Advice on PSAM-PET/MR 3+4=7

Actually, UC Davis is the one that has the best prostate cancer doctors, Other than UCSF.

I know dozens of people that have gone to UCSF and had great treatment. My brother went there a couple of years ago and with very little delay had SBRT radiation. I attend an hour and a half online prostate cancer meeting with UCSF every month. At least 20 people show up and almost all of them are using UCSF, Very few complaints.

Jeff, to me that’s a joke. They are not good if you cannot get into see them maybe UCSF is better. I certainly hope so.

Thanks Jeff 🙂 ,

I'm sure that once that you are "in" the system that treatments and level of care are probably first class !

They have "Prostate Cancer Center" which is a whole building wing dedicated to prostate care and research. They pioneered many new things in the area of PC. I watched some of their conferences and read some papers, all are top notch. They are also building brand new Proton Therapy Center that will be in operation 2029 *yeaaayyy .

The whole "slow" flow is probably related to administration hurdles internally. That, and the fact that they maybe think that we just want to hear "second opinion" while we actually wish to become their patient.

We will have consult soon enough 🙂 and I feel much calmer and optimistic today.

Mauk, My RO at Sloan in Commack, NY is Dr Andrew Barsky - young and phenomenal.
Also want to add, it seems that your Gleason score was gotten via tissue removed during HoLep?
Don’t see any mention of an MRI targeted biopsy. It is possible that the procedure only removed cells LINING the gland to facilitate urination and did not sample cortex tissue INSIDE the gland.
Not to put you through extra testing, but you may have to do that before you can make a decision. Your inner tissue could be higher or lower Gleason-wise. Best,
Phil

When I was diagnosed with 7(3+4), I got a 2nd opinion on the biopsy tissues. I understood fully that a Gleason score is just a pathologist’s educated, expert opinion of what is seen in the tissues under a microscope. A 2nd (& 3rd….) opinion is exactly that as well - just one pathologist’s educated, expert opinion of what is seen in the tissues under a microscope.

Much of the interpretation of images, scans, and slides is often as much an art as it is a science and dependent on the skill and experience of whoever is doing the reading.

In my case, I made a commitment:
> if the 2nd opinion came back a lower 6(3+3), I would still get treated to the higher 7(3+4).
> if the 2nd opinion came back the same 7(3+4), I would get treated to the 7(3+4).
> if the 2nd opinion came back a higher 7(4+3), I would get treated to the higher 7(4+3).

As it turned out, the 2nd opinion came back a higher 7(4+3) so, out of an abundance of caution, that’s what I got treated to.

You’ll have to establish your own criteria for which biopsy interpretation you’ll use for making your treatment decision.

Wishing you the best in your decision.

Hello Phil,

Yes, thats correct it was gotten via a tissue during HoLep, that is why they recommended Decipher, PSMA PET?MR and MR of Pelvic with and without regents so see what left and how bad is it, then we decide how to move forward,,,your thoughts!

Thanks for sharing the RO name.

Mauk

Yes, MRI will show any other suspicious lesions; if so, a biopsy (transperineal strongly recommended) will be done and you take it from there.
You have a lot of reading to do to familiarize yourself with recommended treatments and ALL the factors involved in making s sound decision. Best,
Phil

Any good recommendations for reading! Appreciate it

Thx,
mauk

Oh Geez, nothing definitive I can cite. I read everything from hospital websites, NIH articles, etc. Also, use the Search bar on this Forum to find things such as “Gleason 4+3 Treatment” or “Surgery vs Radiation for Gleason 3+4” - almost anything you want to know! Perhaps other members can help direct you to other sites or Youtube videos, also very valuable.
Phil