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Was Gleason 7 (3+4): How soon can one get off ADT (Orgovyx or Lupron)?
Prostate Cancer | Last Active: 1 day ago | Replies (8)Comment receiving replies
with a Gleason seven the NCCN recommends six months for ADT. Now that’s a guideline not a hard rule. When you had your biopsy was there cribriform or intraductal mentioned, That makes your cancer more aggressive, and SBRT radiation is not sufficient and 6 months would be low. There are a couple of other things that would mean that your Gleason seven could be more aggressive than other people’s seven. if there was nothing found in your biopsy, that was questionable, then as long as you are undetectable for five or six months it. could be enough.
Did you have a Decipher test done? That could give you an idea of the chance recurrence soon.
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Hi Jeff,
I figure you have listened to/joined many webinars, and hopefully you have enough information to be able to comment on the two tests I had after my biopsy, before my SBRT.
Please see below. (I haven't fully digested what they mean.)
Certainly, you know a whole lot more than I do, as you had been on this journey quite long. Many thanks for your help, and your many past comments in this support group that I found very helpful! -- Vir
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Nuclear Medicine BONE WHOLE BODY + SPECT + CT X2 PANEL
Collected on 21 Feb 2025 11:19 AM
Results
Impression
No scintigraphic evidence of osseous metastatic disease.
Narrative
CLINICAL HISTORY: Rule out metastatic disease from prostate cancer.
FINDINGS:
Delayed whole body planar imaging and SPECT-CT imaging of the chest, abdomen and
pelvis was performed.
There is no suspicious radiotracer uptake identified in the axial and
appendicular skeleton.
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CT ABDOMEN/PELVIS W C Collected on 02 Mar 2025 11:35 AM
Results
CT ABDOMEN AND PELVIS:
CLINICAL HISTORY: Prostate cancer. Rule out metastatic disease.
TECHNIQUE: CT images of the abdomen and pelvis following IV contrast.
FINDINGS:
There are scattered small hypodense nodules in the liver measuring up to 5 mm on
image 29 series 201 in segment 4. These are nonspecific.
Gallbladder and bile ducts are unremarkable. Pancreas is unremarkable. Spleen is
normal. Adrenals are normal. Kidneys are unremarkable.
Prostate gland is moderately enlarged and nodular. Bladder is moderately
thick-walled. Pelvic organs are otherwise grossly normal.
No dilated loops of bowel are seen.
There is no significant lymphadenopathy in the abdomen, pelvis, or
retroperitoneum.
No aggressive bony lesions are seen.
SUMMARY:
Enlarged nodular prostate. Moderately thick-walled bladder.TISSUE EXAM
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BIOPSY -- Collected on 24 Jan 2025 2:57 PM
Results
FINAL DIAGNOSIS
View trends
A. Prostate, Needle Biopsy Apex Left:
- Prostatic acinar adenocarcinoma, Gleason score 7 (3+4)
- 2 out of 2 cores are positive for malignancy
- Carcinoma involves 30 and 90% of the affected cores respectively
B. Prostate, Needle Biopsy Base Left:
- Prostatic acinar adenocarcinoma, Gleason score 7 (3+4)
- 3 out of 3 cores are positive for malignancy
- Carcinoma involves 80% of each of the cores respectively
C. Prostate, Needle Biopsy Apex Right:
- Negative for malignancy 0/2
D. Prostate, Needle Biopsy Base Right:
- Negative for malignancy 0/2
E. Prostate, Needle Biopsy Mid Left:
- Prostatic acinar adenocarcinoma, Gleason score 7 (3+4)
- 3 out of 3 cores are positive for malignancy
- Carcinoma involves 80%, 70% and 60% of each of the cores respectively
F. Prostate, Needle Biopsy Mid Right:
- Negative for malignancy 0/2
SYNOPTIC REPORT
TUMOR
Histologic Type: Adenocarcinoma (acinar, not otherwise specified)
Histologic Grade:
Gleason Pattern: Gleason pattern (specifiy)
Primary (Predominant) Pattern: Grade 3
Secondary (Worst Remaining) Pattern: Grade 4
Total Gleason Score: 7
EXTENT
Tumor Quantitation:
Number of Cores Positive: 8
Total Number of Cores: 14
Tumor Quantitation: Proportion (%) of prostatic tissue involved by tumor: 40
ACCESSORY FINDINGS
Lymph-Vascular Invasion: Not identified
Perineural Invasion: Not identified
Your value is PROSTATE GLAND: Needle Biopsy PROSTATE GLAND: NEEDLE BIOPSY -
All Specimens Procedure: Needle Biopsy
TUMOR Histologic Type: Adenocarcinoma (acinar, not otherwise specified) Histologic Grade: Gleason Pattern: Gleason pattern (specifiy) Primary (Predominant) Pattern: Grade 3 Secondary (Worst Remaining) Pattern: Grade 4 Total Gleason Score: 7 EXTENT Tumor Quantitation: Number of Cores Positive: 8 Total Number of Cores: 14 Tumor Quantitation: Proportion (%) of prostatic tissue involved by tumor: 40 ACCESSORY FINDINGS Lymph-Vascular Invasion: Not identified Perineural Invasion: Not identified
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