Conflicted/Confused, any Guidance/Advice out there?
I will be 61 at the end of this month. MRI on August 2022 revealed an area of suspicion measuring 2.2 cm x 1.4 cm within the left transitional zone mid gland base. Impression from Biopsy September 2022 showed 2.2 cm PI-RADS 5 lesion within the left transitional zone mid gland/base with probable extraprotastic extension. 18 cors pulled 3 were cancerous. Gleason score was given 3+3 but my second opinion stated 3+4. Was told low risk and AS is OK.
Second biopsy Jan 2024 for samples revealed 3+3 and 3+4 Gleeson scores. The report came back with 55 mL gland. Redemonstration of PI-RADS 5 lesion in the left anterior transitional zone with probable ECE. My last PSA in Aug. 2023 was 5.7. I was then told I’m no longer low risk but low intermediate unfavorable. I don’t believe there was any big differences that I can understand for the status change. I was scheduled for external beam radiation this week but chickened out after reading the side effects, especially with a bad baseline for bowel symptoms.
If anyone can make some sense of all of this and provide opinions, I would greatly appreciate it. I am trying to make a decision on what treatment to go with. I’m in the Boston area and we have great Hospitals and Doctors but that doesn’t make the decision any easier.
Thanks and best of luck to everyone.
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per my medical oncologist....a PET cant see cancer if the PSA is less than 2.0. sorry about that big waste of money guy. I m on ADT now with less than 0.01 PSA..
Batsam10, why the "unfavorable" label with only 3+4 and PSA< 10? Were the number of positive cores >50% or did I miss something?
did you mean 2.0 or .20? The latter is where they recommend PSMA scan. If it's 2.0 that's not very good in terms of catching it early enough, right?
Not qualified to respond to your question. It’s a good one. He did say that cancer cells on the head of a pin, can t be detected by a PET scan. Not sure of the difference between the two scans. Gotta try to find that out.
Look up SPACE O- it protects the bowel. My bowel is fine with 13 biopsy’s. Gleason scores 9-10. Had nuggets put in my prostate at the same Tim’s for RT shooting accuracy. Hope that helps. Bruce
Thanks for sharing your story, experience, and research. If I’m understanding correctly, you’re choosing to do the ablation therapy. I have looked into that myself and agree that there is not a lot of history, data, or outcomes. I just meet with a Doctor in my area who does the ablation therapy and said I was an OK candidate, not a great one.
He was incredibly honest and said he could only treat one area. He said that there would still be cancer in my prostate and thought it would be wise to stick with surgery or radiation. The sad part I’m hearing within this support group is insurance coverage. It’s bad enough we have do deal with the disease and choices, but get tagged with an enormous bill.
I wish you the very best of luck with whichever treatment you get.
Apparently my misunderstanding. My wife and I were on a telemedicine call and I thought I heard the Dr. say unfavorable. She thought she heard the same. Just saw a different Dr. Thursday March 14th in person who said he didn’t believe I was unfavorable. He did concur with the other Dr. about getting treatment.
Thanks for pointing this out. If I hadn’t seen this Dr. on Thursday, your question would have prompted me to reach back out to the other Dr. for clarification. I’m still tying to understand all of this.
Thanks for the tip. I did hear of the gel that helps spare your bowel. After doing some research and communicating with this incredible group of guys, I did ask the Dr. about the gel, the type of radiation, and the equipment used to deliver the radiation. I never heard back from him but did hear from him right away when I cancelled my radiation sessions. I’m not insinuating anything here but it does make me wonder if folks are being pushed into services.
Over the past 7 years, I’ve had two MRI’s(both negative); and two biopsies(the first negative and the second this past August showed two cores out of 12 with cancer at 3+4=7). I chose RP because was told by two surgeons that if radiation didn’t work, removal is very difficult to perform. Everything went well, including NO incontinence issues at all. (P.S. do your Kegel exercises!). However, and the main point I want to make, is my pathology report indicated my cancer was 4+5=9 and was very close to the capsule. I would suggest getting any additional testing you can to determine the level of cancer and then figure out the treatment options. Best of luck! 🤞🙏
Thanks for posting. Even with all of the support of this great group, It’s still hard choice to make. I’ll be seeing a Rad Onc and Med Onc in two weeks. After that I will need to decide on treatment. Seems like generally the younger group of guys are going for RP. It’s been a nightmare in my head.