Biopsy confirms prostate cancer in 12 out of 12 cores

The Gleason score of 10 after surgery means your cancer is very aggressive. Did they ever mention you had intraductal or cribriform? Those make it much more aggressive and pretty much guarantee metastasis will form with a Gleason 9 or 10.

Instead of Dr. Kwon guiding your treatment (he is a urologist not a GU Oncologist) you could go to Mayo and get help from their oncologists or get an appointment with Doctor Scholz in Marina Del Ray California, you can listen to some of his speeches on YouTube, he’s pretty knowledgeable to put it mildly.

You really do need some expert advice on treatment with a Gleason 10. I would recommend you connect up with Ancan.org. They have 2 hour online meetings every week for advanced prostate cancer patients. They send out a newsletter every week that has incredibly helpful information in it about new and existing treatments. They’ve had a number of people that have gone to Doctor Kwon and have not had the best treatments, even though Doctor Kwon gives some great speeches at the PCRI conferences. They can fill you in on the issues people have had with him. They’ve been working with cancer patients for 15 years and really know what’s going on. New people are given first priority and can usually find very up-to-date. New information on what to do with their treatment.

First of all, sorry to hear about your diagnosis. I felt numb when I got my biopsy results 3 years ago that I had a G8 prostate cancer.

I know you have not yet had your diagnostic tests to determine if the cancer is confined to the prostate, if there is direct contiguous spread, local (pelvic nodes) spread or more distant metastatic disease.

If your disease is confined to your prostate or a few pelvic nodes, it is treatable with a possibility of cure.

If you have oligo metastatic disease (distal spread to about 3 or fewer sited -bone or lymph nodes) there is also hope for long term remission or even cure (according to some reputable medical oncologists). Some cutting edge medical oncologists at Centers of Excellence are treating newly diagnosed oligo metastatic disease very aggressively . RP or radiation to primary (prostate), MDT ( radiation to the few distal metastases), and triple therapy consisting of ADT (Lupron or equivalent), chemotherapy with Docetaxel and androgen receptor blockade drug like Darolutamide. The very aggressive initial therapy is aimed at removing the primary tumor, killing the known few mets with radiation and treating the micro disease with the triple therapy. At some centers this approach has shown to kill the aggressive clones and if the cancer returns it is a more manageable, indolent variety.

Good luck in your journey.

Here’s my score card13/13 cores cancer Gleason 9/10 on Feb 2, 2022, with 2 pelvic lymph node involvement. Here I am today PSA < .01 taking ADT drugs. Gonna stop the ADT in Jan 2025 to see what happens to my PSA. Had 28 radiation treatments too. Side effects- fatigue. Age 76 now. Not dead yet. Hope this helps your mind. Lol

Not good news. But, as you mentioned, at least you know and the issue has been addressed. Now comes the treatment options.

I was diagnosed in 2010 with PC with Gleason 3+3; PSA" 6.47. Because I was in the military and prior to deployments a modest physical and blood work is normally done. As such, I was able to see my PSA "jump" several points in one year. Like you, a biopsy..not one but two to validate.

I went to Loma Linda for proton radiation therapy for 2.5 months. I can recall the doctor at Loma Linda saying to me the cancer was in one small location hence directed proton radiation would be the best option. He indicated many men come to Loma Linda, but because their cancer is more spread out, directed proton radiation cannot be an option. Proton radiation was initially designed for children with brain tumors.

This is just a matter of information/opinion from one who went through all the mental challenges of understanding the disease which effects one out seven men in the US. Good luck..RH/Florida

@jeffmarc, please be careful about telling members what they should do as per the community guidelines https://connect.mayoclinic.org/blog/about-connect/tab/community-guidelines/ Sharing your own experience is fine, but don't tell other members what they should do.

You're right that Dr. Eugene Kwon is a urologist specializing in prostate cancer https://www.mayoclinic.org/biographies/kwon-eugene-d-m-d/bio-20054440

Being a member of Mayo Clinic Comprehensive Cancer Center means Dr. Kwon and colleagues work together with their prostate patients to make treatment choices based on medical evidence and patient preferences. Mayo Clinic urologists, oncologists, radiation oncologists, pathologists and radiologists rely on strong collaboration and multidisciplinary discussion to provide comprehensive care to each person seen with prostate cancer. Read more about Care at Mayo Clinic here: https://www.mayoclinic.org/diseases-conditions/prostate-cancer/care-at-mayo-clinic/mac-20353097

Jeff,
Could you post a link to the UCSF webinar you mention above? Did they say that interductal carcinoma is indicative of large cribriform?
Thanks,
Hiker

They said intraductal , almost always meant there was Cribriform. They did not say it was necessarily large Cribriform.

They just released it in the last few days. Here is the link.
https://www.urotoday.com/video-lectures/a-journal-club-for-patients-with-prostate-cancer/video/mediaitem/4452-unfavorable-histology-classification-aims-to-reduce-unnecessary-treatment-journal-club-jesse-mckenney-cornelia-ding.html