u/Fit_Tomatillo6977

Title: Gleason 4+3, Decipher 0.74 – Refusing "The Poisons" (ADT) and Surgery. Advice?

Title: Gleason 4+3, Decipher 0.74 – Refusing "The Poisons" (ADT) and Surgery. Advice?

Post Body:
I’m looking for some real talk from guys who have been in my shoes. I was recently diagnosed with Gleason 4+3 and just got a Decipher score of 0.74 (High Risk). On the bright side, my PSMA PET scan came back clean.

I also have CKD 3b (kidney disease) and AFib.

I’ve made a firm decision: I am NOT doing surgery and I am NOT doing ADT (hormone therapy). I’m not interested in the "poisons" or the side effects. I also want to avoid gold seeds (fiducials) and SpaceOAR gel if possible.

I’m seeing a specialist (Dr. Nguyen) on the 28th and I’m leaning toward MRI-guided SBRT (MRI-LINAC) or CyberKnife as a "radiation only" approach.

  • Has anyone here done SBRT/CyberKnife for a 4+3 without taking ADT?
  • If you have CKD or heart issues, how did the radiation affect you?
  • With a clean PSMA but a high Decipher, did anyone else decide to go "local treatment only"?

I’m trying to prioritize my quality of life and "good years" over everything else. Thanks for any insight.

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u/Fit_Tomatillo6977 — 1 day ago