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Newly Diagnosed: Removal vs Radiation
Prostate Cancer | Last Active: 3 days ago | Replies (62)Comment receiving replies
survivor 5280,
Sounds like you and I are in very similar place. After having a partial nephrectomy in July at Cleveland Clinic in Ohio, I had an MRI after having a slow but consistent rise in my PSA from 1 to 5 over seven years. With the MRI revealing a .6 cm PI-RADS 4 lesion, I then had a transperineal biopsy revealing four of nine positive cores (two at 5%, one at 15% and one at 35%) and all at Gleason score 3 = 3 =6 Grade Group 1. I then opted for the Decipher test given family history of aggressive prostate cancer and got the results last night showing a high risk at .78. Will be circling back with my surgical oncologist although I suspect he will recommend surgery given the high Decipher score. As you mentioned, I somewhat feel like I went from likely active surveillance to almost certain surgery or radiation in one day.
Am trying to remain positive, learning as much as I can about options; and although I have great confidence in my surgeon, I will at least consider consulting with a radiation oncologist for a second opinion and will push for PSMA and bone scans to rule out spreading.
Would greatly appreciate hearing more about your situation and from others who might have thoughts or comments.
All the best as your explore your options and select your treatment.
Replies to "survivor 5280, Sounds like you and I are in very similar place. After having a partial..."
I also explored if my kidney cancer was related and they said if it was then it would have shown up in the biopsy tests, so in my case it was totally unrelated.
After consulting with a number of doctors, there is literally not a single one that recommended anything other than a prostatectomy - but some of that was based on me being a bit younger than a lot of prostate cancer patients so your recommendations may vary.
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A number of doctors were trying to change Gleason six to non-cancer. Many doctors don’t feel it necessary to do anything with someone who has a Gleason six. Yes, your decipher score was high, but you could go on active surveillance for another year or more and avoid all the problems caused by treating prostate cancer. Checking your PSA every three months at the most could show when your PSA actually starts to rise noticeably. From one to 5/7 years is not really much of a rise at all. That’s a doubling time of more than one year.
Urologists are surgeons they make A lot of their money doing surgery.