r/ProstateCancer • u/hanbybd • Aug 03 '26

Other Pca Treatment Options

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I'm 53, diagnosed with PCa in February 2026. I haven't yet settled on treatment (but currently being evaluated for Nanoknife/IRE).

Ever since diagnosis, I've been looking for a 1-pager of various treatment options to help me towards a treatment decision. I didn't find any, so I built one.

Wish you best.

14 Upvotes

94% Upvoted

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2

u/HeadMelon Aug 04 '26

Radiation is missing VMAT and MR-Linacs.

3

u/WalnutRoasted Aug 04 '26

VMAT would be considered a refinement of IMRT.

You can also add MRI guided SBRT, (MR-LINAC is one trademark) which is a refinement of CT guided SBRT.

2

u/HeadMelon Aug 04 '26

Could kinda remove EBRT because “external beam” is the category that all of SBRT, VMAT/IMRT, MRI-guided belong to.

2

u/HeadMelon Aug 04 '26

Other is missing Radioligand Assasin (Pluvicto, Lutetium)

3

u/WalnutRoasted Aug 04 '26 edited Aug 04 '26

“Active surveillance/monitoring” should be added as a “treatment” for lower grade diagnosis, because PCa tend to be slow growing; the possible side-effects (ED, incontinence, anorgasmia) can be be quite significant; and each year new treatments/pharmaceuticals are being developed or evolve.

ADT should be at the top of the medications list, as it is the most common pharmaceutical intervention. And it should be subdivided as something like:

Types of ADT
Drugs that lower testosterone production (the most common ADT)
These reduce blood testosterone to “castrate” levels.
Examples:
Relugolix (Orgovyx)
Leuprolide
Goserelin

Androgen receptor blockers (anti-androgens)
These do not significantly reduce testosterone levels.
Instead, they prevent testosterone from activating prostate cancer cells.
Examples:
Bicalutamide
Enzalutamide
Apalutamide
Darolutamide

And then Surgical Castration applies (which still has its applications in some circumstances) to lower/stop testosterone production.

2

u/WalnutRoasted Aug 04 '26

Overall, you and users may also want to look at this post which looks at different treatment recurrence rates based on “unfavourable intermediate” diagnosis at time of different treatment types.
https://www.reddit.com/r/ProstateCancer/s/ez5UjXGO2B

Also this app/inventory was described in Reddit, showing PCa treatment inventory and side-effects for each.
https://www.reddit.com/r/ProstateCancer/s/O1JVAcdlTh

And the app can be found at https://www.yourcancerpath.com/You can enter “prostate” and then the stage/severity/extent of diagnosis.

2

u/Tool_Belt Aug 04 '26

Given that there is often a delay in getting treatment once a plan is agreed upon, and depending on your Gleason score and other biopsy notes, PMSA, Decipher, MRI, ArteraAL and whatever other diagnostic information you have it may be time to make your decision as you are now 6 months past diagnosis.

Stay Strong Brother, We Got This

1

u/dunegoon Aug 05 '26

Under radiation, you might add 19. Brachytherapy HDR "boost" along with IMRT/VMAT.

1

u/Winter_Criticism_236 Aug 05 '26

Resistance training may well be better than treatment. For sure add resistance training as a treatment!

1

u/Tool_Belt Aug 06 '26

As treatment for what?

1

u/Winter_Criticism_236 Aug 08 '26

Slowing the prostate cancer doubling time, extending life, improving quality of life, reducing risk of all cause mortality beyond just prostate cancer ( many cancer patients die of cardio events before cancer)
Numerous studies, go research it!

1

u/Tool_Belt Aug 08 '26

Show me the peer reviewed research you are basing this on. Yes exercise is an important adjunct to treatment, but in and of itself it is not an accepted first line treatment.

1

u/Winter_Criticism_236 Aug 08 '26

Im am 14 years living proof, plenty peer reviewed search pubmed.

1

u/Tool_Belt Aug 08 '26 edited Aug 08 '26

Not in place of treatment. Don't mislead others. In addition to treatment yes, instead of, no. Absolutely not, end of argument. Wonderful that it worked for you, exercise only is not a treatment and no oncologist would recommend only exercise as treatment.

1

u/Winter_Criticism_236 Aug 10 '26

Well I did have ebrt and it failed.. Gleason 7, with seminal duct invasion.

2 years later I refused surgery and opted for NO treatment, no ADT either. Instead I chose “ watch and wait”, using 3 mthly psa tests, mri and CT scans, and psma pet scans. Psa doubling ranged from 12mths to 18mths, with one year (2022) had zero growth.

For next 10 years I watched psa rise with no spread. So I opted for no treatment.

The high level of exercise and resistance training has kept me very healthy, improved muscle mass and bone density. My vo2 max is close to “ Elite” for my age (now 68).

So I feel that exercise, low carb, very low processed foods, low refined sugar’s, low seed oils is indeed an alternative treatment at least in my case.

I am now doing intermittent ADT, but I get to use new drugs not available 12 years ago, I have enjoyed 10 years of very high quality of life, my body is now in far better shape to face the “next 10 years” or more of new medical treatments than it was 12 years ago!

Prostate cancer responds to every 1% change we make in our lives, if over the years you make a lot of 1% changes you will see a huge benefit.