggested I check this site out and am now a subscriber + made a small donation. Back to my story, I have 3+4 gleason; no metastasis; localized only, last PSA was 8.6. I don't want to do surgery; leaning towards beam+ brechy; part of the conversation was adding hormone tx; but I rather not go this route. I'm 50 otherwise healthy, within my range weight for height and don't take any meds, no alcohol or drugs, plus stopped drinking dairy milk and all processed and red meat, with reduced chicken and fish, mostly veggie type diet but not exclusively. I find these videos extremely helpful. Am wondering what other considerations am I missing before I make a decision. Thank you!!
P.S. It was also suggested I read the Key To Prostate Cancer by Dr. Scholz, excellent book and highly suggest it.
Im 70. I've had a Gleason 6 for about 10 years. Active surveillance awaiting biopsy results. Highly considering taking my chances with the disease.symtoms are mild.
I am just starting on my journey. Truly glad I found Dr. Sholz and Alex and the wealth of information I have consumed. I hope I make the correct decision for my health and well-being. Thank you for the vast array of knowledge that I can turn to.
@@jaybrown2182 you should get a second opinion from Dr Scholtz. He might be able to cure you of your cancer. He have been keeping me undetectable since 2011.
I had a TURP procedure 2 weeks ago, 6 of 133 chips are malignant 4+4=8. Waiting for my surgery follow up to determine next steps. Thank you so much for the information you are providing to help me make treatment decisions!
This series is incredibly important and supportive. I have 4+3 encapsulated and this series of videos has helped me navigate all the options and acted as the 3rd and 4th opinions, as well as the baseline of being your own advocate. I have opted for proton therapy at the Mayo clinic and you two have even helped pick where to do it. Subscriber for life (a long life).
Have you started your Proton Therapy yet?
Dear Dr. Scholz,
I appreciate the valuable insights provided in your videos. As I continue to undergo radiation therapy in Italy for my prostate tumor (4=3), I am mindful of the collaborative nature of the treatment process. I have observed the dedicated team of technicians who operate the equipment and support me during each session. Additionally, there is a pivotal role played by the doctor (whom I see 1time x week) in determining the treatment frequency, potency, and overall plan tailored to my specific needs.
In light of this, I am keen to gain a clearer understanding of the division of responsibilities within this team-based approach. Given the presence of varying technicians (and sometime technician in training) during my sessions, I am eager to know if I can place my complete trust in them. Furthermore, I seek your perspective on the allocation of greater responsibility -does it predominantly rest with the treating doctor or the technicians?
I am grateful for your guidance on this matter.
Sincerely,
Marco Biancardi
Great info and advice. Thank you! Eight years after imrt I have recurrence, psa went from 1.4 to 3.6. Had the PSMA Pet and MRI, had the biopsy, small area with 4+3=7, confined to prostrate. At 76 really looking at the options carefully, did not go to my oncologyst referral. Been doing a lot of research, maybe too much. No, never too much. The newer ablations seemed very interesting, however now more focused on SBRT, MRI guided. Can't recall seeing one of these video sessions focusing on recurrence.
I’m 67. Like you, 7-years after my SBRT, my PSA went from about 1.5 or less to 6. Had PMSA. Cancer confined to prostate. At 67, like you, I’m researching like a mad man. Never can do too much research. Doc wanted me to start Eligard 3-month injection. I don’t want the side effects of ADT. Would like to see something also on recurrence after radiation therapy. Praying you have a successful outcome.
Another great talk to help us take a deep breath and keep the panic at bay. Thank you.
This is so informative and both are very professional in their approach and knowledgeable and extremely easy to listen to. Thank you.
Excellent series of videos. I found this one slightly mistitled: it's about decision-making generally rather than about how good new treatments are.
Big Thank You to PCRI
After PC diagnosis 7 months ago, Gleason 7a with PSA10.
I did intense research with lots of help from this Channel, excellent !!!
Today I got inserted my gold fiducials and in 2 weeks, cyberknife/SBRT will start. Thank you so much Dr Schulz and Alex !!
Fun fact:
My german Urologist had to google SBRT, unbelievable. His advice was clearly radical ectomy.
I'd Have to Look up the acronym myself. SBRT??? Ya, I don't off the top of my head know what it is either, But a Dr. not knowing???? Hmmmmmmm????? Really.
