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Gleason7(3+4) - treatment options recommendation
Prostate Cancer | Last Active: Oct 7 1:02pm | Replies (237)Comment receiving replies
Surprising your doctor removed so much since you didn’t have seminal vesicle invasion.
You are a Gleason 9 and after radiation NCCN standards call for 24 months of ADT. I recently worked with two guys who didn’t have ADT and both of them had metastasis within a year and a half. One of them had a quite serious tumor on his femur and he was only a Gleason 7. ADT is really important to prevent recurrence.
Do you have a Genito Urinary Oncologist? With Gleason nine that is important. You need to be treated correctly to prevent reoccurrence. What type of doctor are you working with? It doesn’t sound like they are following the standards and that doesn’t protect you.
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Just went back to the pathology report. I am a T3B. But the only Gleason score I can see on it is a 7. Here is the summary:
Synoptic Report
:
Specimen
Procedure: Radical prostatectomy
Tumor
Histologic Type: Acinar adenocarcinoma, conventional (usual)
Histologic Grade
Histologic Grade
Gleason Pattern: Gleason Pattern
Primary Gleason Pattern: Pattern 3: 50 %
Secondary Gleason Pattern: Pattern 4: 30 %
Tertiary Gleason Pattern: Pattern 5: 20 %
Grade: Grade group 2 (Gleason Score 3 + 4 = 7)
Intraductal Carcinoma (IDC): Not identified
Cribriform Glands: Present
Treatment Effect: No known presurgical therapy
Tumor Quantitation
Estimated Percentage of Prostate Involved by Tumor: 41 - 50%
Extraprostatic Extension (EPE): Present, nonfocal
Location of Extraprostatic Extension: Left posterior
Urinary Bladder Neck Invasion: Not identified
Seminal Vesicle Invasion: Present, bilateral
Lymphatic and / or Vascular Invasion: Present
Perineural Invasion: Present
Margins
Margin Status: Invasive carcinoma present at margin
L
inear Length of Margin(s) Involved by Carcinoma: Less than 3 mm (limited)
Focality of Margin Involvement: Unifocal
Margin(s) Involved by Invasive Carcinoma: Left seminal vesicle surgical
margin.
Margin Involvement by Invasive Carcinoma in Area of Extraprostatic
Extension (EPE): Not identified
Gleason Pattern at Margin(s) Involved by Carcinoma: Pattern 3
Regional Lymph Nodes
Regional Lymph Node Status: Tumor present in regional lymph node(s)
Number of Lymph Nodes with Tumor: 1
Number of Lymph Nodes Examined: 13
pTNM Classification (AJCC 8th Edition)
pT Category: pT3b
pN Category: pN1
Best Tumor Blocks for Future Studies
Tumor Block(s): F14
Normal Block(s): N/A