Am I Under-Reacting to my Prostate Cancer Proposed Treatment?

Posted by missetype @missetype, Jun 25 4:04pm

I just had a post-Fusion Biopsy follow-up with my Urologist. I have two lesions of interest. The first lesion is rated a Gleason 3+3=6. The second lesion is rated 4+3=7 with Cribriform Pattern 4 present. I also have a enlarged Prostate. My last PSA was 9.2. The doctor pushed that I should take immediate action and wanted to consult with the robotic Prostatectomy surgeon and a Radiation Oncologist. He also mentioned Hormone therapy. He said I was not a candidate for Focus therapy, Brachytherapy, or Cryotherapy. This is a life changing decision. Is my Urologist's push for immediate action warranted or do I have time to explore other options/opinions?

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pieperfarm | @pieperfarm | Jul 11 6:40am

In reply to @kenpelan "if cancer is in you, get it out." + (show)

Most research shows removing Gleason 6 or active surveillance results in similar life expectancy. Real question is would you be more comfortable without prostate, and deal with continence and erection issues later in life or with active surveillance and have to deal with more MRIs, and biopsies, and more focal ablation procedures. The good news is most get to pick their journey! Best of luck on either choice!

Climber | @stevemaggart | Jul 11 8:00am

You have two tumors, one is a 4+3=7 and that is more significant than you gleason 6. You also have cribriform. If you read about cribriform, you will find it is an independent indicator of aggressive cancer with poor clinical outcomes and mortality. I had similar numbers to you except I was gleason 8. Two urologist from mayo moved me to the top of the list for imaging & surgery. I had surgery 2 weeks ago and my cancer was upgraded to gleason 9 with an extraprostatic extension and ductal adenocarcinoma. It was very serious. My advise is to find good doctors and listen to them.

spryguy | @spryguy | Jul 12 8:41am

My diagnosis (at 75 yrs) is (was?) similar in Jan 2022. I started Lupron in March 22.
Started IMRT in May 22 with 39 consecutivw sessions ending July 22.
July 22 went to Mayo and was told it was aggressive high risk. I was prescribed Abiraterone w prednisone and Lupron for 24 months. At 23 months now and glad to be almost done. The prospects are good. I am expecting 5 to 10 years of low PSA (below 0.2 ng/ml) . At some point the PSA will tick up and treatment will start again. In the meantime I am all about "seizing the day". It is tough at the start but it gets better. GOOD LUCK to all of us.