Similar #s to yours. Can you share why you chose radiation over RP? Thank you.
@@Bupkus68 mainly due to side effects and their severeness and probabilities. And a good portion of gut feeling pro SBRT.
I love you guys! I wish I could hug both of them
Brilliant. Wish i was walking into your office tomorrow and i would feel that i was in good hands. Thank you both.
Great information 👍
nice work Dr. Scholz & Alex. if it wasn't for your my urologist would have my prostate removed 4 years ago. with prostate MRI and active surveillance i would have let them overtreat me. thank you for all you do
Husband was on Hormone treatment for 5 yrs (worst ever sleep & urination). PSA rose, so Taxotere for 5 treatments (1x/ev 3 wks) when PSA rose again. Offered to switch chemo treatments (1x/wk for 2+ yrs).
In 8/2023, MRI noted 3 lesions behind kidneys/in front of spine. Interestingly, PSMA noted 3 lesions in bone only. So apparently patients need both scans.
If still eligible, after next MRI 1/2024, Husband is moving on to Proton Radiation (20+ spot treatments).
Any data before starting the Tx. please?
@@s.chaisrisuk4956 I'll know more at the end of next wk.
@s.chaisrisuk4956 I will know more after scan results, so end of next week.
These video's are very helpful. I made a small donation and had a phone call with the PCRI organization last month. With a high PSA I just received my MRI results as a PIRADS 2. In 2024 I need to be a student and learn more to make the right choices.
Does PIRADS 2 mean no biopsy???
yes correct No Biopsy. Surveillance @@keithcolegrove2924
I had Gleason score 3+4=7. I am 53 yrs now. It was localised at Right Lob of Prostate Gland. My doctor suggested Robotic HIFU treatment & accordingly I undergone it on 21st Feb 2024. I Have been discharged next day. Let see what Will be the result.
Any long term testimonials that you e read ?
I'm scheduled to remove it in a week.
I second that in its entirety. Very well put. The information contained in this channel has been incredibly valuable, and I urge that you keep the flow of new information & and procedures coming. Thank you
Thank you. I am having difficulties with my treatment team at Kaiser. I had a 4/4 Gleason 4 plus years ago and had radiation and Lupron. I am asking them to get another PSMA Pet Scan to determine whether or not the spot on my C3 spine is cancerous because it can now determine if my spot decreased in size after my Lupron shot. If it has, then it can be eliminated by radiation. It there was no change, then it is benign. My team has denied this test at this time. I am afraid it will metastasize. Radiation plus hormonal treatment to me is best. Thanks Dr. Scholz
I have Kaiser, didn't know they do pet scans
I appreciate for all your videos and information..... PCa patient
You are a good team. Exciting new therapies!
Dr sir very very useful feedback through this conversation God bless you both 22/04/2024
In Britain you see the surgeon your given and are told what treatment you will have. I was only given 2 options surgery or radiotherapy i had surgery and my PSA has gone from 0.0 to 0.18 in 5 years
I am on the road to recovery from a Gleason score of 4+3. I just wish sometimes that you would focus on some older technologies that still work because not all of us have access to or can afford to use a modern cancer center. We are dealing with regional hospitals that may have limited access to super modern stuff or not the leaders in their fields. The best they could offer me was 25 radiation sessions rather then SBRT. Did it work? So far I can say yes? Thanks to you both for these videos. They are always informative and professionally well produced.
Did you research and are convinced one of the modern techniques is better ?
No real research of more modern technology since I was limited to surgery or radiation at my regional hospital and none of these were an option.
@@patpolicastro6622 thanks
u on Medicare?
@@rodneykahn6927 I am I found out the same month I turned 65
That was a piece of excellent information much needed for me at the moment. After having an MRI done I've been told there is a high possibility of prostate cancer and was suggested to make a biopsy which I refused, wanting to have more time on research. Thank you.
On 1/11/24, my PSA was 11.65, referred for MRI and Biopsy. MRI on 2/4/24 yielded Impression results, "No multi-parametric MRI evidence of clinically significant prostate carcinoma." PI-RADS Assessment: "Very Low (Clinically significant cancer is highly unlikely to be present)." Biopsy on 2/13/24 provided a "Gleason Score of 4+3=7" with 2 of 18 cores showing 3% and 10% "Adenocarcinoma of the prostrate" and "Grade Group 3." Decipher test results, "High risk - .67." Next on my agenda is a PSMA-PET scheduled for 3/18/24.
