PC and enlarged prostate

Posted by tl64 @tl64, Mar 30, 2023

58 year old white male in otherwise good health. I was recently diagnosed with Gleason 7 (4+3). Previous MRI showed prostate volume was 120cc. PSA 5.3. Sending pathology to Johns Hopkins for a second opinion and will be consulting with their Multidisciplinary Clinic for future treatment. My question is will my enlarged prostate determine which treatment (RP, radiation and/or hormone therapy) is best? I realize Hopkins will have the answers but I can't seem to find anything on this. Thanks

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web265 | @web265 | Mar 30, 2023

Hey @tl64 , sorry to hear about the diagnosis. To answer your direct question, I've read on here somewhere that some surgeons don't think it a great idea to do an RP with a larger prostate. I don't know what that decision size would be though. However, having said that, I don't think it the only determining factor. I was 4+3 with a normal size prostate and have two of those treatments under my belt, RP and radiation and currently in hormone therapy.

Was told there was likely no spread so did the RP, then found out there was micro metastasis in the lab report, psa started to climb a little and off to the radiation oncologist. The hormone therapy was something we decided to do with the radiation.

My point is that they really can't tell you exactly what is going on, it's often a "percentage of outcomes" game.

It sounds to me like you going to one of the best places you can be for advice and treatment recommendations!

Best of luck to you!