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Decipher risk: prostatectomy RP vs radiation.
Prostate Cancer | Last Active: Mar 14 11:09am | Replies (75)Comment receiving replies
@jonathanack Hello-I am new to the forum, just got my PET scan results and they are 4+3, so I am at an intermediate risk level. So, the urologist gave me 2 options; I am leaning towards the DaVinci robotic assisted removal, as besides the 3 cores that have the non-cribriform type of cancer structure, I have at least one more area that looks suspicious. I would just like to clear the seed bed for the cancer by removing it vs. continually chasing new spots that show up. I don't like the radiation beads idea either, as they can honeycomb the gland making it more difficult to remove it later.
Replies to "@jonathanack Hello-I am new to the forum, just got my PET scan results and they are..."
@drcopp
Welcome to Crew!
I am far less well informed than many of our cohorts here, but happy to help answer any questions. I can honestly say that a couple things are more important than I had initially thought: Exercise consistently, Your wife or partner, and understanding that though our situation is not ideal... a lot of people have a much more grim issue.
What Jeff M has noted below matches what my docs advised.
I am a big advocate of second / third opinions as well. Also, I Jeff also mentioned, a decipher test. That test had a lot of influence from my oncologists perspective (Joseph Wagner - Hartford Tallwood Mens Health). Wagner was one of the first to use the DaVinci...he was very candid with me re: the cribriform... So, so far so good.
My SBRT treatment came along with 120 days of Orgovys (just finished). My psa test was this week and ... undetectable and less than .1 (mine was never all that high 4.7 tops).
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@drcopp
A lot of it depends on how old you are. If you’re on your mid to late 70s then five sessions of SBRT could take care of it. They also work if you were younger, and the results are just about equal to surgery. A lot fewer side effects at the time compared to surgery.
Are they able to spare the nerves if you do surgery? If not, then getting an erection is a real problem. There are Solutions, but you definitely want to ask the doctor if they can spare the nerves.
While large cribriform is A real problem were any of these found in your biopsy, intraductal, Seminal vesicle invasion, EPE or ECE. (Extraprostatic extensions extra capsular extensions). They can make the cancer much more aggressive.
Did you get a PSMA PET scan? That could tell whether or not the cancer has spread beyond your prostate and needs to be handled differently than surgery.
I found out I was a 4+3 after surgery and it gave me 3 1/2 years before my cancer came back. I have a genetic problem, so that’s why it reoccurs.
If you want to know if yours is going to reoccur, you should get a decipher test and an Hereditary, genetic test. Those two can narrow down the possibility of you having future problems.