@@alaskanlangolier8622 My PSA was around 6 +/-0.5, most recently.For years it was slowly going up from 4 something.
@@globaldouglas6375 pretty high PSA, biopsy intermed/unfavorable. looks like u gotta treat.
Excellent information: Appreciation to both of you for sharing this important research & information!
So very informative. Thank you.
Can you guys do something on a MRI guided SBRT vs CT guided? Evidently early data show its less toxic....
I am diagnosed with a 3+4 Gleason score. 25 samples were taken with 18 showing cancer. The discussion I have had with my urologist and radiation oncologist resulted in wanting to remove my prostate because of the bad BPH I have . I am in the 73% on BPH and both doctors stated that seeds, radiation will swell the prostate more causing a complete block of urine flow. Have you ever addressed prostate cancer with bad BPH? M level of cancer was a 2. 1 being best and 5 being worse. I am scheduled for removal for March 6th but watching your videos is making me question that surgery. The big thing is the size of my prostate.
I know two people who had " closed" radical prostatectomy via endoscopy . Both are doing well years later 👌
@@jamescalifornia2964 I believe Tulsa can also remove tissue while addressing the cancer..i have bph also so was considering that
@@DeathSentryCoH I got 3 plus 4 for 4 years, I am 64 now. I have an enlarge prostate but can pee well. I get a biopsy in Dec, I hope to stay on AS. No spreaD AND psa UNDER 5 . I will remain on AS is no change
Very informative. Thank you for these videos.
awesome ties...thanks
Thanks for research
I was diagnosed with prostate cancer from an biopsy on August 1st of this year. I will not know my Gleason score until the 21st. of this month. I can't believe I have to wait this long. It was in the Anterior portion of the prostate glands. Sleepless in 29 Palms California.
My Gleason Score is 4 +3 and waiting for a Pet Scan.
@@greetingsearthlingspluto6666 Geez I got my Gleason score within two days.Good luck with Pet scan
@@greetingsearthlingspluto6666 make sure you get a decipher score
@@johnmchale8308 what is that?
Overview
+7
The Decipher test is a genomic test that assesses the risk of prostate cancer spreading and death. It analyzes the activity of 22 genes in prostate tumors to calculate a score from 0 to 1. The score is then categorized into three groups
Agreed 3+4 with 67% genetic result. 66 and two recommended radical prostate removal. Doing more research looking at other optiona.
I was diagnosed withGleason six I was on active surveillance for six months. I decided to have the robotic surgery. I do not want to live with this disease I’m 56 years old I have a very supportive spouse my PSA drop from 2.13to 1.63 i’m doing great, but I made my decision
I like Alex, she seems to genuinely care about PC patients. Dr Shill however is obviously biased against surgery and never seems to acknowledge that radiation has its fair share of risks and side effects. There is no perfect treatment option and cool names like Cyberknife don't reflect what their name implies. Make the choice that is right for YOU and your cancer based on your research. I wish you well in your journey.
Thank you for the information. You've been so helpful during this situation. Thank you for all the videos.🙏🏼
You can look up quercetin phytosomes and curcumin phytosomes on the NIH. This high absorption/bioavailable form of plant compounds is spoken of highly for prevention in many clinical papers.
I have a CA : 5+4=9 . In 6 Cores Gleason 9. Group 5.. PSA, above 80.
Very Aggressive. I Had a
Cryoabolation ( Freezing) of the Prostate. My Tumor was Locally, in a PET Scan.. What is my Chances, it has been Cured.?? Its been 7 weeks. Going to checky PSA. Level.
Going to take PSMA PET Scan, in 2 months, to see images, hopefully it has not Spread.
Hope that does the trick for you and you’re all clear.
Alex is vert good.
I had a Gleason score 3+4 cancer in the prostate and lymph node in pelvic cam after radiation of prostate went back to cyberknife miami and treated again and 6months of hormones now they tell me every 3 months PSA test last psma scan said no visible cancer where it was in previous scan
Diagnosed at 49yo with Gleason 6. 53 now psa up to 6 now. Thinking brachytherapy maybe the way to go. Anyone else in similar situation?
