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My husband has Gleason score 3 + 4 = 7 (Grade Group 2 Perineural Inva?

Posted by bettycesar46 @bettycesar46, Jul 28 12:42pm

Hi Everyone,
My husband had biopsy done and the results came back that he has a Gleason score 3 + 4 = 7 (Grade Group 2 Perineural Invasive.

We are waiting for the doctor to call us with the official results and the next step. Does anyone know the course of treatment might be? I am so freaked out and was wondering if anybody had any thoughts to share.
Thank you

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mlabus3 | @mlabus3 | Jul 30 6:55pm

I would be more worried about the IDC than the PNI. IDC is more aggressive and should be considered as part of a your treatment decision. Your biopsy should show more detail. if it doesnt, get a second biopsy review. Part of the problem is IDC and cribiform have long been overlooked as bad actors, and proven treatments (clinical studies) are just being developed.

I agree go to a center of excellence and insist on a RO with experience in this area. i agree you should get the Decipher. Note I am on my 3rd RO - the first two were pretty junior and could not provide me the level of detail or experience i wanted. I finally found a senior RO with the type of experience I was looking for. Dont settle. You should feel very confident you have the right person for you.

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bearcat998 | @bearcat998 | Jul 30 9:45pm
In reply to @handera "You definitely need to follow up with your physician(s) to discuss the specifics of the Intraductal..." + (show)
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You definitely need to follow up with your physician(s) to discuss the specifics of the Intraductal carcinoma (IDC-P) found in your husband’s pathology report.

IDC-P is often associated with more aggressive prostate cancer.

Although some Gleason 3+4 can allow for active surveillance, the presence of IDC-P could shift the recommendation toward definitive treatments like surgery (prostatectomy) or radiation.

Here’s a few questions I’d be asking my urologist or oncologist, regarding the IDC-P finding:

• How extensive is the IDC-P, based on the current pathology report?

• Does the IDC-P observed in this report change the risk assessment in my particular diagnosis?

• Can you help me get a 2nd opinion on my biopsy pathology, especially focused on the severity of the IDC-P?

• Can additional tests (e.g., especially the Decipher genomic testing) help to assess the overall aggressiveness of the PCa, for my specific case?

• How does the current IDC-P finding, in my particular case, affect my treatment options or monitoring plans?

I wish you and your husband all the best, as you chart your path forward!

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This is great advice. The only thing I would add is that getting a second opinion from John's Hopkins was easy (I did it online) and relatively cheap. ($300)
They upgraded me from a 3+4 to a 4+3.

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