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Follow-up after diagnosis
Had my follow-up appointment for my 2 of 12 core biopsy 3+4 Gleason score and a 20% and 30% involvement on each, doctor offered active survalance but I declined if it was 3+3 in the same senerio I would have done it, he was leaning towards prostate removal versus radiation because of options after reoccurance but referred me to an oncologist and a surgical urologist so I will make an appointment and schedule removal surgery but will talk to oncologist and see what they say and that's 2 to 3 weeks off so will see what happens.
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Sounds like a good plan.
What they look at with the 3+4 when they consider active surveillance is how much “4” there is. If it’s only 5% “4”, that’s different than if it were 45% “4”.
You might also consider getting a 2nd opinion on that biopsied tissue — not necessarily because you don’t trust the 1st one or don’t like that opinion. But, because much of the interpretation of images and scans is often as much an art as it is a science, and is dependent on the skill and experience of the pathologist reading the slides. It’s good to have an independent set of eyes reviewing the biopsy. (What one pathologist might see as a 7(3+4), another might see as a 6(3+3), while another might see as a 7(4+3).
As for options if there is local recurrence, with modern primary radiation you have many options - focal therapy (e.g., cryo), brachytherapy, SBRT (because they’re all very targetable), and even re-radiation in some cases.
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1 ReactionThanks. I will hear both sides and make a decision, I want to avoid adt
therapy as much as possible so in my situation if I can avoid it with
radiation I would consider that as well.
Also, in my pathology report two pathologists looked at the sample and came to the same conclusion of diagnoses.
@ginger38314 With a 3+4, they don’t usually recommend ADT (unless there are other significant risk factors).
If you want to know whether or not ADT would be beneficial, get the ArteraAI prostate test. ArteraAI assesses your biopsy tissue to predict whether you will benefit from hormone therapy and estimate long-term outcomes.
I will see what the oncologist says when I see them, but at this point in time I'm leaning more towards prostate removal but will hear the other side first.
Best Wishes on this journey.
1. Based on your information, you have no reason to rush to make a treatment decision.
2. Join Ancan Favorable Intermediate support group. The meeting is twice per month. You will learn alot from the group.
3. You want to find prostate cancer specialists (Center of Excellence, Cancer Center, Best of the Best) for treatment.
4. Post your PSA, age, MRI and Biopsy tests and others can provide more feedback.
5. I have RP scheduled in Sept.
6. My 1st biopsy was a year ago. You may be able to delay treatment into 2027 or beyond.
Best Wishes.
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2 ReactionsJust so you know what an expert in the Field thinks about active surveillance with your type of prostate cancer, you should take a look at this video.
Excellent Fred Hutch doctor video: Dr. Claire de la Calle
Active Surveillance for Intermediate Risk Prostate Cancer w/ Dr. Claire de la Calle | Ep. 288
Thanks I'm not rushing into anything, I will see how things play out with
the oncologist and the surgeon and go from there my cancer is low volume so
will see what happens. My current psa is 5 and psa density .156 mri level 4
but dwi score of 3, findings noted consistent with prostate infection, so
had a exodos test done came in at 77 for >or= to 3+4, so that's it.
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1 ReactionThamks