My husband 65 years old with a Gleason of 4+3,/Decipher/MRI/PSMA confirmed his diagnosis of cancer He has never had an abnormal PSA. Just an abnormal 2 point rise within 6 months, and intermittent prostatitis from biking riding. His treatment is 1 injection of Lupron(last 6 months,) Then waits 2.5 months and will do the Low-Dose Brachytherapy by an oncologist that does 500+ of these a year. Then wait a month or so, then do 5 weeks of daily 5 min of radiation treatments, with a SpaceOar(rectal spacer). This protects the rectum from the radiation.
There are several different hormone treatments. The Lupron knocks down the testosterone which feeds the cancer, essentially putting the cancer on ice hopefully stopping/slowing it down. This gives the low-dose radiation seeds and the following low-dose radiation the best knock down punch at the cancer. Then active surveillance afterward.
Excellent as normal
I was diagnosed 4+3 gleason score (intermediate non- favourable) in multiple cores. A low score Decipher test helped me choose radiation w/o ADT. Can you pls cover role of decipher test to establish metastasis risks in future and helping patients choose the correct treatment for themselves.
Hello, here is a video on Decipher: ua-cam.com/video/k811g78YRQE/v-deo.htmlfeature=shared
@@ThePCRI link did not work
@@jamesrhoades1524 Decipher, SelectMDx, and 4K Score in Active Surveillance & Intermediate Prostate Cancer | PCRI ua-cam.com/video/k811g78YRQE/v-deo.html
Spouse was just diagnosed with a G7 score. Urologist recommended removal straight off and not even radiation or other options. We're also being scheduled for a bone scan. I wonder why he didn't offer any other options besides surgery?
My guess is the reason he only offered surgery as an option is because he is a surgeon. That's not a negative comment. Whatever the doctor's chosen field (surgery, radiation) will typically be his/her recommendation. That's why it is so critical to do your own homework. For me, Proton Beam Therapy was my choice. My doctor didn't include it as a treatment choice but when I told him that it was my preferred treatment he commented that it was a very good treatment choice and we went from there. Turned out to be one of the best life decisions I've ever made! I highly recommend looking into it as an option
4+3 or 3+4? and how many cores were cancer?
@@rodneykahn6927 4+3 =7 and really 19 of 21 cores were adenoma cancer. Only 2 cores were listed as totally benign on the Left. Of the 7 Left cores, 5 cores in the left were HGPIN or Low grade adenocarcinoma. 11 of 14 cores on the right ranged 4+3, 3+4, and 3+3.
@@robertbrazeau7049 Robert, why PRoton Beam? I'm in NY, there is one center up in Harlem.
I wonder what treatment plan for radiation would be best for those patients who have an additional complication with another diagnosis that prevents them from being able to empty their bowels every day for 45 days regardless of investing things like miralax and milk of magnesia or tye use of enemas that a prove ineffective on a daily basis, and maybe helping to produce results once a week at best.
Great advice. Thank you.
Although I agree with having to do your own research, how much more knowledge can I gain to make a right decision when doctors in the field can't.
Have 4+3 Gleason score, with previous robotic surgery, radiation and 2 times recurring psa and now just had Pet scan. I basically have given up and am counting my days, months , etc
Exactly. Had a RO keep calling me wanting to do treatment. He didn't give 2 S**ts about me.
I like the look - 'Dr Mr Scruffy'.
My issue is, My PSA is going up and I am being told NOT TO WORRY we have not seen Cancer with that LOW of a PSA #. Of which mine is Now 2.11??? Confused, you might ask??? YES I AM.
I’m not a medical professional, I do believe you have some time to watch and evaluate.
My PSA was
2.03 on 11/15/2021
2.17 on 11/21/2022
4.07 on 9/8/2023
I think the key is to watch for doubling on the lower PSA numbers.
The one thing I wish I would have done is the DRE along with the PSA.
I thought my information from PSA were all I needed but if I had requested the DRE more, mine might have been detected earlier.
Newly diagnosed
G9 with lymph node invasion
5 cores positive.
Last PSA 10/9/2023 was 4.63.
Get that DRE done in case the PSA stays low and don’t tell the whole story.
