#ProstateCancer

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The PSMA PET scan is radically changing prostate cancer staging; however, studies have not yet been finished for each of the many possible situations of prostate cancer, and so deciding on the most appropriate treatment intensity--balancing the risks of cancer and the risks of side effects--still is not always straightforward, and requires a careful consideration of factors like a patient's age, the risk of the cancer spreading or recurring, and so on. Here, PCRI's Alex and medical oncologist Mark Scholz, MD, prostate cancer staging in 2023, and how patients should speak with their doctors to ensure that their personal needs are being taken into consideration.
0:25 What is sequencing in prostate cancer, and is it better to use treatments earlier rather than later? How do you decide on treatment intensity?
3:02 How do factors like age, disease state, quality of life, etc. factor into deciding the appropriate treatment intensity?
5:12 Can you explain how the PSMA PET scan has changed prostate cancer staging, and by extension, decision-making about the appropriate treatment intensity in each individual case?
6:50 Should patients always be thinking of doing the least amount of treatment possible knowing that if there is a relapse, the PSMA PET scan will likely be able to find it and further treatment can be administered, or are there reasons to use more intense treatment to ensure that a cure is achieved?
7:57 How does quality of life, specifically, factor into treatment decisions?
9:13 How can patients ensure that they are receiving the optimal treatment, or that their individual desires are being taken into account?
11:24 Should all prostate cancer patients be seeking out a second opinion?
12:13 Can treatments like radiation and chemotherapy be used more than once?
13:33 Should patients continue hormone therapy if their PSA is rising despite treatment?
15:37 How do factors like the Gleason score determine which treatments and treatment protocols will be appropriate for their individual case of prostate cancer?
Don’t know your stage? Take the quiz: Visit www.prostatecancerstaging.org
To learn more about prostate cancer visit www.pcri.org
Sign up for our newsletter here to receive the latest updates on prostate cancer and the PCRI: pcri.org/join
Who we are:
The Prostate Cancer Research Institute (PCRI) is a 501(c)(3) not-for-profit organization that is dedicated to helping you research your treatment options. We understand that you have many questions, and we can help you find the answers that are specific to your case. All of our resources are designed by a multidisciplinary team of advocates and expert physicians, for patients. We believe that by educating yourself about the disease, you will have more productive interactions with your medical professionals and receive better-individualized care. Feel free to explore our website at pcri.org or contact our free helpline with any questions that you have at pcri.org/helpline. Our Federal Tax ID # is 95-4617875 and qualifies for maximum charitable gift deductions by individual donors.
The information on the Prostate Cancer Research Institute's RU-vid channel is provided with the understanding that the Institute is not engaged in rendering medical advice or recommendation. The information provided in these videos should not replace consultations with qualified healthcare professionals to meet your individual medical needs.
#ProstateCancer #MarkScholzMD #PCRI

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2 июл 2024

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Комментарии : 54

@eddiegardner8232 Год назад

I feel like Alex and Dr Scholz ARE part of my medical team. I make decisions from an informed viewpoint when a decision point requires my awareness of treatments, side effects, time frames, and cancer stages. Much of this information comes from these videos, the annual conference presentations, the interviews of experts, the Grand Rounds of Urology lectures, and the many NIH studies that are available. Never doubt that you are doing good with your work. Hugs!

@aymanutube11 4 месяца назад

Same 4me 👍👍🫶

@petermathieson5692 4 месяца назад

Alex, you're a rock star. Such a great manner. Such well-considered questions, and Dr.Scholz, such clear, considered and concise responses.

@jhodini Год назад

I would like to thank PCRI for the depth and quality of educational resources you have provided to me on your RU-vid channel. Dr. Mark Scholz and Alex are now such familiar faces, they feel like my friends! Friends who have helped me navigate a challenging medical landscape over the past 5-years. This particular video is one of the best...very helpful sound up-to-date info. Can't thank you enough.

@aymanutube11 4 месяца назад

Same 4me 👍🫶

@hyperlinkphilosophy 4 месяца назад

I love both the Alex and Dr Scholz. You’re doing a fantastic job of presenting information. Dr. Scholz is extremely knowledgeable answers questions in a clear, concise, and digestible fashion without sacrificing nuance in his answers. Excellent! In a sense, as someone else stated in the comments, I too feel you are part of my medical team. I like how passionate and compassionate Alex talks to us that are dealing with prostate cancer. It means a lot just to hear ‘we care’ or ‘I care’ or ‘you matter’, kind of statements. Alex presents great questions and gives off a wonderful feel & rhythm to this podcast. I liked and subscribed of course and spreading the word about this wonderful podcast for prostate cancer patients.

