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What do you do when one lymph node on PSMA is inconclusive ?
Prostate Cancer | Last Active: Sep 28, 2025 | Replies (45)Comment receiving replies
Thank you for your insight. Much appreciated. I’m 76. Diagnosed at age 70 with Gleason 6. Was on active follow up until September 2024 when path came back Gleason 9. WTF! All my care is at an NCCN/NCI designated cancer center in Ohio. Doing well on Orgovyx and starting 28 IMRT sessions soon. I’m not concerned at all about radiation to prostate but freaking out about para-aortic treatment. I wonder how many other men are out there diagnosed with Gleason 6 but harboring something much more aggressive.
Replies to "Thank you for your insight. Much appreciated. I’m 76. Diagnosed at age 70 with Gleason 6...."
Just came across this old message trail and wanted to share, too, that I was Gleason 3+3, 3+4 when I was diagnosed in 10/2021 (at age 69 - turned 70 12/2021) with low Oncotype score and recommended AS. This year on routine follow up my PSA jumped from 8.7 to 15 and although MRI was unchanged from previous, a repeat biopsy confirmed Gleason 4+5, 4+4 and PSMA PET CT confirmed bilateral disease in the prostate and an equivocal external iliac lymph node (not enlarged on imaging) with low-grade tracer uptake. Just started SBRT and ADT (will be 74 in 3 months).
Hope your treatments have been going well …
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Same here - 2019 gleason 6 in only 2 cores of 12, genetic test (one of the first available at that time ) showed "low " risk , like in 30 years low "prediction". Six years later - IDC-P with cribriform : (. That is why biopsy should be done every 2-3 years once gleason of any kind is discovered.
I think that it is unconscionable to tell patients that 3+3 means "nothing" and that it is not even cancer ! IT IS CANCER and should be alarming in a sense that "ultra active surveillance" should be initiated at that point no matter what MRI shows or what PSA level is .
What is the point of "active surveillance" if it does not find out cancer in 3+4 stage and localized ???? Now that PSMA /CT is available it should be part of active surveillance every 2 years .