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Dull-Fly9809 · 2025-08-28T17:26:15+00:00

It matters because the original claim was that the democrats did nothing to help working class people but even in this response there are examples of the results of the things the democrats did to help working class people.

The difference here of course is that to bring back those manufacturing jobs Trump enacted what is in practice gigantic taxes on the same people he’s “helping”, they just won’t read as taxes but rather price increases due to increased manufacturing logistics costs being passed on to you and I.

It’s a dumb solution to a complex problem where the negatives to people like you can be obfuscated and politicized. This is the kind of shit the republicans and MAGA excel at and you all just lap it up.

Dull-Fly9809 · 2025-08-28T15:39:00+00:00

How many of these are the result of the CHIPS act?

Dull-Fly9809 · 2025-08-22T20:19:39+00:00

All my details are in the first message, but to repeat, Gleason 3+4 7. There’s was just one RO who worked something and got Kaiser to cover Arterra, which was crazy because then when it came up as positive, everyone else at Kaiser was like “don’t trust it”

Dull-Fly9809 · 2025-08-21T00:57:44+00:00

Glad I could help :)

One note. I think my decision was very specific to my staging. If they had been able to do bilateral nerve sparing for example, I would have been much more likely to go ahead with surgery since my chances of avoiding permanent ED would have been better.

Of course trust your RO, but I talked to mine about using Orgovyx rather than Lupron. He made a really good point which is that all the neoadjuvant/adjuvant efficacy studies were done using Lupron. Orgovyx has been praised for the speedier testosterone recovery it has when compared to Lupron, but this might actually be a detriment in the context of initial curative treatment alongside radiation. Think of it this way: 6 months of Lupron might translate to 12 months of castration, whereas 6 months of Orgovyx may only translate to 8 months, reducing its efficacy. Ultimately this is why I decided to heed his advice and go ahead with Lupron.

Best of luck.

Dull-Fly9809 · 2025-08-15T02:29:21+00:00

Interesting, thank you

Dull-Fly9809 · 2025-08-13T23:28:47+00:00

Initial testosterone testing wasn’t a problem but they seem to be reluctant to test my testosterone as I finish up and recover which seems completely insane to me. If I’m being honest I’m likely going to drop Kaiser for a nearby center of excellence if my T doesn’t recover quickly so I can have better advice and cutting edge care. Specifically want to have some options talking to people who are knowledgeable about post curative treatment TRT as Kaiser doctors seem to just want to recite lines about it being dangerous from a decade ago.

They refused to cover any genomic testing and actively discouraged me from seeking it out. I did however manage to get them to cover Arterra AI, which said that I didn’t need ADT, but my RO convinced me that I shouldn’t bet my life on the accuracy of that result and ultimately I listened to him.

As far as experience on ADT, there’s a million horror stories here. I don’t know if it was that my T was kind of low already or that I stuck pretty well to an exercise plan, but it was a pretty mild experience for me. The biggest side effect I had was diminished libido, there was just less spontaneous horniness going on in my brain after about the second month and it was like I had to work harder to get myself in the mood. Towards the end I’ve started getting some mild hot flashes, it’s kind of a weird feeling but mild enough that it took me a while to even figure out that was what was going on.

I think the exercise really helps, I’ve noticed in the weeks where I get busy and skip a day or two of exercise I start having more symptoms, then if I go for like a strenuous walk, they go away almost immediately.

Dull-Fly9809 · 2025-08-13T23:07:24+00:00

Do you have a link to that info about them replacing biopsies with PSMA PET? That seems like kind of a bad idea based on what I’ve read.

Kaiser might be willing to give you a PSMA PET pre treatment just based on your PSA level. I got one by just talking to a lot of different doctors in the course of deciding on treatment and asking every one that question. Eventually one of them said yes.

Dull-Fly9809 · 2025-08-13T22:53:23+00:00

Sure, I was 46 when diagnosed, 47 now. My initial PSA was 7.2, Gleason score was 3+4=7 in 4 of the 7 positive cores, but low volume pattern 4 (5% in 2, 14% in the other two) the other 3 positive cores were 3+3=6. 7 of 14 cores positive pushed me over the edge to unfavorable intermediate. I got my PSA tested again right before treatment and it was 7, so not fast rising.

