1. < Prostate Cancer

Conflicted/Confused, any Guidance/Advice out there?

Posted by batsam10 @batsam10, Mar 10 1:03pm

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.

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

paulcalif | @paulcalif | Mar 18 10:02am
In reply to @batsam10 "Thanks for the post. I just had my appointment with a center of excellence and the..." + (show)
@batsam10

Thanks for the post. I just had my appointment with a center of excellence and the Dr. who does the ablation with TULSA Pro said in his words that I would be an OK candidate not a good one. There was only one area he would be able to treat and said other areas of cancer would be left behind. We had along discussion and he said honestly that I am better off with removal or radiation.

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Good to know. I hope I'm a good candidate for Tulsa but won't know until I have my consultation.

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1 reply
batsam10 | @batsam10 | Mar 18 5:25pm
In reply to @paulcalif "Good to know. I hope I'm a good candidate for Tulsa but won't know until I..." + (show)
@paulcalif

Good to know. I hope I'm a good candidate for Tulsa but won't know until I have my consultation.

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I wish you the best of luck. Take care!

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hbp | @hbp | Mar 18 9:34pm

RP is not just for younger guys. At 74, G9, CR , aggressive and advanced, my UCLA doctors recommended 6 months ADT and Erleada, then Robo surgery, then 6 more months of the same drugs. I started this 30 months ago and my PSA remains at .01. I am hoping for the best, however, I think my UCLA doctors gave me good advise and good service for a difficult PC case

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batsam10 | @batsam10 | Mar 19 8:45am

This is interesting. So you did ADT before RP? I might ask about this at my next appointment. I don’t want to role the dice but could use a little time deciding. I feel incredibly pressured to make a choice. As I mentioned in one of my other posts, I should have been doing my research earlier. I want to feel like I’m making the right choice. Thanks for sharing your story. Everyone in this group has been most helpful. Best of luck to you.

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1 reply
michaelcharles | @michaelcharles | Mar 19 9:33am
In reply to @batsam10 "Agreed, my comment was only from most of the guys I have spoken with and the..." + (show)
@batsam10

Agreed, my comment was only from most of the guys I have spoken with and the great guys in this group seem to be on the younger scale for RP. I am also learning it depends on many variables for each individual case regardless of age. I ‘m still having difficulty choosing a treatment but have a better understanding of the various therapies now. I wish you the very best of luck with everything.

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72 @ RP 2022
I had excellent surgical experience and postop recovery. Would elect surgery again.
However, others have done well with radiation.
Information is that outcomes are similar.
Best of luck to you with your challenging decisions.

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hbp | @hbp | Mar 19 10:13am
In reply to @batsam10 "This is interesting. So you did ADT before RP? I might ask about this at my..." + (show)
@batsam10

This is interesting. So you did ADT before RP? I might ask about this at my next appointment. I don’t want to role the dice but could use a little time deciding. I feel incredibly pressured to make a choice. As I mentioned in one of my other posts, I should have been doing my research earlier. I want to feel like I’m making the right choice. Thanks for sharing your story. Everyone in this group has been most helpful. Best of luck to you.

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Batsam 10, My treatment was part of an Erleada clinical trial for high risk cancers and meds before RP was not then SOC. My surgeon recommended the clinical trial for me because the meds before surgery made the tumors smaller and gave the surgery a better chance of success

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1 reply
batsam10 | @batsam10 | Mar 19 1:54pm
In reply to @hbp "Batsam 10, My treatment was part of an Erleada clinical trial for high risk cancers and..." + (show)
@hbp

Batsam 10, My treatment was part of an Erleada clinical trial for high risk cancers and meds before RP was not then SOC. My surgeon recommended the clinical trial for me because the meds before surgery made the tumors smaller and gave the surgery a better chance of success

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OK, understood and wishing you the very best outcome. Take care.

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jsh327 | @jsh327 | Mar 20 7:37am

I recommend reading the PCF.org and PCRI.org information on exactly this situation and also get an opinion from a radiological oncologist that specializes in prostate cancer. You still have time to make the right decision for you and those resources provide an unbiased summary of risks and benefits of both treatment options. Also consider a scan to check for the spread of cancer outside of your prostate, as this may affect your decision or surgery versus radiation. There are also two books that help to guide you through this decision (Dr Patrick Walsh and another by Dr. Mark Schultz).

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batsam10 | @batsam10 | Mar 20 11:17am

I have been watching the pcri videos which are great. I like Dr Schultz and wished he was in my area. I have reached out to their help line. I’ve asked about a scan and all of the urologists I have seen say they don’t do scans for Gleeson 7 which I’m not happy about. It would help on making a decision. It could be an insurance issue that they are aware of. Thank you for posting and sharing your information.

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1 reply
hbp | @hbp | Mar 20 12:25pm

It is probably an insurance issue. Before my clinical trial started they directed me to do a PET scan and when I went in for it, the attendant told me that it was not covered by insurance and it would cost $3,000. I paid that and afterwards successfully argued with medicare and blue cross. Good luck to you, this cancer stuff is more than irritating

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