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Gleason7(3+4) - treatment options recommendation
Got recently diagnosed with Gleason group 2, 7(3+4). Was in state of shock to know about the cancer.
I’m 56 year old and fortunately I’m with Mayo care since last decade.
Recommendation for me is to have prostatectomy as radiation therapy has long term implications. Took outside opinion also and same recommendation. But not sure how to deal post procedure with urge to urinate situation currently there.
Biggest thing is I’m hoping there is no recurrence occurring after this. Any suggestion/recommendation?
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Hi,
I’m glad I did the surgery route to avoid the radiation/ADT/testosterone replacement therapy cycle. As a lot of people have testified on this and other sites this cycle can really be a burden to your quality of life. I think it would be wise for people contemplating treatment for Prostate cancer to look at this cycle and look at alternative treatments also, then decide. I really have compassion for people that have to deal with all the side effects. I’m glad I only have to deal with two(ED and a drip). Can’t imagine adding all the other side effects on top of my two.
Dave 3+4
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1 Reaction@davidz26
My prostate cancer was diagnosed 16 years ago with a 3+4. I had a prostatectomy. After surgery, they found it was a 4+3.
None of those focal therapies were available at the time, Only radiation and surgery.
Am I really the Jeff you were referring to?
@pesquallie
I took a look at the links you provided. TRT does seem to be pretty well handled in a lot of cases. I don’t think this really got into the subject of not using ADT, Especially for new cases.
I do see that There are unknown exceptions to these Positive results..
“However, the findings from the 12 included studies suggest that, in appropriately selected individuals, TRT may be both effective and oncologically safe.”
They did say they underrepresented high risk individuals, so they were a little cautious in how they presented it.
“TRT may be cautiously considered in men with documented hypogonadism and stable post-treatment disease, provided that treatment decisions are individualised and closely monitored.”
These type of statements are the reason that I am not sure it really fits everybody. Those with serious cases have to be very careful.
@davidz26, welcome. What treatment options were available for your prostate cancer?
My urologist basically told me I have 2 options RP surgery or some form of radiation treatment. I discovered on my own and confirmed with a consultation that with 3+4 Gleason intermediate localized prostate diagnosis that I am a good candidate for IRE /nanoknife which is less invasive and similar fical treatments to Hifu or Tulsa treatment but a better choice for me based on the location of my cancer. I am also considering active surveillance based on my next PSA test and how I feel. AS I was also told that I am an okay candidate for.
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1 ReactionThere is a clinical trial using transurethral aquablation. You may want to explore this option. They are evaluating its effectiveness vs RP and believe that the side effects (ED and incontinence) will be greatly reduced.
It is not a big trial and is only being done at select hospitals, and you may not qualify if you have comorbidities.
I am trying to get into the trial at Johns Hopkins since my surgeon is the principal investigator there.
Good luck.
I had IRE 2years ago Gleason 2-7(3+4) did not get all the cancer now with Gleason 2-7(3+4) have the option for another folcal therapy or RD. Ian going with RD starting September 10th looking back I wish I had gotten RD 2yr ago might have gotten all the cancer then.