Thanks animalhouse972. I have to go look up All these acronyms every time I read these Posts 🤪, I do believe that the DRE is the Digital Rectal Exam??? I assume?? I always have the Digital Rectal Exam every Year. The G9, I'am just guessing is the "Gleason" Score #??? And as much as I watch this channel, I really don't totally Understand just exactly (Without Looking it Up) What GLEASON Refers to or actually is?? Again, Sorry, my Bad. So Yes, My Dr. says my DRE was "NORMAL" Whatever that means (To Him)?? And that he watches for a "Doubling" of the PSA # B 4 "he" gets Alarmed??? I just don't want to have any Dr. MISS Something and then say, "O" GOSH it appears as tho we should do some testing now, I felt something abnormal. And this Core thing, I know a guy that just went through that, 😳, had 12 Cores and tested + on a few of them, went through the Treatment process and his PSA just came back at 1.15 last week. He's doing fine. But watching this Channel, I'am under the Impression that Digging out core samples is old school, (ya still done) but that 3TMRI's and Color Doppler Ultrasounds are Non Invasive, and Better Quality Diagnostic tools & More Accurate???
My PSA. has steadily risen over the years due to benign prostatitis . It is currently 3.8 (age 73 with family history)and I am tested twice a year, plus a digital exam. The PSA number bounces around the 4 number. The PSA free info seems to indicate that the possibility of cancer is really never zero; but I was told that, absent a significant and sudden increase in the score , no biopsy (or treatment) is recommended.
Ya, that's what I Been Told Also. Just Scary to even think that CANCER "could" Be Missed. I'am 70 (this Feb) Just had the Digital Exam, PSA is @ 2.11, Up from 1.94 Last year.
@@kendavis1198 Keep in mind that the test itself is not that accurate. The hundredths digit is probably useless and I was told that test results could vary 20 percent depending on proximity of sexual activity and other factors. Several years ago , my PSA rose to 4.5. The doctor had me get a second test at a different lab and it came back as 3.7. Just like the treatment options, this ain't a perfect science. My brother had PC. almost 30 years ago. His PSA was 15 when they operated and he didn't die from that 25 years later. I had one friend die of it when he was 81. They implanted seeds in lieu of radial removal which I gather they don't do anymore.
Am I the only one who perseveres with a wait and see. At 79 3+4 psa5 it has to be the best? side effects are too much.?
I have no doctor really on my side. Each of the urologists I have seen simply recommends the therapy that they do the most. It’s ridiculous
>>Undetectable levels of Prostate Specific Antigen (PSA) have been reported from the first patient with metastatic castrate-resistant prostate cancer (mCRPC) to ever receive two cycles of Clarity’s 67Cu-SAR-bisPSMA at the 8GBq dose level. PSA is a marker of tumour burden, clinical response to treatment and an indicator of the recurrence of disease for prostate cancer.
having both BPH (80 cc) and PC T1c. Is there a preference for doing HOLEP before SBRT radiation?
Did you check out TURP?
Did you have your HOLEP yet? If so how did it go.
Any update sir
How often do you hear of a PSA of 33 and a Gleason score of 6 3 + 3 and the surgeon recommends removing the prostate?
Hopefully I’m not too late but I would either do nothing OR the most minimally invasive treatment possible is HIFU, focal therapy etc.
u can keep monitoring your PSA. how many biopsy cores were cancerous?
@@rodneykahn6927 for me, i have 10 out of 13 cores which were 3+3 =6. Urologist recommends prostate removal. Im trying to determine if this is too aggressive.
I've got to say, I listened to this and now I'm more confused. You threw a lot of variables out there but gave no basis to choose from. You were ambiguous as to side effects and outcomes but affirmed that once done you have to live with it.
if you have prostate cancer what is the best BPH treatment
Watch "BPH, TURPS, and Alternatives | #Prostate Issues #MarkScholzMD #AlexScholz #PCRI"
ua-cam.com/video/GXLNf42gPAA/v-deo.html
What about IV OZONE Therapy?
12 cores taken 2 cores had adenocarcinoma one core 2 and the other 20 Gleason score 3+3 I'm at a lost
Is Duke Cancer center a good institute?
