4 + 3 = 7: Should I involve a prostate cancer specialist?

Posted by rex5789 @rex5789, Feb 19, 2023

I am unused to blog/discussion groups...just diagnosed with 4 + 3 = 7, PSA 4.08 (2018 was 1.59)... I am 77, super active, mission trip to Cent America next week, work my own wood on 35 acres and involved in establishing Charter schools. Parents lived till 95 & 86. Have an appointment in Ashland WI tomorrow-I do not note my radiologist/oncologist is a prostrate specialist. Am I correct that this is an important issue. I can travel anywhere. Thanks!

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

Yes Rex, this is a serious issue.

The Prostate Cancer Patient Guide (downloadable and hard copy) from the Prostate Cancer Foundation (PCF.org) and Dr Patrick Walsh's book "Surviving Prostate Cancer " are excellent resources for information.

Good luck; the breadth of information about diagnosis and treatment of Prostate Cancer can be challenging.

I am not a medical expert, however this require serious attention, and there is a fair amount to know.

Good luck with your appointment.

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1 year ago I was diagnosed with 4+3=7. I was immediately asked "radiation or prostatectomy surgery" . It was a like looking into an abyss.
After some research on my own I realized that scans were needed to provide the information to make the decision. I had to talk the Docs into approving the scans. METASTASIS TO LYMPH NODES. Long story short
I did the radiation, I LEFT the "small town " Doctor's and I am now being treated at Mayo Phoenix.
Get the scans particularly a " PSMA PET/CT" to get a full picture of your condition. Your travel may be affected by the scan results.
I love the Ashland, Iron River area. You may want to consider Mayo Rochester. Best of luck
Jim

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Rex5789, definitely agree with what has been stated above. Your Gleason Score (4/3) is the same as mine and this is a serious issue that you need to address. I am a very active 56 year old and had a radical prostatectomy in November, 2022. I was initially at a local hospital in Iowa, but after doing my research, decided to go with Mayo-Rochester. The quality of life, for the rest of your life, will depend on the experience and expertise of your doctors. You do not want to be on or near the learning curve for your urologist/surgeon/radiologist/etc.
Best of luck and good luck with whatever treatment you decide to move forward with!!
Jim H

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@rex5789, I'd like to add my welcome along with the helpful responses you got from @hammer101 @spryguy @michaelcharles. I have to agree that having a prostate cancer specialist on your team is important. Comprehensive cancer care at a major cancer center preferable. Naturally, I vote for Mayo Clinic since travel is possible for you.

You can self refer or find out more about requesting an appointment at Mayo Clinic by clicking this link: http://mayocl.in/1mtmR63

You might also be interested in this related discussion:
- Which Mayo Clinic is best for Prostate Cancer treatment and wait times https://connect.mayoclinic.org/discussion/which-mayo-clinic-is-best-for-prostate-cancer-treatment-and-wait-times/

How did your appointment go today?

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I too had 4+3, a few of them. I too highly recommend Dr Patrick Walsh’s book - it is a must.

Diagnosis was in March of last year. Had RALP on Aug 23. I was told that the pathology report indicated an area of a Gleason 8 or 9, plus this was a type of cancer that would have survived radiation.

So yes, get the biggest and baddest on your side ASAP. They can tell you what they can detect, but, there could be worse.

Best of luck to you!

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I am also 4-3 and the PSMA Pet scan showed it is only the 7mm lesion and confined to the prostate. So, I elected for a genetic test (Oncotype) which came back as a 42. Under 40 you should do watchful waiting. I am also waiting for a 2nd opinion on the pathology report to come back. I will probably do radiation as having surgery is not something I will consider. Too many risks of spending the rest of my life in depends. It is very hard to trust anyone in the medical field after they all told us if you take the vaccine, you won't get covid, spread covid, get hospitalized from covid or die from covid. The medical profession has killed their credibility and now I do not trust anything from them. My desk is filled with Clinical Trial data and study results so do your research before making a decision on your own for what is best for you. I am also in my 70's and very active so I intend to be around a while longer but do get a PSMA Pet Scan for real helpful information on where your cancer stands.

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@maxvt

I too had 4+3, a few of them. I too highly recommend Dr Patrick Walsh’s book - it is a must.

Diagnosis was in March of last year. Had RALP on Aug 23. I was told that the pathology report indicated an area of a Gleason 8 or 9, plus this was a type of cancer that would have survived radiation.

So yes, get the biggest and baddest on your side ASAP. They can tell you what they can detect, but, there could be worse.

Best of luck to you!

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What in the report stated/determined that the Ca would survive radiation?

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If you can, get a second opinion from a radiation oncologist if you go down the radiation road. Different machines have different Impact. As Suggested above, get a prostate MRI and if you get a biopsy, get put out for it. You might wanna get that decipher test which takes the material from your biopsy to judge how aggressive it is. It served as a back up to the pathologist report. I had spaceoar done and I am a fan of it for the long-term results. Try to. spend time on this web site. there is a lot of good information. Some areas are a little greyer than others but the questions and answers may help you go down a path that you feel comfortable with at least more so than without information. good luck and keep coming to the site and asking questions.

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@mikewo

I am also 4-3 and the PSMA Pet scan showed it is only the 7mm lesion and confined to the prostate. So, I elected for a genetic test (Oncotype) which came back as a 42. Under 40 you should do watchful waiting. I am also waiting for a 2nd opinion on the pathology report to come back. I will probably do radiation as having surgery is not something I will consider. Too many risks of spending the rest of my life in depends. It is very hard to trust anyone in the medical field after they all told us if you take the vaccine, you won't get covid, spread covid, get hospitalized from covid or die from covid. The medical profession has killed their credibility and now I do not trust anything from them. My desk is filled with Clinical Trial data and study results so do your research before making a decision on your own for what is best for you. I am also in my 70's and very active so I intend to be around a while longer but do get a PSMA Pet Scan for real helpful information on where your cancer stands.

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mikewo-so helpful...I am chceking to insure my 3/8 /23 'scans include PSMA Pet. Totally agree with you re the Vacs...I dutifully took 2 Pfizers in 21 followed by a year of ferocious moving headaches, vertigo, loss of taste/smell etc...now comming out of this hades. no boosters for me & no Vacs at all for my wife.....covid twice for both of us & we use Text2MD docs for that issue. I am going to check in later today to MAYO-do not want surgery...what radiation are you considering? kind regards, ed...no REX!

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@rex5789

mikewo-so helpful...I am chceking to insure my 3/8 /23 'scans include PSMA Pet. Totally agree with you re the Vacs...I dutifully took 2 Pfizers in 21 followed by a year of ferocious moving headaches, vertigo, loss of taste/smell etc...now comming out of this hades. no boosters for me & no Vacs at all for my wife.....covid twice for both of us & we use Text2MD docs for that issue. I am going to check in later today to MAYO-do not want surgery...what radiation are you considering? kind regards, ed...no REX!

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I have an appointment with a CyberKnife facility today and I will go from there. The CyberKife is 5 treatments and their machine tracks prostate movement in real time as you are in a CT scanner from what I have read. % high doses seems way better than 28 for Proton. They both claim to spare healthy tissue but when you read the area targeted it is the whole prostate and 1.5 cm of the seminal vesicles even though my lesion is only 7 mm and on one side. That is one of the questions I have for the doctor today as to why.

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