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Newly diagnosed stage 2. Trying to decide on a treatment plan.
Prostate Cancer | Last Active: 7 hours ago | Replies (12)Comment receiving replies
@172sar
FAVORABLE INTERMEDIATE RISK PROSTATE CANCER COUNSELING: Reviewed NCCN guidelines
showing patient falls into favorable intermediate risk category based on Gleason 3+4 w/ only 5% pattern 4 and
less than 50% cores positive. Emphasized very low risk of cancer-specific mortality (less than 5% at 15 years
w/ treatment). Explained that only 1% risk of lymph node involvement, so bone scan and extensive staging not
currently indicated. Discussed Decipher genomic testing which analyzes genetic expression in cancer cells to
refine risk stratification and confirm appropriateness of active surveillance if chosen.
One line summary: 52M w/ favorable intermediate risk prostate CaP (Gleason 3+4 w/ minimal pattern
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@172sar The other option is AS with focal ablation of the lesion. This can be done with laser, DC current (NanoKnife), Ultrasound (TulsaPro), or Cyro. All of these treatments have higher reoccurrence rates than radiation/RP but much lower side effects and do not preclude any later treatments.
It might also be useful to get a second opinion on your biopsy. If pattern 4 was under 5% it would have be classified as 3+3 with a note that some pattern 4 was detected. Does an expert 2nd opinion show the cancer to be less or more severe. That may determine if you go AS or AS with focal.
Regardless of what you have been told ALL of the PCa treatments that will really suppress the cancer have significant risks of ED and incontinence so you should not rush into either RP or radiation. Also, none are a final cure as some on this board have had reoccurrence 15+ years after RP when you would be 67.