1. < Prostate Cancer

Gleason 8 - Surgery scheduled in early Sept - timing ok?

Posted by undetectable @undetectable, Aug 1, 2023

My husband (71, active) was diagnosed June 16, Gleason 8, PSA 8, 9/18 positive cores, four 4+4. PSMA PET is clear. He is scheduled to have surgery on Sept 7 but is on a waitlist to have it done sooner. He's psychologically comfortable with this wait time - should we push for an earlier date because of the aggressive nature of the cancer?

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undetectable | @undetectable | Aug 7, 2023
In reply to @groundhogy "You made very quick work of that graph! Sharp. They are not simple. One thing those..." + (show)
@groundhogy

You made very quick work of that graph! Sharp. They are not simple.

One thing those graphs don’t show is the benefit of salvage radiation. So when i was researching, i looked for papers on salvage rad performance. I didn’t find much useable data. From what i remember, i used a benefit of 12% boost to the RP numbers.

Basically i drew a parallel line 12% above the RP line.

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Finally my graph-reading skills have come in handy

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undetectable | @undetectable | Aug 7, 2023
In reply to @spino "When you look at these sites, it's good to remember that they are often linked to..." + (show)
@spino

When you look at these sites, it's good to remember that they are often linked to providers, who have found them to be an excellent way to generate referrals. In this case, it doesn't take a lot of looking to identify the MD behind this site... https://www.seattlecca.org/providers/r-alex-hsi. And surprise, he is in fact a radiation oncologist 🙂

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Aha. Not a surprise, but a little creepy

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groundhogy | @groundhogy | Aug 7, 2023

The graphs were created out of frustration at the PCa industry not doing their job. The industry could have long ago easily compiled and presented this data to the people of the world.

I had many uros look me straight in the eyes and tell me RP and radiation have identical curative outcomes and that you should just pick based on side effects.

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wellness100 | @wellness100 | Aug 8, 2023

He should do a PET/SC scan, if he can to make sure. In any case, he should also be on ADT, to make sure.

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undetectable | @undetectable | Aug 8, 2023
In reply to @wellness100 "He should do a PET/SC scan, if he can to make sure. In any case, he..." + (show)
@wellness100

He should do a PET/SC scan, if he can to make sure. In any case, he should also be on ADT, to make sure.

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He has had the PSMA PET/CT and it's clear. What is a PET/SC? Why ADT right before surgery?

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wellness100 | @wellness100 | Aug 8, 2023
In reply to @undetectable "He has had the PSMA PET/CT and it's clear. What is a PET/SC? Why ADT right..." + (show)
@undetectable

He has had the PSMA PET/CT and it's clear. What is a PET/SC? Why ADT right before surgery?

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Sorry SC is typo for CT.
If you are sure of the PET/CT scan, then you can wait. However, you seem not so sure. In that case, you might need ADT in case, with or without surgery, to make sure. Dr. Eugene Kwon on u-tube explains well.

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undetectable | @undetectable | Aug 8, 2023

The PET results were conclusive. I was just wondering if it made sense to push the surgery up by 2-3 weeks because the cancer is aggressive. But the consensus is that waiting a few weeks don't matter. So diagnosis in mid June, surgery in early September.

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kenhorse | @kenhorse | Aug 13, 2023
In reply to @undetectable "The PET results were conclusive. I was just wondering if it made sense to push the..." + (show)
@undetectable

The PET results were conclusive. I was just wondering if it made sense to push the surgery up by 2-3 weeks because the cancer is aggressive. But the consensus is that waiting a few weeks don't matter. So diagnosis in mid June, surgery in early September.

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Always best to talk to your urologist about these types of concern. In my case, my urology surgeon said no later than January after I missed my original scheduled date in November, 2022 (came down with the flu 2 days before I was to undergo the procedure!).

Ended up happening on January 31st, my wife's birthday! Nice present, eh?

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undetectable | @undetectable | Aug 13, 2023
In reply to @kenhorse "Always best to talk to your urologist about these types of concern. In my case, my..." + (show)
@kenhorse

Always best to talk to your urologist about these types of concern. In my case, my urology surgeon said no later than January after I missed my original scheduled date in November, 2022 (came down with the flu 2 days before I was to undergo the procedure!).

Ended up happening on January 31st, my wife's birthday! Nice present, eh?

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Ugh - sorry about that timing! How were your results?

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kenhorse | @kenhorse | Aug 13, 2023
In reply to @undetectable "Ugh - sorry about that timing! How were your results?" + (show)
@undetectable

Ugh - sorry about that timing! How were your results?

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All contained within the prostate, negative margins and negative lymph nodes

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