Comments by Alan Meyer About the Treatment of Aggressive Prostate Cancer

Alan Meyer, a long-term advanced prostate cancer THRIVER who is very well respected by all of us at Cancer ABCs wrote on an advanced prostate Cancer forum the following;

“During my recent participation in a prostate cancer review panel (see: Proton beam vs. x-ray therapy) I asked two professors, one a radiation oncologist and one a urological surgeon, what they thought should be done about high-risk cancer, e.g., Gleason 9 or 10. Their answers surprised me.

The surgeon said that she didn't believe that high-risk cancers are easily cured by a single treatment. She thought multiple treatments were needed. She recommended surgery to get rid of the whole prostate, and Lupron + radiation to treat the area around it.

I then turned to the radiation oncologist. He was present and heard what the surgeon said. I said that my radiation oncologist had told me that she thought that, if having surgery didn't cure the cancer and radiation were needed to finish it off, then the patient would probably have been cured by radiation alone without having to go through surgery.

His answer surprised me too. He said that up to just a couple of years ago he would have said the same thing, but now he's not so sure. He thought it was possible that a very aggressive, high Gleason cancer might not be completely killed off by radiation. He, therefore, endorsed what the surgeon had said, thinking that surgery followed by radiation + Lupron offered the highest odds of a complete cure.

The answers weren't what I expected. I thought the surgeon and rad oncologist would disagree, as they traditionally do. Neither of the two people seemed to me to be shy about expressing their opinions forcefully, so I'm not ready to say that they were just polite to each other, though it's possible that they were.  I guess that all I can do here is report what they said.”

Allan asked that we make it very clear that the opinions expressed were just the opinions of these three “doctor/professor” individuals and did not necessarily represent the general opinion of anyone other than those responding to Allan’s question. 

The editorial opinion of Cancer ABCs is in agreement of the sentiments expressed by the two professionals at the prostate cancer review panel.  We agree that Gleason 9 and Gleason 10 prostate cancer is best treated by multiple modalities; surgery, radiation and hormone therapy. 

Joel T. Nowak, MA, MSW wrote this Post.  Joel is the CEO/Executive Director of Cancer ABCs.  He is a Cancer Thriver diagnosed with five primary cancers - Thyroid, Metastatic Prostate, Renal, Melanoma, and the rare cancer Appendiceal cancer.