@garymiller277 Год назад

Awesome information. Don't stop putting out these incredible videos.

@edwinvargas931 Год назад

18:23 this is by far the best RU-vid channel for PCR.

@Truth_seeker743 Год назад

Thank you Alex for kind words God bless you great information

@denisshelton8501 Год назад

Hi guys I am a 74 year old with metatastic cancer in my right lymph nod and the very top of my hip bone.I have had 6 months of hormone therapy (firmagon and 3 monthly triptotolene )a daily radiation session for a month targeting my prostate and 10 sessions of IMRT on my hip bone I am now half way through my chemo(dosetaxel I think you call it taxetore) My problem is that my testosterone level is now 11 (10 to twenty normal range) but my PSA is .75 My oncologist wants to put me back on ADT but my PSA is low I am meeting with her next Tuesday.. I am in Australia(Victoria living in a seaside town of Paynesville) Your you tube is fantastic and I look forward to your sessions Keep up the good work

@1royalpalm Год назад

My history: 74-years-old. Been on lupron/eligard since 2018. Prostate and four lymph nodes removed 4/1/2019. Became hormone (lupron) refractory and then subsequently erleada refractroy in 2022. Had a PSMA - PET scan in late 2022. I'm metastatic throughout my bones. Oncologist gave me four 3-week cycles of taxotere -- yet PSA still rising. Oncologist then gave me four cycles of jevtana -- yet PSA still rising. Today I had PET scan. Will get the results with my oncologist 3-17-2023. Prior to PET scan my oncologist wanted me to get some radiation to my pelvic and spine. PET scan should dictate where the radiation should be applied. I no longer want any more chemo since for the most part it isn't working, and I'm tired of the side effects. I want to get on with some radiation as my oncologist said it should bring my PSA down some. Further, my oncologist is in the process of setting me up with a nuclear doctor that can administer Lutecium -177 -- which is in short supply, so in the meantime I'm looking at getting some radiation.

@iamric23 6 месяцев назад

Wow you have and are going through a ton. How were the results from the pet scan?

@1royalpalm 6 месяцев назад

@@iamric23 Since my last posting I've had five pluvicto infusions (lutetium - 177), and my PSA was down to 1.25 after my 4th pluvicto infusion. I have to wait four weeks for my blood work to see if the 5th pluvicto infusion brought my PSA down further. My oncologist said that after my 6th pluvicto infusion he will order up another PET scan for me to compare with the one I had prior to going on chemo and pluvicto. No side effects at all with pluvicto as compared to chemo, but the cost is astronomical. My insurance pays out $48,000 for each pluvicto infusion.

@iamric23 6 месяцев назад

I have to echo what I read here below. My entire education on the prostate and mediation therapies have come entirely from sitting and clicking on these informative videos. I think I am officially a groupie at this point. Honestly, I do not know what I would of done without there persistence in doing these videos. Who knows if I can be cured, but that's life, at least I will have a better understanding when i have to make that so important decision on what type of care is best for me. Thanks to "You Tube" also, this was not around some years back, such a great resource.

@maxthemagition 9 месяцев назад

In August 2007 I got a private health check and my PSA was 5.64. Early this year 2023 I went ot the doctor for frequent visits to the toilet during the night and the doctor took a blood sample for a PSA test which was foun to be over 10 at 11.5. So my PSA went from 5.64 to 11.5 over a period of 15 to 16 years during which I have been very healthy other than the frequent visits to the toilet during the night for a wee. Anyway this was followed up from early this year ...scans, biopsy etc to find that I have Gleeson 4/3 localised in the prostate and now I am on Hormone therapy for 6 months during which I will receive radiation therapy over 3 weeks. My testostorone level is going down and I feel aged, body sweats and fatigued. I read that my PSA should come down to near zero after Ratiation Therapy, but if it goes up slightly, I could be back to square one as it indictes that the cancer could still be present. Is there no escape for this nightmare? I will be 77 years old this December 2023.

@user-jk7vz8tw3q 4 месяца назад

hang in there, some things can only be taken one day at a time.an ole friend had the similar thing, he had the ancer at 60,he lived until 82.. i am 76. dec 23.

@mneveitt 6 месяцев назад

I’m probably going to have radiation treatment for intermediate adenocarcinoma, nobody’s mentioned hormone therapy yet there doesn’t appear to be any lymph node involvement or any other metastasis outside the prostate at this time, I don’t want hormone therapy, sounds like it really adversely affects your quality of life, I will either be receiving.IMRT or SBRT UPDATE: decided to go with IMRT,17 out of 28 treatments, and so far so good, no hormone therapy needed

@montanamike53 Год назад

I wanted to reach out and thank you for helping educate myself regarding my prostate cancer. Especially the videos that Alex and doctor Mark Scholz. after 6 years of active surveillance it's become necessary to choose a course of treatment. My radiologist oncologist is beginning the process of Genome testing and then PSMA Pet/CT scan before determining further treatment.

