high risk (4+4) diagnosis with moderate PSA (4.2)

Wheel

Decipher can be used between intermediate and advanced on whether to go surgery or accept need for Radiation plus 2 years ADT, or possibly 18 months ADT, or anticipate even with surgery go to adjuvant Radiation plus ADT. One core of a Gleason 8 considered advanced with an intermediate or less Decipher would still likely not be an AS case but could be a decision factor as to going with just surgery and not radiation with hormone treatment. That being said there are other factors also that could affect surgery as outside capsule, lymph nodes etc. more information is better than less

skl8r

https://csn.cancer.org/discussion/comment/1722985#Comment_1722985

thanks wheel, I will ask for that test... I'm firmly of the belief in knowledge. I know the decision is mine of who to trust and what to believe.

(Drs keep asking me if I was in a medical field ;) but no, just physics and computers! they don't have to simplify things down for me)

Old Salt

Once upon a time surgery was the gold standard, but radiation therapies have come a long way in the last decade or so. Even the urology association has stated such:

Clinically Localized Prostate Cancer: AUA/ASTRO Guideline (2022) - American Urological Association

See items 8-16.

Each case must be looked at carefully and often there is more than one option.

Wheel

Old Salt,

Absolutely each person’s case needs to be individually looked at. After looking at your link which is really lays bare current recommendations, I am dizzy. I am just glad I am past all that part.

Clevelandguy

Hi,

Whether it’s radiation of some form or surgery look into the potential side effects vs the benefits. There have been good and bad results with both treatment paths. One other thing about Proton vs other external beam radiation. If you have external beam and max out an area with future external beam you can use Proton in that area where you can’t use external beam. If the Proton fails, you can use it again in the same area. And despite claims that Photon is more precise than Proton is not true from what I have read. Most credible sources rate them equal. Just another tool for the tool box…..

Dave 3+4

Paul_Cancer_Survivor

https://csn.cancer.org/discussion/329411/high-risk-4-4-diagnosis-with-moderate-psa-4-2

Your urologist likely is not as familiar with the relationship between your Gleason Score and PSA levels as your oncologist. It is great that you have had a PSMA-PET Scan, this is superb technology. To grasp the significance of your numbers, I'd respectfully suggest you simply ask your oncologist. If you have both a medical oncologist and a radiation oncologist, ask both. They're the ones who know your situation and can give you a good, informed answer.

Best wishes and stay mentally strong. You can beat this.

skl8r

my oncologists all say there's not really any significance to the question other than suggesting that maybe it isn't a big tumore - though it actually is fairly large. that is easy to see on MRI, which was the first test I had so - no big deal ;)