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Gleason7(3+4) - treatment options recommendation
Got recently diagnosed with Gleason group 2, 7(3+4). Was in state of shock to know about the cancer.
I’m 56 year old and fortunately I’m with Mayo care since last decade.
Recommendation for me is to have prostatectomy as radiation therapy has long term implications. Took outside opinion also and same recommendation. But not sure how to deal post procedure with urge to urinate situation currently there.
Biggest thing is I’m hoping there is no recurrence occurring after this. Any suggestion/recommendation?
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Is there benefit doing PET scan? I’m getting conflicting views between UO and RO.
UO saying that there is no need on the basis of mri and biopsy that they feel strongly that my treatment with UO should be able to resolve
RO saying that PET can detect anything not covered in mri and biopsy even if there is no spread found beyond organ. Again kind of a situation where patient need to decide
The PSMA Pet has replace the MRI and bone scan because it can find more cancer in the body than the other two can. You also want to get a benchmark from which to evaluate future scans.
This is why you need to get a Genito urinary Oncologist on your team. Without the.PSMA Pet they really can’t tell for sure where metastasis are in your body. They can only guess based on those other two scans.
If your PSA is above.7 You should definitely ask for the scan, if you’re undetectable because you are on ADT then the scan may not be of any use.
How long after the LDR Btachytherapy did you discover it failed ?
It showed signs of failure 32 months after treatment and had clearly failed 36 months later when my PSA doubled in less than 6 months. My RO was out on medical leave and I couldn’t find another RO in the Chicago area that was familiar with LDR brachyherapy. I was finally diagnosed with stage four PCA with metastasis 42 months later at Barnes Jewish Hospital in St. Louis.
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Hug
1 ReactionYes. You want to know if the cancer is somewhere other than your prostate. Waiting for my PSMA test was the most anxious time after my diagnosis of Gleason 7 (4+3). Having the scan come back clean was a huge relief. I still have cancer, but likely contained to prostate!
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Hug
1 ReactionI also read this Brachytherapy Report .
In my case I am 85 years young , My 1st Biopsy 5 Cores " All Negative " My 2nd Biopsy ( very shortly thereafter , not happy with the negative following a PI-RADS 5 on my MRI ) this time 6 cores in the same target area plus 10 cores elsewhere , came back all six cores Gleason 3 + 3 = 6 in the target ares - all 10 negative outside . A 2nd opinion on the Gleason 6 came back ALL Gleason 3 + 4 = 7 in the target area . . A 3rd opinion on my 2nd biopsy came back as some 4 , but not in all cores .
GO FIGURE - IN THE EYES OF THE BEHOLDER ., as they say .
I am currently on active surveillance . My Urologist followup is at the end of October . I have already consulted with a Radiation Oncologist .
I am considering ( at my age ) Monotherapy - 5 Treatment SBRT .
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Hug
1 ReactionI think your decision is sound based on your age and biopsy results. SBRT is probably your best bet, avoiding many of the complications with other forms of therapy. Best of luck!
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1 ReactionMy brother at 76 had five treatments of SBRT, he was a 4+3. It was an active surveillance for over five years. Seems to have knocked it out pretty completely. Had 6 months of ADT after radiation.
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Hug
1 ReactionI prefer to avoid ADT at all costs , if possible .
I may consider NanoKnife .
I prefer to avoid the ADT at all costs , if possible .
I have a 70 year old associate who had the 5 dose Mon-Wed-Fri and Mon-Wed SBRT treatment of SBRT , to date he is very satisfied .
p.s. Was he a 4+3 when on active surveillance or did it develop from a lower Gleason score over the 5 years .