1. < Prostate Cancer

Gleason7(3+4) - treatment options recommendation

Posted by manojsmishra @manojsmishra, Aug 25 3:42pm

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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jeffmarc | @jeffmarc | Oct 6 4:58pm
In reply to @clandeboye1 "I prefer to avoid the ADT at all costs , if possible . I have a..." + (show)
@clandeboye1

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 .

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It was a 3+3 on active surveillance.

At your age, you could probably avoid ADT because you are only a 3+4. Usually, they want to put you on six months of ADT to prevent the cancer from coming back soon, but that is up to your doctor.

Where are you going for treatment? If it is a Mayo clinic then you are getting the best advice. A urologist does surgery so they want to do surgery? You could consult with an oncologist to see what they feel your best options are. If you do that, you want A Genito Urinary Oncologist, since they specialize in prostate cancer, unlike a medical oncologist.

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jeffmarc | @jeffmarc | Oct 6 6:46pm
In reply to @clandeboye1 "I also read this Brachytherapy Report . In my case I am 85 years young ,..." + (show)
@clandeboye1

I 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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Be aware that at your age surgery should be totally out of the question. I would really question any urologist that would recommend that.

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1 reply
heavyphil | @heavyphil | Oct 7 5:06am
In reply to @clandeboye1 "I prefer to avoid the ADT at all costs , if possible . I have a..." + (show)
@clandeboye1

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 .

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If your Decipher score is low you do NOT need ADT - my 73 yr old friend just had SBRT with NO ADT at Sloan.

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1 reply
clandeboye1 | @clandeboye1 | Oct 7 12:56pm

I have consulted with a Radiation Oncologist , at my request , to investigate Monotherapy HDR Brachytherapy - 2 Treatments 2 weeks apart , plus Monotherapy SBRT 5 treatments . I have also consulted on the NanoKnife procedure which is used worldwide . ( to a lesser extent in the USA . ) I am working with two Centers of Excellence in Toronto - The Princess Margaret Hospital ranked as 5th in the world regarding Research & Treatment and Sunnybrook Hospital , also a world leader in cancer research & treatment .
I am proactive with regards to events in my life , and more so with regards to my health . I lived for 22 yyears in the USA and am well aquainted with their centers of excellence .
I am also a big fan of Dr. Patrick Walsh's book : " Guide to Surviving Prostate Cancer " .
Additionally , I have consulted , via telephone with world leaders in the treatment of prostate cancer , in the USA , Australia, U.K. Germany and Canada . As an engineer , I am a gluten for learning .
Thanks for your sage responses .

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clandeboye1 | @clandeboye1 | Oct 7 12:59pm
In reply to @jeffmarc "Be aware that at your age surgery should be totally out of the question. I would..." + (show)
@jeffmarc

Be aware that at your age surgery should be totally out of the question. I would really question any urologist that would recommend that.

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Thanks - I fully understand the situation and agree 100 % with your comment .

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clandeboye1 | @clandeboye1 | Oct 7 1:00pm
In reply to @heavyphil "If your Decipher score is low you do NOT need ADT - my 73 yr old..." + (show)
@heavyphil

If your Decipher score is low you do NOT need ADT - my 73 yr old friend just had SBRT with NO ADT at Sloan.

Jump to this post

Thanks for your sage advice .

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jeffmarc | @jeffmarc | Oct 7 1:02pm

Sounds like you really have it under control. Some of the best options I’ve seen for people in Canada. Wish you the best in treatment results.

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