What do you do if you’ve been diagnosed with a 3+3 at 40 but also have severe BPH symptoms. Treating the BPH through surgery, could result in poorer outcomes if radical prostectomy is ever needed. But medication has sexual side effects. This combination seems to be a grey area with not a lot of detail on how to approach. Physio and medication isn’t really treating the symptoms, but the risks of full removal mean it’s hard to know what to do
You need Proscar or Avodart to shrink that prostate. I think the sexual side effects are exaggerated....
I am listening regularly thank you so much but recent sudden death of a famous and great singer from PC at age 55 in India frightens me. He had a cerebral stroke then things deteriorated . Wondering if stroke was from hormone or something in treatment can you explore?😊
My fatther diagnos. Prostate cancer,last dec5 last inject for prostate for two years it means father he survive please reply
Just tell me how I will die. Two days ago I passed out for over two hours. I have a pacemaker so I guess it keeps me going. Tell me how I will die!
In short don’t let anyone cut it out yet.
What about " nano knife or electric focal points to kill the cancer 16:36
I believe i am in a very gray area. I only have Gleason 6, but there are other things to consider. Five cores on biopsy were positive and throughout both sides of the prostate. Two lesions present on MRI on opposite sides of the prostate with both abutting the wall. Decipher score was .1 asay from being intermediate risk, family hx of father and both grandfathers having prostate cancer, and dre observed hardness on one side where one of the lesions were present. Should I still do AS? Been to three reputable hospitals
All leaning toward treatment. I will probably do SBRT five sessions. I believe saying Gleason 6 without all the facts could be a bit misleading. Maybe I’m wrong, as I am concerned about waiting too long.
SBRT???? Had to Look it up "AGAIN".... 😎.
I was in a similar situation with 4 or 5 (can't remember exact number) cores (Gleason 6) but only one side abutting the wall. Unfortunately I got a very bad urinary tract infection from the biopsy and from that point was not going to do active surveillance with annual biopsies. So I looked at my options. I decided on SBRT and went to Penn Medicine. I went through a procedure to get SpaceOar to protect the Colon, then a month later started SBRT (5 treatments). I'm now 1 year post treatment with relatively few side affects. The SBRT process is harder than it seems, though. You have to perform an enema before each treatment, and you have to drink about 20 ounces of water 45 minutes before, so if they are backed up on patient treatment appointments it does get a bit uncomfortable, especially since the treatment is about 45 minutes. They do perform CAT scans right on the treatment table before you get the radiation and check the results before you get the radiation. You do not really feel anything from the actual radiation treatment. Other than that no regrets on my choice at this point. My PSA at my last appointment was 1.95 down from a high of 4.2. It takes about 2 years to get to near zero PSA. I hope that helps and if you have any questions, let me know.
@@markwisniewski4165 i start my SBRT treatments in 3-4 weeks from now; are you on Hormone therapy too. Thank you, Tony
I found this.... poking around on the internet, and yes, this is real.
>>First patient with metastatic prostate cancer to receive 2 doses of Cu-67 SAR-bisPSMA achieves undetectable PSA level
Does using 500mcg Dutasteride a day increase the prostatic cancer risk?
No it hasn't been proven
I'm sorry I missed the last day here today is history repeats it
Your website says you accept cash but billing department says no. Is this true?
I have not been impressed with the urologist/s I have dealt with to date. My urologist office (only one in town) is extremely overwhelmed there and it's a 'herd like mentality' there. The two doctors ( both old-school urologists) there have been doing this a long time (maybe too long) and they are pretty set in there ways. Collectively they have not gained my confidence. In fact, I have a lack of confidence in them. Both urologists I have seen seem taken aback by my wanting to be the decision-maker in my treatment option. I have 11 of 12 cores that are 70-90% positive all 3+4 (20% on whole are 4's). The first urologist ordered a PSMA Pet Scan. Aside from confirming cancer in my prostate my PSMA Pet scan indicates one other statement ... "Equivocal for sub-5mm right internal iliac nodal metastasis." I took to be that it is ambiguous or not sure or uncertain finding. However, the urologist (2nd one that I've seen at the same place) says given my PSA of 81 he is certain I have micro metastasis and is wanting to treat me as if I have certain spread/metastasis and is pushing Hormone Therapy. He even said "I would not have even ordered a PSMA Pet Scan for you." I was taken aback by this statement and it just reinforces my lack of confidence in him. I am now being referred to radiation oncologist that the urologist works with. Not sure how my consult will go with the oncologist. I would like the least aggressive approach possible and am hoping for brachytherapy or Proton Beam Therapy and hope that I will be a candidate. Would like to avoid hormone therapy and standard/typical radiation treatment but not sure what options I will have available.
