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Gleason 3+3 to Gleason 4+5 in 7 months.

Posted by Chevy @stanshintaku, 5 days ago

Hello
The lesion sample from the 3/2024 mpMRI fused biopsy was read as Gleason 3+3. After detailed option discussions, both the urology surgeon and radiation oncologist strongly recommended the monitoring option. A 12/2024 confirmatory biopsy samples showed a substantial aggressiveness upgrade to Gleason scores of 4+5 and 3+4. That was devastating to say the least.

With a subsequent 12/23/2024 PET CT PSMA scan, I was told I was lucky that there wasn’t any evidence the cancer had spread beyond the prostate (yet). I had played the odds by electing to monitor and I rolled snake eyes. I just want it out now, ASAP. I believe things can get worse and my option less promising very soon. I have an earliest available appointment with my surgeon on 1/17/2025.

As such and concurrently, I fly to Rochester this coming Tuesday 1/7/2015 to get an assessment and recommendation by the MAYO Clinic. I feel a second opinion by a top institution is justified given the aggressiveness. I have an appointment with Dr. Tollefson I believe is a surgeon.

Some questions I have:
1. Is RP now the best option. It seem having it completely removed now is best.
2. Should I also see a radiation oncologist while at MAYO just in case there are good radiation options I should consider? They only scheduled me for the one surgeon appointment.
3. Is there something I should take, avoid or do in the meantime for the cancer’s aggressive character? Shouldn’t we be trying to determine more about the cancer’s DNA and character?
4. Is my extreme urgency justified (based on Gleason 6 to 9 in 7 mos.)? I just feel it’s not long before it metastasizes.

Thank you for listening and your comments.

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

Chevy | @stanshintaku | 2 days ago
In reply to @jeffmarc "You got some great recommendations. Get that decipher test. Discuss getting on ADT before surgery or..." + (show)
@jeffmarc

You got some great recommendations. Get that decipher test. Discuss getting on ADT before surgery or radiation. Get genetic testing, Mayo will definitely do it for you, just ask.

1. Surgery is one way to resolve it, Radiation works just about the same as surgery long-term. Then there are the other non-radiation treatments like HIFU, cryotherapy, TULSA-PRO or more. You have many options.

2. As others have said, Seeing a radiation oncologist is essential. When you go to a surgeon, they recommend surgery. You want to have many more options to pick from, radiation is very successful and you will Probably not have ED after having radiation.

3. The genetic test is one thing you need to do. Getting on ADT Should stop your cancer from growing, they frequently want you to do it for a few months before radiation. There’s really nothing else in the character of your cancer, The Gleason score and decipher score tell you the most right now.

4. A Gleason nine is definitely aggressive, So you don’t want to wait long before doing something. ADT Is what almost all of us start using to keep the cancer under control.

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Thanks for all the good comments and leads!

REPLY
Chevy | @stanshintaku | 2 days ago
In reply to @jc76 "@stanshintaku I can see other poster providing information to you. You are going to Mayo Rochester..." + (show)
@jc76

@stanshintaku
I can see other poster providing information to you.

You are going to Mayo Rochester what in my opinion is best medical clinic out there. I go to Mayo Jacksonville.

Asked the question on your list to the specialist at Mayo. They have the medical expertise to be able to anser you by medical experts. The available treatment options continue to change over the years and even some new ones since I was diagnosed in January of 2023.

You have already had an important test the PSMA. Asked Mayo about Decipher test. I did not know about it until my Mayo R/O mentioned to me after my diagnosis. It is a genetic test that uses the same biopsies taken already to determine a more precise aggressiveness of your cancer.

My initial Gleason Score indicated I was intermediate risk level. The Decipher test came back at low risk. This changed my treatment recommendations (from two different medical facilities) to radiation only versus radiation and hormone treatments. I and many others mentioned it from personal expereince and something you should asked your urologist, surgeon, R/O about if you have not had it.

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Thank you

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