@WallaceDunn 7 месяцев назад

Good luck sir! I'm in the same boat today...

@timothyfay1209 8 месяцев назад

Great information here. I just started with the Mayo Clinic to treat my metastatic prostate cancer, Mayo will do radiation on the prostate where the previous Radiation Oncologist said no, only for bone pain. Also, the Mayo Clinic gives you one hour for an appointment with the doctor. All questions are answered and they don't rush through the appointment, I highly recommend the Mayo Clinic if you have access.

@user-jk7vz8tw3q 4 месяца назад

thanks for posting. i have medicare ins. and the Mayo clinic in AZ does not accept medicare patients. my son was treated there , he is 50. so it it quite unfortunate for me,the mayo clinic is quite good,

@timothyfay1209 4 месяца назад

Sorry to hear that.@@user-jk7vz8tw3q

@gvet47 Год назад

I am going to stop my Lupron shots as I spend my whole day dripping wet. Cannot do anything in this condition. Already destroyed my hearing aids with the dripping hair. At 75 I want some normal life even if a short time.

@raymonddavis5271 Год назад

Another great job!!! Stay safe and much love for what yall do .

@John-the-Bass Год назад

Thank you for your excellent work. It is appreciated. I rely on your information. Take care!

@trailrider9526 Год назад

Thank you so very much!! With watching your videos I have the information to discuss different treatment options with my Doctor. Keep up the great work, it is so valuable.

@JayeSmoothMusic Год назад

Hello. I had 3+4 intermediate non metastasize prostate cancer. I had 4 on 3 cords. My psa started raising every 3 months from 11 to 25 before I started any treatment. I've been taking monthly lupron shots combined with radiation and every month my psa reduced in half. I was told this was 6 months treatment. I'm at my 5th treatment month and my psa is at 1:14. God willing at the end of this month I should be at 0. My doctor suggested maybe I should extend my hormone therapy for another year and a half. I asked what would be the benefits and he stated it's a small benefit, but he was worried that my gleason score got up to 25 before treatment. He said maybe we can complete the 6 months treatment and recheck in 3 months to se if we should continue. Witch idea you think would be best for someone who psa was at 8 , 4 years before I even knew what prostate cancer was and 8 months after diagnosed before starting my treatment and radiation and no spread was detected after my pmsa pet scan test.

@barrie888 Год назад

top quality content as usual

@quirkwoods 4 месяца назад

Fantastic videos, thank you!

@user-jk7vz8tw3q 4 месяца назад

i concur, remember cancer is only the first step, i opine the greatest challenge is having a good expert doctor to work on one . i was butchered in a skin cancer surgery 2 yrs ago.yey it was at Hope cIty, in goodyear ,az. one must be well informed and careful. remewmber its your dick,not the doctors.

@jblue2435 Год назад

Excellent advice as always

@marinacabrera8293 11 месяцев назад

Thank you

@gtracer6629 Год назад

I was diagnosed with prostate cancer almost 2 years ago. In the meantime I had a stroke. I was sent to a nursing home to recover from a stroke. During the time I have been in the nursing home I've been unable to get any treatment for the prostate cancer. They did do it TSA test and his come down on its own when the original setting. I wonder if other people I've been in the same situation. They keep telling me I have cancer but they have ignored me. I hope they go to Assisted Living and maybe there I will be able to go to the doctors to treat my prostate cancer. But at this point, I don't have much hope. My latest PSA results I dropped a 6.7 down from 7.2.

@vandhanagopalakrishnan9401 Год назад

Towards the end of this video Doctor mentioned that with PSMA it’s a more decided issue of whether it’s metastatic or not. However, what if PSA is increasing while PSMA shows no signs of progression when patient is on second generation therapy like Apalutamide or Enzalutamide? Should we then rely on PSA increase being the more sensitive indicator or back off a bit until something shows up on PSMA scans?