Perhaps a change of physician and a visit to a cancer center if one is nearby
I share your frustration. Imagine living in a small town in the US not near any major centers and having little to no resources with a bad Medicare Advantage HMO plan and having to deal with all of this, not to mention the trust issue from urologists.
My radiologist told me I should welcome a penile implant..said it so flippantly.. also told me i am on the internet too much because i asked some questions...sigh
Natural remedies
Like what?
I sm 4 months into adt with a starting psa of 121 rising to 230 while I waited for an appointment w ith a urologist. My psa has dropped but rate of dropping is decreasing. My mental health has never been worse. I cannot find a reason to live. I feel that the best outcome available will leave me in a level of misery where i will wish evrn harder to die. What to do?
@@williammack571 what is your Gleason score
Did you have a biopsy?
hi I have bee with prostate cancer metasised to my bones for 3 years now ... first my PSA was 275 3 years ago and I was on hormon pills and elegard I had Chemo 3 times radiation now I am on lynparza and my spa is start going up after it it did went down to 3.9 and now it is 7.8 and still on lymparza my dr. said I have to go back to chemo one the PSA is going up to 16 or more what is you advise to me shall I do chemo or not.... thanks dr.
There is something called modified citrus pectin, I don't know if it is for someone in your position or not... however you can research it, it was said to reduce PSA but again, where you are at matters a great deal. There is a urology center in Omaha that is involved with the Cu67 trial that seems to be showing stellar results. You can search for it.
thanks for the replay @@DCGreenZone
My gleason is 3+3 in 3 cores that they saw in the biopsy
Hello, we are not able to answer case questions on our comment section but we can help you through our Helpline who can speak with you either by phone or email. Here is the link to contact them: pcri.org/helpline
Is Alex Scholz Dr. Sholz's daughter?
Daughter-in-law
I would imagine. No way they are husband and wife.
I believe, in an earlier video, it indicated she is Dr. Sholz's daughter-in-law.
Who would consider prostatectomy it is so froth with all kinds of risks and dire post surgery issues, there is potential for severed nerves, damage to the intestines, just look at lloyd Austin's complications probably nicked his intestine during surgery. Then after surgery one needs a catheter and most likely will have bladder leakage for the rest of life, necessitating the need to wear adult diapers.
ED for a younger man is terrible, only slightly better than death
@@davidrichards2113 that would be a horrible adjustment and adaptation
Dr. Reiter (at UCLA) operated on me a in 2005. Saved the nerves. No ED, no leakage. Catheter needed only for first week.
You know, this is very disheartening. Why do WE have to do the research? What ever happened to "First do no harm"? Outcomes are terrible for Prostate Cancer treatments. Where are the therapies to control it? It's all about the fuckin $$$.
Don’t know what your experience was but, all of my doctors presented my “numbers” and I decided treatment based on what side effects I was willing to endure and confidence that the approach would be effective. If you have doctors pushing towards a specific treatment without a “by the numbers” discussion. Get a new doctor. Sure, every doc has a bias based on how they were trained and what speciality they are in - every body has biases. It’s up to the individual to make the final call…it is very tough but ultimate the individual is in control. Don’t be so quick to go down the $$$$ hole conspiracy theory.
The side effects are pretty much the same. Long tern vs short term mumbo jumbo.
We hat about just letting me die?
Whow the tie...
If you like his tie you need to watch his other videos
Fact: The doctors with the most colorful ties are the most trustworthy 🙂
it is a shame that the urologists that are profit driven only consider revenue over their patient's needs. the UK seems to be light years ahead of the US on prostate cancer treatment since they are not profit driven
You are either joking or you are totally unaware of the issues facing British patients who depend on the NHS for care.
@@dondgc2298I disagree with you. I could not have received better treatment from my local hospital - my doctor was the failure in initially refusing me a PSA test. ( AGE 79 with PSA 310 )
You change what you put in your mouth.
LOL
But the new technologies haven't been proven.