← Return to Prostate Cancer (47 yrs old) - Guidance Request


Prostate Cancer (47 yrs old) - Guidance Request

Prostate Cancer | Last Active: Apr 21 9:10am | Replies (36)

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Just a few thoughts:

I would get a 2nd opinion on the pathology from Dr. Epstein at Johns Hopkins. He is the world's leading authority on pathology of prostate cancer. They do 2nd opinion reads frequently.

The needle biopsy samples only a very small portion of the prostate. There could be higher grade (I hope not) cancer that was not sampled.

I am sure your doctors will be following your PSA frequently. You may also consider yearly MRIs. No risk or downside with the exception of the cost.

At your age, I would opt for AS if your doctors believe this is an acceptable option. All treatment modalities have side effects and potential complications. With a Gleason 3+4=7 you will likely need definitive treatment at some time, but I would kick the can down the road as long as possible (provided your physicians believe this is a safe option).

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Replies to "Just a few thoughts: I would get a 2nd opinion on the pathology from Dr. Epstein..."

Just a caveat to my post. Obviously, this is a very personal decision. It's the classic risk vs reward scenario. What do you value the most. Longevity survival or quality of life? Clearly, most want both but to some it isn't 50:50 but 90:10. No one can predict your future or if your disease will spread if you opt for AS. It is a difficult decision. Some of us (me) had limited options when diagnosed with a high grade tumor (got to kill it now).

Good luck to you!

Note Dr. Epstein is no longer at JHU. He has left at this point but is not somewhere new that I have heard as of March 2024, but I suspect he is not completely retiring but we will see.