1. < Prostate Cancer
Profile picture for frank1956

Received the news on Halloween. I have prostate cancer. Need advice.

Posted by frank1956 @frank1956, Nov 1 7:26pm

I previously had 2 benign biopsies in 2024. Urologist/Oncologist asked to follow up in a year. So on September 2025, I did PSA (5.4) and MRI (2 legions PI-RADS3, and PI-RADS4). These 2 legions are similar in size with the previous 2 MRI's from 2024.
Doctor ordered a biopsy. On Halloween day, the report came and it shows out of 18 cores, there are 2 Gleason 6, and 1 Gleason 7 (3+4), which is with 40% core, and G4 is 10%.
I am scheduled to see my Urologist/Oncologist on Wednesday. I will ask for a Decipher or Polaris test and a PSMA scan. Maybe a genetic test to check BRCA1, BRCA2 genes?
I am not sure what else to ask from the doctor. Any advice will be greatly appreciated.

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

Profile picture for crusader76
crusader76 | @crusader76 | Nov 14 11:49am

Suggest meeting also with a Radiation Oncologist. I was treated for Gleason 3+4 with 5 sessions of SBRT. My PSA is now undetectable.

REPLY
Profile picture for sarge15926
sarge15926 | @sarge15926 | Nov 14 2:08pm

I agree with everyone on this forum. You are going to be ok. I got diagnosed in June and the anxiety was out the roof for me. I had the Prostatectomy on 4 Nov. I feel relief the C is gone
And the procedure really wasn’t that bad at all
The worst part is the Catheter but it’s only for a week
Good luck and Gods speed

REPLY
Profile picture for jc76
jc76 | @jc76 | Nov 14 5:02pm
In reply to @rlowenstein "I'm a fit 74 year old. I had the same (3+4) Gleason score as you on..." + (show)
Profile picture for rlowenstein @rlowenstein

I'm a fit 74 year old. I had the same (3+4) Gleason score as you on my second biopsy, a year after the first 3+3. I ultimately decided to have radiation treatment, but the reasoning is possibly useful to you. Yes, I could have continued Active Surveillance, but we already see that the cancer is growing, even if it's not high risk. The doc said he could not endlessly do biopsies. I had a Decipher test (highly recommended) that showed relatively low risk and no need for hormone therapy, but still...how long do you want this growing within you? That's a question every man needs to answer for himself. What I found is all the tests and medical appointments were very stressful and it was affecting my mental health and my partner's. I decided let's treat this now rather than later and try to move on with life.

Jump to this post

@rlowenstein
Your post almost equals my journey and decision I made with prostate cancer. My state of mind was important to me as it was to you.

Making the decision is a personal decision and what another does may not be the best interest for you not only physical heatlh but mental health.

REPLY
Profile picture for soli
soli | @soli | Nov 15 10:25am

My biopsy also showed Gleason 3+4 but my PSA was 14.5. Only 1 out of 18 cores were positive. Those with 3+4 are a very hterogeneous groups with a subset being very low risk similar to Gleason 6 and others with very high risk similar to Gleason 8 or higher. If I am in the very low risk group I was going to consider active surveillance, but if not: definitive treatment. So, how do I know which sub-group I belong to? Like you are planning to do, I took a genomic case (in my case a GPS test) which produced a score of 47: meaning very high risk. Therefore, active surveillance came off the table, and I decided to seek definitive treatment. I evaluated surgery vs radiation and settled on surgery after assessing many factors including the negative impact of radiating my post-TURP enlaarged prostate with its pre-existing urinary symptoms.

So, I think getting a genomic test is the most important next step for you. Good luck on the difficult but manageable journey of fighting cancer.

REPLY
Profile picture for nymitch
nymitch | @nymitch | Nov 15 10:59am

My first biopsy showed a 3+3 lesion. My urologist/oncologist offered cryo ablation, but I chose active surveillance. Second biopsy was negative so I felt good. Third biopsy was a major change, with 5 of 10 cores showing 3+4 or 4+3.

Had RARP on Oct. 29. Went well, but I regret not having the simpler, easier, quicker cryo ablation in the beginning - might have done well with that alone. So ask about that.

Most important consideration is your surgeon. Find the best, regardless of where you might have to go,

REPLY
Profile picture for Colleen Young, Connect Director
Moderator
Colleen Young, Connect Director | @colleenyoung | Nov 15 12:37pm
In reply to @cward0624 "In same boat waiting to set up surgery ." + (show)
Profile picture for cward0624 @cward0624

In same boat waiting to set up surgery .

Jump to this post

@cward0624, welcome. Did you consider other treatment options or was surgery the clear choice for you? What type of surgery will you be having? How are you doing?

REPLY
1 reply
Profile picture for Colleen Young, Connect Director
Moderator
Colleen Young, Connect Director | @colleenyoung | Nov 15 1:08pm
In reply to @wmt101 "3+4 is not life threatening. Basically, just keep an eye on your PSA. Any significant increase..." + (show)
Profile picture for wmt101 @wmt101

3+4 is not life threatening. Basically, just keep an eye on your PSA. Any significant increase in that number beyond 6 and you will initially be put on hormone treatment to stop your testicles producing testosterone which cancer needs to feed on.

Jump to this post

@wmt101, welcome. Have you also been diagnosed with prostate cancer?

REPLY
Profile picture for cward0624
cward0624 | @cward0624 | Nov 15 2:02pm
In reply to @colleenyoung "@cward0624, welcome. Did you consider other treatment options or was surgery the clear choice for you?..." + (show)
Profile picture for Colleen Young, Connect Director @colleenyoung

@cward0624, welcome. Did you consider other treatment options or was surgery the clear choice for you? What type of surgery will you be having? How are you doing?

Jump to this post

@colleenyoung having a pet scan ( soon) I am young enough to deal
with issues (ed) do not want radiation, electing nerve sparing surgery with one of the best surgeons at U OF M .. I am dealing with it … 😁

REPLY
View MoreView Less
Please sign in or register to post a reply.