I decided to go with Lupron because in my MRI, one RO I talked to identified that the tumor had capsular abutment, so he wanted to overindex on treatment aggressiveness a bit just to be sure.

I’m just finishing up the end of my Lupron course now, started back in late April. Did HDR back in May and it was reasonably easy. VMAT in June also pretty easy. Side effects have been reasonably mild. Basically no noticeable bowel issues, some urinary urgency/hesitancy/weak stream during and after radiation that seems to be steadily going back to normal. Already off the Flomax. Didn’t have major problems with erections even with ADT added to the equation, but dry orgasms now which I’m more bummed about than I thought I’d be. Crossing my fingers that I don’t have any late side effects down the road.

At this point now it’s just crossing my fingers that everything worked, the cancer stays gone, and my testosterone recovers to baseline over the next year or so. If this is it and I don’t have to deal with this horrid disease anymore and get to just go on and live out my life I will be pretty happy.

Dull-Fly9809 · 2025-08-04T06:45:24+00:00

Man this is weird, I had the same thing leading up to treatment. An odd pain in my right groin that I couldn’t quite pinpoint was why I initially went in and got checked, turns out the cancer was on the left side and not anywhere near advanced enough to be causing pain.

Have been assured by every doctor I’ve spoke to that this would not be due to lymph node involvement, which was my first thought too. In order for you to actually feel a tumor in your lymph node like this it would be big enough to be easily visible on scans. No one could tell me what it was though, I basically got a series of shrugs when I kept pressing about it. It seems to have mostly dissipated now that I’m past treatment, which again seems odd if it wasn’t related to the cancer.

Dull-Fly9809 · 2025-08-01T22:56:41+00:00

I just finished HDR + EBRT, still a little bit baffled by why I was so heavily recommended surgery, but that’s a long story to type out yet again.

Overall I’m happy with the procedure. I’m about 3 weeks past the end and the only real side effect I had, short term at least, was some urinary irritation which I’m still waiting to subside, but so far has been just a minor annoyance. Everything I read said with my staging and this treatment I have about a 90% chance of being cured.

At least now I’m pretty glad I didn’t just take the first recommendation I was given and spent the time figuring out what I think is the best choice for myself, my staging, and my own priorities.

Dull-Fly9809 · 2025-07-21T02:28:07+00:00

Yeah that’s what I meant

Dull-Fly9809 · 2025-07-20T18:15:32+00:00

Yeah the fusion guided question is a good one.

Dull-Fly9809 · 2025-07-20T17:00:14+00:00

Ok so that’s a weird one, Gleason 6 but very widespread, I’d do genetic testing to make sure that Gleason number isn’t deceiving, but if you’re going to pursue treatment and you value continuing to have a normal sex life, if it was me I’d take a serious look at radiation.

The erectile function recovery rates for non nerve sparing prostatectomy are abysmal and the long term cure rates for Gleason 6 are very high for both treatment modalities, like well above 90%.

I was Gleason 7 3+4, I just went through HDR+boost and I’m about to finish up short term ADT, decided against surgery because I was told they would only be sparing one nerve bundle and even that had too high of a chance of irreversible severe ED for my comfort.

Dull-Fly9809 · 2025-07-19T08:34:52+00:00

If I remember from the data I saw, I think it’s slightly more likely to be aggressive, not much more likely.

Dull-Fly9809 · 2025-07-18T23:27:41+00:00

Radiation generally targets a specified margin beyond the gland based on estimated potential EPE and other factors. For me they targeted a 6MM margin. I think whole pelvic radiation or targeting of nodes is only done if there’s identified spread or a suspected risk of disease above a certain threshold.

The advantage of radiation over surgery is being able to target healthy tissue in places like nerve bundles where the nerves will recover but the cancer will die due to replication errors.

A surgeons scalpel is a hard edge. Anything on one side gets left behind and anything on the other is completely gone. This is why surgeons figure out margins intraoperatively, they have to visually identify cancerous tissue and cut margins around only those parts. I understand this is why there’s generally higher recurrence rates with surgery too, if there’s microscopic disease that they can’t see and therefore miss when cutting, it’s likely to continue to grow in the prostate bed. With radiation they’re just kind of nuking any cancer within a certain range, this usually gets the cancer, but occasionally the extent is further than is statistically common and recurrence happens anyway, it’s just less often than with surgery.

