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prostate MRI results one year after SBRT

Prostate Cancer | Last Active: Feb 11 8:13am | Replies (28)

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Profile picture for diverjer @diverjer

Well it looks like I am toast! The MRI showed only one Lesion like shown above. Had biopsy done yester, they did 3 from the Lesion and 6 from each side. I wondered why they did more biopsy that were outside the lesion, but didn't ask. Got report today- not good. The lesion look better than areas where MRI saw nothing. They took 15 samples total.
Results:
Final Diagnosis
View trends
A. Prostate, "LLB", biopsy:
Prostatic adenocarcinoma Gleason score 3+4=7 (Grade group 2) in 1 of 1 core, involving 30% of needle core tissue.

B. Prostate, "LMB", biopsy:
Prostatic adenocarcinoma Gleason score 4+3=7 (Grade group 3) in 1 of 1 core, involving 70% of needle core tissue

C. Prostate, "LLM", biopsy:
Prostatic adenocarcinoma Gleason score 3+4=7 (Grade group 2) in 1 of 1 core, involving 60% of needle core tissue.

D. Prostate, "LMM", biopsy:
Prostatic adenocarcinoma Gleason score 4+3=7 (Grade group 3) in 1 of 1 core, involving 60% of needle core tissue.
Large cribriform glands present.

E. Prostate, "LLA", biopsy:
Prostatic adenocarcinoma Gleason score 3+4=7 (Grade group 2) in 1 of 1 core, involving 60% of needle core tissue.

F. Prostate, "LMA", biopsy:
Prostatic adenocarcinoma Gleason score 3+4=7 (Grade group 2) in 1 of 1 core, involving 50% of needle core tissue.

G. Prostate, "RLB", biopsy:
Benign prostatic tissue.

H. Prostate, "RMB", biopsy:
Prostatic adenocarcinoma Gleason score 4+3=7 (Grade group 3) in 1 of 1 core, involving 10% of needle core tissue.

I. Prostate, "RLM", biopsy:
Benign prostatic tissue.

J. Prostate, "RMM", biopsy:
Prostatic adenocarcinoma Gleason score 4+3=7 (Grade group 3) in 1 of 1 core, involving 50% of needle core tissue
Large cribriform glands present.

K. Prostate, "RLA", biopsy:
Benign prostatic tissue.

L. Prostate, "RMA", biopsy:
Prostatic adenocarcinoma Gleason score 4+3=7 (Grade group 3) in 1 of 1 core, involving 25% of needle core tissue

M. Prostate, "ROI#1", biopsy:
Prostatic adenocarcinoma Gleason score 3+4=7 (Grade group 2) in 3 of 3 cores involving 70% of needle core tissue

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Replies to "Well it looks like I am toast! The MRI showed only one Lesion like shown above...."

@diverjer

You have a Gleason 4+3 7 BUT you have large cribriform and doctors a UCSF say that puts a 5 in your Gleason score.

It is quite aggressive and must be treated properly.

If you have SBRT radiation it is not sufficient to get rid of large cribriform. In that case you would need to have brachytherapy in addition.

IMRT radiation may work, but they recommended using ADT as well if you do it this way. Back

Proton radiation could be sufficient to handle it, discuss this with the radiation oncologist.

Having surgery may work but it is not guaranteed, you may need radiation as well.

You need to discuss this with a radiation oncologist and a urologist that has done a lot of prostatectomies.

It would make sense to get a second opinion on this treatment as well from a center of excellence, even if you are already going to one.