Decision time following decipher

rel8services

I was Dx with high grade prostate cancer 01/05/24. I had one of twelve biopsied sections showing 2% with a 4+4, leading to a Gleason 8.

I'm 53, single, 3 kids. My PSA started at 7.4 in November of 2023 and is now 10.4. My PMSA shows no spread, fully contained, as of February 2024. I just got my Decipher test back and it was low risk at .44

I also had a genetic test that showed no mutations or risks for other cancers.

I've been pushed towards surgery the entire time, but very scared of living with the side effects and haven't gotten the best feeling from the surgeons I've met with.

Any advice on how to proceed? Is there any benefit to getting another biopsy at this point considering that only 2% showed Gleason 8?

I've been following some metobolic medical plans, but would have no idea if it's had any effect on the tumor or cancer cells.

Steve1961

low risk young man the gold standard is surgery ..find a surgeon that you can trust ..a major institution that has done well over 2500 of them ..younwill beat this .i personally know 5 older men that had surgery they are all cancer free many years later …thats the goal ..

Radical prostatectomy remains the gold-standard treatment for clinically localised prostate cancer. Look it up good luck u will do great.
but then again if your cancer is not aggressive 2% you say is 4+4 what is the rest of it gleason 3 so if 98% of it is 3 +3 radiation could take care of it but I would be concerned a three-point rise in six months is nothing to play around with mine went up three points and five years and I have aggressive cancer and in the last nine months it went up .5 Maybe these are some questions you should ask why would it be going up so fast if it wasn’t aggressive you don’t want to wait too long and have it leave the barn . Not to rile you up over 10 starts to get real concerning maybe go get another PSA test just to make sure maybe you got a false reading or something had made it gone up.just my opinion i’m sitting here on day three after salvage surgery wishing to God I took it out the first time, but that doesn’t mean that will be your case…take care we are here for you ..try not to get too confused .. others will chime in

centralPA

I had one of twelve biopsied sections showing 2% with a 4+4, leading to a Gleason 8.

Did you have an MRI? Did it show a lesion? Does the positive biopsy sample correlate with the lesion?

Josephg

Find yourself a Medical Oncologist who specializes in PCa. This professional is not predisposed to specific treatment therapy options (surgery or radiation), and this professional should be the head of your medical team throughout your PCa journey, and will help guide you in the decision-making processes. Keep in mind, though, these decisions are yours and yours alone to finally make.

Clevelandguy

Hi,

The age old question, surgery or radiation? It really up to you and your doctor team to get you into remission. Both surgery or radiation can give you side effects from mild to severe, there are no guarantees. I had robotic surgery almost ten years ago and don’t regret it, I have been undectable( less than .1u) ever since. Minor ED & I drip a drop every now and then. If you want radiation my choice would be Cyberknife or Proton. Proton has a fixed beam length which means no damage past your cancer location. Surgery side effects happen right away and hopefully get better over time, radiation usually has no side effects to start but can develop over time. Get the best doctors & facilities which should equal the best results. I have included a link for you to study..

https://www.cancer.org/cancer/types/prostate-cancer/treating.html

Dave 3+4