Prostate Cancer Patient Conference November 4 through November 21 2020

Your prostate cancer and quality of life questions will be presented by our moderator during the 21 days of presentations. Please post your question(s) below.

Prostate Cancer Question Catcher

Current Submissions:


1. Is there another term or acronym that could or/and should be used for patients rather than castration resistant prostate cancer, it seems to be very patient insensitive?
2.Are there any future genetic tests that are being developed to test our children, grandchildren, nephews etc. in the high risk families?
3. Are there any techniques that can be used to limit the hot flashes (AKA power surges) with the use of GNRH receptor agonists (i.e. leuprolide)?
4.In CRPC with mets could you discuss the use of abiraterone (Zytiga) in combination with eplerenone (Inspra) rather than prednisone.
5.Are there newer diagnostic tests that may be used in the future rather than the DRE and PSA that may be more specific?
6. I am 60 yo. Had RP at Mayo (Rochester) 12/18 for Gleason 7 (4+3), Grade 3 (1 of 13 lymph nodes positive), pT2c, pN1 – currently monitoring PSA. No other treatment. PSA remains undetectable. In the event of a biochemical recurrence what are my options regarding:
1) detection of possible metastatic involvement without having to anxiously wait for PSA to rise enough to detect Mets on standard imaging; and,2)treatment – at what point should I consider radiation to pelvic nodes/floor (and how long should I be on ADT if radiation is my best option?).  In responding I’m interested in your opinions of Abugharib et al study  that found four fold better outcomes for “very early” salvage radiation (PSA 0.01 -0.2). Thank you!
7. Are low libido and anorgasmia typical after successful aggressive nerve-sparing robotic surgery for someone in their 50’s who was on testosterone (before and starting again 2 years post-surgery)? That is, does the removal of the prostate effectively drive a dramatic decline in the ability to enjoy sex?

8. What is the minimum frequency of PRP penile injections to achieve an erection that are necessary to maintain penile erectile health and avoid atrophy?  Is recovery possible for those who who still have some natural response but have found it challenging to frequently inject in the past?

9. How does one gingerly bring up the issue of inability to ejaculate with either a prospective date or a brand new partner so that the other person does not feel unsuccessful, rejected or disappointed in their performance?  (This can ruin a new relationship.)

10. For gay patients that find they must either transition from topping to bottoming due to erectile dysfunction, or who continue to bottom, how large a decrease in pleasure in bottoming is typical due to removal of the prostate and related nerves?  How does one adjust to this substantial decline in pleasurable sensation?

11. When I was diagnosed with intermediate risk prostate cancer last year when I was 54 years old, I was surprised to learn how “old fashioned” and limited my treatment options seemed to be, and the fact that a real “cure” or treatment without significant side effects had not yet been developed.  While RALP (robotic) surgery is certainly impressive, it seems that not much has changed or progressed in the past ten years.  Do you expect the next ten years to be the same, or do you expect a new “state-of-the-art” treatment or “cure” without significant side effects for men under age 55?
12. My biopsy report states:  “ERG protein expression is Absent in tumor tissue.  ADT is likely to be less effective in ERG negative prostate cancer when compared to positive ones.  When indicated, ERG negative cancer responds better to taxane chemotherapy because resistance to taxanes may be twice as likely in ERG positive than in ERG negative prostate cancers.”  Does this mean that in the event of BCR, I would be treated with chemotherapy rather than ADT?  I have been unable to find much literature regarding ERG.  Thank you!
13. I switched to estradiol patches from trelstar eight months ago after talking to some other guys and reading the U.K. PATCH trial preliminary results. Big reduction in side effects and T and PSA are fine. Is this being discussed?
14. Is it possible someone diagnose with Gleason 6 and his PSA for two time 1.6 and 1.7?