@vycuraci Год назад

Yo been so cool

@vandhanagopalakrishnan9401 Год назад

At 13:33 to the question - Should patients continue hormone therapy when PSA is rising Doctor answered that the accepted method is to continue treatment to keep the clones asleep and this extends to second generation treatments like xtandi, zytiga etc. Whereas in another video titles New FDA Approval…on Darolutamide, at around 8:07 Doctor said that some patients come to him have rising PSA for 6, 12 or even 18 months but it’s hard to understand why hasn’t some change in therapy been implemented. He said “It sort of seems obvious that that is PSA is rising it’s time to rethink the treatment plan and consider some other alternative”. The 2 approaches seem contradictory. Could you please clarify. When PSA continuesto rise after 1 or 1.5 years on Enzalutamide, should one consider Apalutamide or Darolutamide? Or should they continue on Enzalutamide to suppress the clones as mentioned in this video on the assumption that other second generation treatments are unlikely to help? In other words Is the switch between second generation treatments justified/warranted only based on side effects? Doctor mentioned around 15:10 that switching “rarely helps” - is he talking about switching between second generation treatments?

@jimjohngirard Год назад

Dr. Sholz. a small tumor, Group 2, 3+4=7 has been found in the right apex, PSA 3.3. How can the urogenital diaphragm be protected during treatment of the tumor, or what treatment would you recommend for a lesion in the apex. Can Space OAR using hydro dissection, protect the urogenital diaphragm as well as the rectum? What are the dangers of a tumor in the Apex of the gland that should be considered along with the opportunities.

@pgh3657 Год назад

Surgery vs Radiation as it relates to biopsy results - Does it matter how many samples were positive from the biopsy? For instance, would a person with 2 or 3 cancerous (3 + 4 or 4 + 3) areas be a better candidate for radiation than say a person with 8+ areas of cancer? It just seems like there might be a stronger case for surgery as the number of cancerous areas goes up. For my case the MRI showed 3 areas of concern but when the biopsy was done 8 of the twelve samples showed 3+4 or 4+3. My Urologist is recommending surgery of course but recommended and referred me to a radiation oncologist and said I will have to make the decision. I'm 60 and leaning towards radiation but I'm concerned about the quantity of cancer found in so many different areas of my prostate.

@jabster58 2 месяца назад

Not sure if this is helping or making the decision much harder

@mariagiantsios4354 Год назад

Prostate adenocarcinoma gleason score 7( grades 3+4 noted in 1 out of 1 submitted prostate core segments approximately 41% of submitted tissue involved grade group 2 gleason grade 4 comprises 30%of the tumor. My husband concerns about what kind of treatment he can have the doctor recommended radiation is that okay? Thank you.

@jackloverde7291 Год назад

Hi - I am having the hardest time choosing a treatment plan,........I have mostly all 4-3s with one 4-4,..PSA is very low at 2.4.......Help !!!

@masoudsaeedinia2191 Месяц назад

Hi, I hope you are doing well, Did you find what to do?

@bigdaddy5948 4 месяца назад

Having prostate cancer is a terrible thing. There are no real good treatments without side effects. It's a very difficult decision. It's a lot about facing life and death.

@frederickrich7393 Год назад

Hi there, just a question about my Prostate treatment, I was gleeson 8, psa 7 T3a mo, no. Had 18months Prostap hormone treatment , 7 months after starting hormone treatment I had 20 radiotherapy treatments. My Psa Nadir was 0.01 3 months later.7 months after finishing hormone treatment, my testosterone had gone up to 17.5 from 0.58, and my Psa is now 0.34, due to raise in testosterone, for last 2 months my right nipple is sensitive and tender is this due to my testosterone coming back up to normal or is it something to worry about, any thoughts or comments much appreciated. Thank you.

@frederickrich7393 Год назад

@ThePCRI. Follow up in 6 months time!!

@davewilton3101 3 месяца назад

I'm in Canada so thankfully no bill for treatment though over the years i've paid a boatload of taxes so i view this as recycling my tax dollars. Only negative side is that things move much more slowly it appears than in the USA. I've had a CT, Bone Scan and the hi-tech prostate mri and 2 biopsys the last being a fusion mri targeted. At 70 i passed on surgury and chose radiation, hormone therapy was offered & as i'm intermediate favourable i passed. Quality of life choice. i didnt want the side effects. Get the gold beads installed next month and hopefully radiation to follow shortly after. One 3+4, three 3+3, 7.12 psa. It's been a year since the psa test indicated this needed to be investigated. I was assigned to a great RO who i trust who listened to me, put forth his assessment and thoughts. He agreed with not doing HT at this time. I feel fortunate the way things are working out.

@richardcanfield3125 Год назад

Could you take a psmapet scan once a year and skip the biopsy? Do the scans have harmful effects?

@todstrucks2919 Год назад

Great question I really would like to know that one.

@Giovan_Nino Год назад

@@todstrucks2919me too…

@Dickie9028 Год назад

One biopsy for me , if I had known what I know now I would not have done the biopsy. No more disturbing that enclosed bag of cancer. PSMA only for me going forward.