Biopsy Results and treatment concerns

Posted by Setters and Birds @jonathanack, 5 days ago

I am interested in understanding from participants how things went with either a prostectomy or radiation treatment.

I have copied in the results of my biopsy below delivered yesterday. The first tumor is new since the last biopsy (18 months ago).

Treatment: TBD pending decipher results.
I expect to be recommended for prostectomy or radiation.

63 years old (retired 2 years), fit - 5'8 126 lbs (I have lost 15 lbs since December), good condition - ... daily activity of one sort or another - hiking, fishing, avid gardener, bird dogs, busy body around our place. Annoyed by this diagnosis and not certain whether to pursue treatment.

The biopsy results (perineal biopsy - 16 samples).
INVASIVE PROSTATIC ADENOCARCINOMA
4 tumors:
1. Acinar Adenocarcinoma
Grade Group and Gleason Score: Grade group 2 (Gleason Score 3 + 4 = 7)
Architectural Patterns of Gleason Pattern 4: Cribriform Glands, Poorly Formed
Glands
Percentage of Pattern 4/5: 20%

2. Acinar Adenocarcinoma
Grade Group and Gleason Score: Grade group 2 (Gleason Score 3 + 4 = 7)
Architectural Patterns of Gleason Pattern 4: Cribriform Glands, Fused Glands,
Poorly Formed Glands
Estimated Percentage of Prostatic Tissue Involved by Tumor: 27%
Perineural Invasion: Present

3.Acinar Adenocarcinoma
Grade Group and Gleason Score: Grade group 1 (Gleason Score 3 + 3 = 6)

4. Acinar Adenocarcinoma
Grade Group and Gleason Score: Grade group 1 (Gleason Score 3 + 3 = 6)

Thank you to all of you. I really appreciate the help and comments I have received. Best of health to All of You.

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

bjroc | @bjroc | 4 days ago

I did Tulsa Pro. Other than a few weeks in a catheter there are no side effects.
https://connect.mayoclinic.org/discussion/tulsa-pro-initial-experience/

michaelcharles | @michaelcharles | 4 days ago

My choice at age 72 was surgery for the possibility of a cure by complete removal of the cancer.
Others have chosen radiation and been satisfied.
Surgery also reserved the radiation option for salvage treatment in the future. While I needed salvage treatment right after surgery for persistent PSA, others have not needed it until years after surgery.
My parents lived until 95 each, and without other commorbidities, I hope for the same and that calculated into my thinking.
Side effects from surgery can be immediate and side effects from radiation over time.
I would elect surgery again; others are very pleased with radiation.
Best wishes in your decision making and treatment.

inconsolable | @inconsolable | 4 days ago

Don't do anything before PET scan. If it has spread outside the prostate (and i see you have perineural invasion which could indicate that some cancer cells might be in your blood stream) then there is little point in removing it. My dad had pretty much the same results, except 4+3 instead of 3+4, and his first met was actually in his left foot! Nowhere else just the foot, since it was spreading via bloodstream, and not through lymphatics. But radiation killed it and subsequent PET scans never showed any uptake of the tracer. I hope your PET scan shows nothing but prostate. Good luck!