I had prostate cancer eight years ago and had 40 external radiation treatment for 8 weeks, which took care of it. For years I had PSAs around 0.5, but not so long ago it rose to 1.1 and three months later to 1.8. I went to the oncologist who did the radiation before and he felt I should do the brachytherapy. I had CT and bone scans (all clear) and then a biopsy. Showed tumor in same place as before, still small, but Gleason of 7. My urologist felt that watchful waiting would be much better. After researching and reading about the seed deal, I found it was not as simple as I thought, and with more unpleasant side effects than I had expected. I am 82, in excellent health otherwise, climb a local mountain three times a week, lift weights for upper body strength. I am not really happy with watchful waiting, as my father and uncle died of prostate cancer and my mother of spinal cancer. I have had too many friends who had died from metastasizing prostate cancer, and it was not easy deaths. So, now I am in a hard place between two treatments, neither of which I am especially happy with. I am trying to be upbeat about this, but it is a bit depressing to realize the the cancer has come back. Both doctors agree that waiting for three to six months will probably be OK, so am scheduled for another PSA and appointment in three months. Meanwhile, am drasticlly changing my diet and taking some supplements hoping it may hold the cancer from growing. Most of my family members lived until late 80s, so I was aiming for 102. My urologist’s idea of waiting for 8-10 years to avoid the side effects of radiation, but then it will probably spread. I don’t want to die of cancer, and the watchful waiting assumes you will croak of something else before the cancer gets you. I don’t think that will happen, so would like to get the thing out of my body, but it is hard to decide. The more I research and read about PCa, the more bewildered I get. Any advice?
I also think seed implantation in your case would be quite a risky approach. As you may know, I was diagnosed with metastatic prostate cancer at age 55. While I am in remission, the cancer can always come back. So, I have had an intense interest in the idea of slowing or stopping the return of cancer. There are many options for slowing the progression of prostate cancer. Our white book “Beating Prostate Cancer http://www.prostateforum.com/beating-pc.html ” gives a broad discussion of some of the options.
I would never consider watchful waiting, which says you are doing nothing. Clearly, you are not going to do that because you are adopting a diet and supplement program. That is not watchful waiting, but active treatment. We call that a growth arrest program at my clinic. One option would be for you to optimize that program. It would have to be fitted to your overall health.
At the next level, intermittent hormonal therapy would very likely be very effective as your cancer is already growing slowly. You might need 6-9 months of hormonal therapy to drive the cancer down to a low level and this might have to be repeated every 2-5 years.
Finally, you could use a low level form of continuous hormonal therapy. Avodart daily plus Casodex. Casodex might need to be daily for two or three months, but then it could be tapered to two or three times a week. This is usually very well tolerated and with the slow progression your cancer shows so far, it would likely be very effective.
