44yr PSA180 Gleason9 non-metastatic. Surgery or Treatment?
I am 44 yr old, Navy Veteran, just got diagnosed with prostate cancer. First rectal exam showed enlarged prostate, followed by PSA180. Biopsy showed 9 out of the 12 samples with cancer cells (most of them Gleason8 or 9). MRT shows no spread. CT with contrast shows no spread. I just got today my bone scintigraphy. Initial results show no spread. Father had prostate cancer last year, therapy, seems to be cured. Mother has breast cancer and stomach cancer (surgery and treatment) now cured.
My big question now: should i go for complete prostate removal or should i go with the various other treatments?
I am currently being seen for this at the University Clinic of Heidelberg in Germany.
Appreciate all the support and stay positive.
Interested in more discussions like this? Go to the Prostate Cancer Support Group.
If they’re gonna take that long to do the somatic test, And your doctor doesn’t agree to speed it up, You could get the hereditary test first maybe even sooner. It takes 2 to 3 weeks to get the results from the hereditary test so at this point, your results are a couple of months out probably.
The somatic test usually takes a long time to get results as well.
Good luck
Hey, Shipmate! Retired Navy corpsman here. I am also new to the group, but I can already tell you that this group of guys (and some women, too) is amazing! There is so much collective knowledge being shared that my understanding is growing by leaps and bounds, while feeling authentically supported. I want to share a video I watched last night by Dr. Michael Ahdoot. He makes a very sound, research-based case for taking action, as it seems you are doing with Heidelberg University. Good luck, stay very positive and active! Steve https://www.youtube.com/watch?v=CvnFDkTx6Ic
Thanks Steve! I have been overwhelmed by the support of this group from the beginning! If you have not look at the ancan.org, i recommend doing that as well. I have attended couple of their live support video group session and I was mind-blown by the kindness and dedication of the people there as well. There they even have a group specific for veterans addressing VA disability claims related to cancer. I am positive and the more I learn and talk to people familiar with PCa the more confident I am in a positive outcome. Thanks and stay in touch!
Thanks for the recommendation to check out ancan.org -- I just spent some time at the site, and it has great information and ways to connect with others experiencing cancer -- various types of cancer. Be well!
Hi everyone,
quick update on my situation. Just got my PSMA PET CT scan results today. It looks like it is contained to the prostate and two lymph nodes.
Here is the official summary:
• Local Finding: Large lesion in prostate involving seminal vesicles: 36.4 (Score 5)
• Lymph Nodes:
Right iliac: 5.9 (Score 4)
Left iliac: 114.8 (Score 5), 79.8 (Score 4)
• Other: Prominent lymph node at right lung hilum, likely nonspecific: 4.5 (Score 2)
Maximum PSMA Expression Score: 3
Thoughts?
I’ve also been recently diagnosed with prostate cancer Glisan nine all scans are clear. I don’t really know what option to choose everything I seem to read says the new thinking is hit withwith radiation and ADT upfront due to the fact the chances are very good of microscopic spread radiation might be the first and best option for cure. Otherwise you’re looking for surgery radiation and ADD all down the road. Does anybody have any advice? I’m very confused.
I’m glad you were finally able to get these results. The fact that it has gotten to your lymph nodes means that it’s in your bloodstream and could show up anywhere if you don’t take the right drugs. You should probably be on an ADT right away. Because your cancer has already spread to lymph nodes You want to be on ADT and probably an ARS I like Zytiga or Nubeqa. Speak to your doctor and find out what their recommendations are. They’re going to be different than they originally were because you didn’t think it had spread outside the prostate originally.
Due to the spread, they usually do not do surgery. They do radiation to treat the lymph nodes and your prostate and the prostate bed. They could take out the prostate and the lymph nodes if they’re easy to get to, but that would not be a normal procedure when there’s already spread.
Having spread to the seminal vesicles, it can be more aggressive as well, Even though you already have a Gleason nine That does increase the chance of reoccurrence.
I’m glad you have all this information already and can work with the doctors to get the best treatment so that you have the best chance of a long-term survival
As you probably know, Gleason nine is quite aggressive. I do know at least one person who had surgery with a Gleason nine and his cancer didn’t come back for 30 years. I know other people That were able to go 20 years without recurrence.
Yes, ADT and radiation can work, but it depends on the other things found in your biopsy. Were any of these found extra capillary extensions< intraductal, Cribriform, seminal vesicle invasion or EPE?
They can mean it is even more aggressive and that surgery plus radiation might be your best choice. Either that or IMRT followed by brachytherapy. This is something your doctor will decide, along with you.
Did you have a PSMA PET scan? That really is required in order to find out if you have had spread to anywhere else. What was your PSA when you had the scan?
Hi Steven,
In addition to the information Jeff suggested you provide it would be helpful to know your age and any underlying health issues so both can be factored into the perspectives you receive here.
Bill