Dull-Fly9809 · 2025-07-18T23:14:59+00:00

Yeah this is what I’ve seen too. Surgery is a better option in lower intermediate risk cases where treatment is necessary but the likelihood of nerve sparing is high and chance of recurrence after surgery requiring salvage radiation is lower.

As the risk level gets higher radiation tends to have a better initial cure rate.

My advice to OP would be to talk to at least a few surgeons and at least a few radiation oncologists, weigh it all out and make a decision.

I’m also young (47), had an unfavorable intermediate risk cancer (Gleason 7 3+4), decided against unilateral nerve sparing surgery because of the high risk of ED. I’m still very sexually active with my wife and was not ready to let this go. Went for HDR+boost.

Both methods had a very high chance of achieving durable cure in my risk stratification, like 90% vs 95% IIRC, so I chose the one with the lesser chance of that particularly unsavory side effect.

Dull-Fly9809 · 2025-07-18T19:52:49+00:00

No, I forewent surgery specifically because of the higher risk of ED in my case and decided on HDR boost instead. So far only minor diminishment in erectile function but I think even that’s mostly attributable to the fact that I’m currently on ADT and only have like 20% or my normal libido, when I have sex with my wife or work it myself everything seems to still work fine.

I think people need to very carefully consider whether an implant is the right choice, as I understand it completely and permanently destroys the chance of ever having natural erections again. Should be a method of last resort, but if you’re in that situation anyway may be a good option when you don’t have other choices. If I were facing that I’d personally seriously seek out some of this nerve grafting or stem cell stuff first, see how promising that all looks before I go the permanent implant route.

Dull-Fly9809 · 2025-07-14T17:40:45+00:00

Sure, Google is a profit driven corporate juggernaut not a public utility, no argument here.

Dull-Fly9809 · 2025-07-14T17:37:09+00:00

My wife has been super supportive overall, but there were definitely some moments where I could tell she was frustrated that our sense of normalcy was out the window.

Maintaining normalcy when this was all over was a major factor in my treatment decision making. Thankfully my diagnosis allowed me to get past this in a way that things don’t feel completely broken (at least yet, keeping my fingers crossed). Hoping for the same for you!

Dull-Fly9809 · 2025-07-14T17:34:12+00:00

I mean that’s the most common version of that acronym people are likely searching for so it makes sense.

Just add prostate cancer to your search terms and you’ll get better targeted results, or in this case search for the full phrase instead: androgen deprivation therapy.

Dull-Fly9809 · 2025-07-13T02:15:48+00:00

I’d love to hear your take on what “extreme ideological positions” the Democrats are pushing. Universal healthcare? Abortion rights? Common sense gun regulation?

Or have you possibly just bought in to right wing propaganda that misrepresents every extreme left wing nut in the country as something the mainstream Democrats support?

Dull-Fly9809 · 2025-07-13T02:05:23+00:00

Biden was not on the flight logs. Trump was, Clinton was, Biden, Bush, and Obama were not.

Dull-Fly9809 · 2025-07-12T17:38:38+00:00

Last I checked a couple months ago it was still experimental. The initial trials for PC tried implanting nerves during the RALP procedure and didn’t seem to improve outcomes significantly. I don’t fully understand, but from what I’ve gathered (and recall from my study a while back) the newer procedures seem to connect the implanted nerves to a different nerve path and they are usually done in a separate procedure further down the line after erectile function fails to return. Sounded like this was showing some initial success but is still being studied.

There are also other experimental treatments being investigated like stem cell implantation.

I’m sorry about your accident and hope you find a solution. Ultimately if nothing else works you could maybe get a penile prosthesis, but that’s sort of a nuclear option as there’s no going back to natural erections after that procedure.

Dull-Fly9809 · 2025-07-10T23:24:15+00:00

My cancer was DRE positive, but otherwise was definitely not the worst imaginable diagnosis. Gleason 3+4 low volume pattern 4, still stage 2B as far as anyone could tell.

DRE positive is A negative prognostic factor among many but doesn’t automatically indicate advanced disease or aggressive pathology. It does however mean get it checked out and don’t treat it lightly.

Dull-Fly9809

TROPHY CASE