Gleason 6 (3+3) treatments

Posted by joe1 @joe1, May 21 3:39pm

Hi,
I had a biopsy and it came back with Gleason 6 (3+3). The urologist first told me it was extremely important that I have a biopsy done every 12 - 18 months to monitor this. 3 years later with no followups and now he's telling me we will just do MRI's instead (I also have ulcerative colitis so biopsy is extra painful). He also told me my cancer is nothing and don't worry about it. Problem is, he's told me a lot of things and then told me the exact opposite, so I'm not sure if I trust him.

Question for others with Gleason 6 ....... what type of treatment/monitoring are you being treated with?

Thanks

Joe

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clandeboye1 | @clandeboye1 | Aug 18 3:46pm

In reply to @milburnd "Here are some things I suggest based upon my own experience: 1) Request a decipher test..." + (show)

@milburnd

Here are some things I suggest based upon my own experience:

1) Request a decipher test on the tissue from your biopsy. This is a step beyond the Gleason score and helps determine how aggressive your cancer is.

2) Give thought to getting a second opinion from a Cancer Center of Excellence. Here's a link:
https://www.cancer.gov/research/infrastructure/cancer-centers/find
3) If your tumor(s) are contained within the prostate, focal treatment is something to look in to. These treatments use a variety of ways to ablate (kill) the tumor(s) without removal or radiation. Look up things like HIFU, cryotherapy, Irreversible Electroporation (IRE), and others.
https://www.medicalnewstoday.com/articles/focal-therapy-for-prostate-cancer
My PSA score that got the urologist's attention was 4.25. A follow-up MRI indicated two tumors (PI-RADS was a 4), both contained within the prostate. My biopsy showed a Gleason score of 3+4=7 (intermediate risk) and my decipher results indicated low risk, making me a candidate for active surveillance or focal therapy. I chose focal treatment because one of the tumors was abutting the edge of the prostate. I had the IRE treatment in January 2024. After the treatment, I had some relatively mild incontinence which has mostly cleared up. I also had some blood in my urine for about six weeks after the treatment, but that has totally cleared up. My sexual function is unchanged from before the treatment.

My PSA last week was down to 1.95. The follow up multiparametric MRI (mpMRI), also last week, showed “post ablation changes of the prostate with no new recurrent tumor in the treatment area and no new suspicious lesions in the prostate”. My doctor said that later, if there is an indication that cancer has returned, I can consider an addition IRE treatment, removal or radiation.

Focal treatment is definitely not for everyone, but with the proper set of circumstances, it would be an alternative worth considering.

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I totally agree . A 2nd or 3rd pathology opinion of your Biopsy results .
You treatment decision relies on it's accuracy .