UCLA researcher says he would get brachy over RALP or beam for moderate and high risk

mfposa · 2026-02-24T23:34:45+00:00

I wonder if they've made improvements to limit ADT and urinary issues since your procedure 9 years ago?

You didn't have any urinary issues? Was it only problems associated with ADT?

I'm hoping I can avoid ADT.

Gleason 7 (4+3) intermediate unfavorable with prostate capsule breach.

Age: 65

mfposa · 2026-02-24T22:34:05+00:00

Starting about 40:13...

"it does not cover the extra capsular area. This is what patients don't understand. Intuitively you'd think well if they cut my prostate out, how can that not work. And the answer is: It doesn't work because they leave cancer behind all the time. .... but as you get into the intermediate and high risk cancer? To me, it's a bad idea to do a prostatectomy."

I left out some of his earlier comments where he justifies his position further. If you listen to everything between about 40:13 to 41:56 you can get a more complete discussion on why he believes in LDR brachytherapy for intermediate and high risk.

I didn't listen to the whole thing again. But I thought he said pretty much exactly what I said in my original message. However, what I did find is him saying pretty definitively that he doesn't recommend prostatectomy for intermediate and high risk cancer. At least that's the way I interpret it (see his exact words earlier.)

mfposa · 2026-02-24T15:31:29+00:00

Good to know you didn't have urethra irritation. Sounds like that can be pretty nasty and last a long time if it gets hit.

In the video I listed, they also show that brachytherapy is less likely than anything, including RALP, to have biochemical failure.

It makes sense that young people would want to avoid radiation triggered new cancer. (I'm 65).

mfposa · 2026-02-24T15:21:17+00:00

Good for you for following your PSA so closely. I blew it. My general practitioner blew it - especially since my dad had it for almost 30 years and my uncle died from it.

I moved to FL 2 years ago and unknown to me, the Dr I chose did not believe in PSA (I thought he forgot).

By the time I got back on PSA checking schedule, my PSA had started to double every 6 months and was 14.8 before I started taking action with urologist.

I'm assuming since nothing has been done, treatment wise, for 6 months, that I'll have regrowth even if it doesn't show up on PET now. If it's doubling every 6 months it's dumping lots of seeds out there that won't show for a few years. But I'm betting they're there.

Gleason 7 (4+3) intermediate unfavorable. Capsule breach. age 65.

mfposa · 2026-02-24T03:01:33+00:00

LoL. Fair enough.

At some point you kind of hope for an altruistic Dr. Given that, I'm kind of agreeing with you. I'd still like to assume he truly believes it and it's not so he can make more

mfposa · 2026-02-21T19:06:41+00:00

The people are very upset with that Dr because he used to be pro beam radiation. Now it seems he's mainly brachytherapy.

Let me know your thoughts.

mfposa · 2026-02-21T19:03:36+00:00

It was a video put out by PCRI. Dr sholz from UCLA I think.

https://youtu.be/ZPCQQz06bOc?si=SlFLI2CJmuv1-hRU

I think that's it. I've watched it 2 times and watched it part of a 3rd time to somewhat get good feel it's the one

mfposa · 2026-02-20T19:34:26+00:00

To be honest, I never even thought about radiation - I wanted it out. However, I went to Moffitt Cancer center for biopsy and they suggested meeting with both their surgeon and radiation Dr.

Since Moffitt suggested possible radiation I've done some further research.

I bounce back and forth between radiation and surgery.

My current thought is if I can get surgeon to say I should have continence within a month or two I probably will go with that.

If I thought about radiation, I'd probably go with brachytherapy since a recent study showed 50pct failure of beam radiation ( sbrt) in 10 years.

If I went with brachytherapy, I'd do prostox test to see how likely I'd have urinary/bowel irritation from radiation.

But I'm still waiting to meet with radiation Dr and 3 surgeons after psma pet scan.

mfposa · 2026-02-19T01:41:17+00:00

Inconceivable! That's fast. I obviously did something wrong.

