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Reply to "Jpouch prostate cancer treatment"

Hello foges11. I'm replying to share info and hope you continue to do same.

As a reminder, following my prostatectomy the biopsies showed the cancer had extended into my right seminal vesicle.  I first saw a radiation oncologist who then referred me to a medical oncologist since radiation was out of the question. I met with Dr. Wee, a medical oncologist at Cleveland Clinic, this week. He agreed radiation is not for me, but he also said that ADT is usually prescribed following radiation treatment, sort of a one-two punch, and not used solely. However, because of my j-pouch we're in a grey area and there's little documentation on the use of ADT alone. He says I am at "high risk" for metastatic disease. In his opinion, I have three options at this point:

  1. Start ADT for a couple of years, although he doesn't know if two years is enough or even if it will help. Continue to monitor PSA.
  2. Wait and watch to see if my PSA level continues to go up. If it goes up a little, we can potentially delay ADT somewhat, but if the PSA goes up a lot, we would start ADT now. This is the option he recommends.
  3. Wait and see if I develop metastatic disease and if so, we would have to use at least two agents at that point.

I had another PSA test this week which showed a slight increase from two months ago. I am waiting to hear back from Dr. Wee with his recommendation.

Yes, I am anxious. I feel like I'm doing everything I can to be smart about this but I really need some good news. For anyone reading this, any thoughts or experience you can share?

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