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Surgery or radiation?

Posted by freed58 @freed58, 7 hours ago

I’m sure questions like this have been raised here before, but I welcome your inputs.
I am an otherwise healthy 68 year old with a BMI under 21. A 20 core biopsy randomly found a single positive core graded as a Gleason 4+3. Core is defined as located in the left lateral apex. My PSA is 4. My prostate is 73g. My PSA density is 0.055. I do have BPH and a weak stream. PSMA PET verifies cancer is contained to the prostate. Decipher test and pathology 2nd opinion in process.
The docs I’ve seen in northern Virginia area say to pick your treatment path. They’re both reasonable but carry different pluses and minuses. They did say if I picked radiation I’d first need an outflow procedure such as TURP or HoLEP.
I welcome your inputs from your experiences.

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

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freed58 | @freed58 | 2 hours ago
In reply to @charlesprestridge "Based on the information provided, you need more info in order to begin “desired treatment” decision-making...." + (show)
Profile picture for charlesprestridge @charlesprestridge

Based on the information provided, you need more info in order to begin “desired treatment” decision-making.

1. Did MRI show any lesion(s)?

2. As others have asked, from the one positive core, how much was Gleason 3 and how much was Gleason 4?

3. You will want a Decipher or similar test performed on the biopsy.

4. Active Surveillence may be your best option, at this time. More info will guide this decision/option. Some of this may be: Genetic testing to test for BRCA or other inherited gene(s), 2nd opinion on initial biopsy (Dr Epstein or similar), and Decipher.

5. With the information you provided, I would not be ready to make a treatment decision.

6. https://ancan.org/prostate-cancer/ Join Ancan and particpate in either the Active Surveillence or Low/intermediate group. Lots of great support and information. You will be able to introduce yourself and provide information you have. You will get lots of recommendations and information.

Best Wishes.

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@charlesprestridge
A bit more info:
MRI showed one lesion which turned out benign. The one positive core was found randomly. 80% non-benign with 70% given a Gleason 4. So, overall Gleason was 4+3.
(Intermediate unfavorable)
Decipher test ordered.
2nd pathology review in process, too. Waiting on those redults.
Thank you for your suggestions and questions.

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