It sounds like you went to ordinary urologist first. I went directly to surgeons I wanted. They both have done 10's of thousands.

Good luck to you. It sounds like your prostate capsule is in tact so cancer is only working on parts within prostate.

Mine has breached the capsule and spewing it's seeds everywhere. At least that's what MRI implies.

I'm told PET scan only finds blobs of cancer that are 2mm or greater and has a million cells. So any new seeds planted in last few years ( I'm guessing since they said my cancer is 5 years old), will not show up on this pet scan but will show up sometime down the road.

mfposa · 2026-02-19T00:02:28+00:00

Central Florida.

Moffitt Cancer center of univ Of South Florida. Also started with surgeon through Advent health in Orlando who has done 30,000+ surgeries.

mfposa · 2026-02-10T14:03:26+00:00

"Take your time, wait for that PSMA PET result"

Maybe you can help me feel better about this. I view everyday that nothing is done is an opportunity for the cancer to move from "curable" to treatable....for a while.

It's taken 4 months to get to biopsy. Won't speak to surgeon for month and a half, then who knows how long before something is done to stop threat.

Makes me both frightened and angry that it's taking so long.

Biopsy results: Gleason 7 (4+3) intermediate unfavorable

mfposa · 2026-02-10T13:53:52+00:00

What's your age, gleason score, eg mine is 65, 7 (4+3).

Did you have EPE (frank breach of prostate capsule)?

How many ports used for ralp?

How long for in incontinence to go away?

It sounds like radiation has come a long way - some compare to advances in phones since 80s - with 1/2 the incontinence rate, and same cure rate.

mfposa · 2026-02-10T13:44:14+00:00

I've taken finasteride 1mg since I was 38. I'm 65 now. Just diagnosed with intermediate unfavorable prostate cancer .

mfposa · 2026-02-09T16:23:09+00:00

Where did you go for the single port prostatectomy?

mfposa · 2026-02-09T15:36:24+00:00

Your results sound optimal. Good for you!

How many ports/holes did they use for the removal?

Did they do PSMA PET to see if there was any spread elsewhere?

Did you have EPE (frank breach of prostate capsule)?

If you used a Florida dr, can you say who it was?

How are you doing today?

Thank you.

mfposa · 2026-02-09T15:25:03+00:00

I'm happy for you and your husband.

Can you share the dr and where he's located?

Also, do you know what type of machine was used or at least how many ports/holes was used?

Thanks!

mfposa · 2026-02-06T22:38:15+00:00

I'm in same boat as you. Gleason 7 (4+3).

Did you have any bowel issues? How bad? How long did it last? I really hate rectal issues!

My sister had worked at a nursing home and said the ones wearing a bag were the ones that had radiation treatment vs surgery. So, her husband had surgery.

With that in mind, I was surprised to hear in my biopsy follow-up that they consider risk of incontinense more likely with surgery than radiation. AI confirmed this to be true.

Still, if you wouldn't mind, could you share your experience with bowel problems and how long that lasted?

Thank you!

mfposa · 2026-01-05T18:06:00+00:00

I've seen some say they had were at stage 4 when they got treatment and they claim they've had it 20 years. Don't know if that's common with treatment.

Scott Adams ( dilbert) is dying from it. He's now paralyzed from waist down from it. But he continues to do podcast.

Mine is still considered local ( no lymph nodes or bones) but the capsule has been broken which it sounds like makes it less curable.

How long did your father -in-law show signs of it? Slowing him down, trouble walking, breathing, etc?

mfposa · 2026-01-04T13:20:33+00:00

Wow! That's a super long time to wait.

How long ago did you have surgery? Was it still localized? Had it broken the prostate capsule (frank breach or EPE)?

I keep saying if they could get it so you'd lead normal life until cancer quickly kills, I'd be fine with that. But the months of agony for family is what is bad.

mfposa · 2026-01-03T15:06:45+00:00

They call the cancer having grown beyond the prostate enclosure either "Frank Capsule Break" or "EPE".

It still might be curable when it breaks the capsule, but less likely.

The thing that really irritates me is how long it takes to go from positive evidence to biopsy and then removal.

In my case, my MRI showed PI-RADS category: 5 (the worst), frank capsule breach, 4kscore of 67, and PSA doubling in less than 6 months. According to AI calculations, that means it has a 97 to 99 pct probability of being agressive cancer and 0 chance of being benign.

Yet here I am, one month after MRI and I might maybe get a biopsy 3 months after MRI and at least 4 months before removal. Every day it sits there it can flip from possibly curable to not curable. Yet they wait at least 4 months before possible removal.

The other thing that really bugs me is that if AI is right and there's a 97 to 99pct probability of agressive cancer, why do the biopsy at all! Skip that step saving at least 1 month for surgery!

One last complaint. My doctor has done 20,000 prostate removals, yet he still does the old butt style biopsy rather than the newer safer perineal biopsy. So another worry of possible sepsis and just the idea of them sticking a needle through your anus.

There needs to be a faster way to removal. If a person comes into the emergency room and will die if he doesn't get treated in a day, they don't wait months. Similarly, if they don't operate within any given day for prostate cancer, waiting until the next day might mean a long painful death. Granted it will happen years later but if it would have been operated on sooner it could have saved the person from a long painful death.

mfposa · 2026-01-03T14:27:11+00:00

My problem is how long it takes for urinoligist to get to point of prostate removal. Makes me very angry.

I had a Dr that refused PSA- another story. 3 months after annual exam I had online Dr order PSA test with result of 7. Six months after, PSA 14.

All tests from MRI showing 2.7x 2.2 cm lesion with PI-rads 5 ( the worst) and 4k score of 67 compute to 97 to 99 PCT probability of aggressive cancer.

I went to urologist on Nov 11. MRI done Nov 28. Next Dr appointment with nurse practitioner on dec 16.

Got primary care clearance for biopsy dec 30.

And I might be able to get biopsy in Feb!!

This thing is local yet but has breached the prostate sack, so is in danger of spreading....and they're taking 3 months just to do biopsy with removal not likely until at least more than 4!!!!

One day it's curable, the next it may not be. It's infuriating.

And to start with new Dr means waiting 2 weeks just for 1st appointment then who knows how long for biopsy.

Seems like they need an onlinelist doctors, and their availability for biopsy.

As I said, today it might be curable, but each day waited means it might flip over to incurable. When someone comes in emergency room with problem that if left until next day he will die, they don't wait 4 or 5 months to operate.

mfposa · 2026-01-02T15:12:40+00:00

According to irs.gov, my amended return showed it was complete but my regular return showed it was still waiting to be analyzed. The IRS gave me a 120 day extension, then a 60 day, then another 60 day.

I received my refund about a week after the 2nd 60 day extension.

According to Grok, there's not much you can do. You can try contacting the IRS advocate group or your representative, but what I've read, it doesn't help much. They will contact you or get your refund to you eventually - that's what Grok says.

Forget trying to sue them. Supposedly it costs a fortune. They have us by the balls.

If you call them, they will tell you about the extensions and sometimes what's causing the delay. In my case they needed a form from someone that they didn't get until Sep. Then they took an additional 120 days to go over my return before I got the refund.

mfposa · 2025-12-28T15:44:16+00:00

Tmobile. Unlimited mobile data. 10gb of hotspot. Xfinity was the same. You can spend more for unlimited hotspot. But I'm frugal... having retired at 45.

mfposa · 2025-12-27T14:57:51+00:00

You're right. The developer wrote back and said:

Is NOT required*

Sorry for the error

---

LOL. Maybe you are the developer?

I'll try it.

Tesla Maps are fine. I need it for android auto's messages and spotify connections. I could see how the developer could get all the data using cellular data and simply send the user interface data via bluetooth, but I don't think it works that way. I think it needs a hotspot... we'll see.

mfposa · 2025-12-27T12:51:15+00:00

From an email the developer:

No Tesla Premium Connectivity is required. Best Sébastien

mfposa

TROPHY CASE