New Prostate biopsy results

billblack2692

I’m a couple of months from 65th birthday. Just received results from biopsy:

Gleason 3+3=6, Category 1 cancer - most common, low risk.

• It shows perineural invasion, which may slightly raise the concern for spread, but the overall Gleason 6 cancer is usually considered low risk.

MRI showed PiRads 4 lesion contained within prostate.

Most recent PSA 5.64 (up from 4.1 60 days prior)

Live in Atlanta metro - receiving care at Emory. Great facility and reputation.

Still, seeing the C word is a gut punch. Follow up with my urologist this coming Thursday. Most stuff I’m reading says active surveillance is an option. That seems risky/scary??? Am I playing with fire if I take that route?

Wheel

Sorry to welcome you to our group. The perineural invasion is certainly disconcerting along with the jump in your PSA. It is good news that it is Gleason 6, and you are receiving excellent care at Emory. AS is an option but the elephant in the room is the perineural invasion. That as I understand means it had left the prostate capsule and then the next step is into your lymph nodes. It is always possible you have a higher Gleason in your prostate that was missed in the biopsy that has caused the perineural invasion. Have you had a Decipher test or PSMA PET?With a Gleason 6 I know some insurance doesn’t cover the genomic testing or the PSMA PET, however with the perineural invasion maybe they might. It is unusual I believe to have perineural invasion with Gleason 6. If not for that perineural invasion, AS would be a no brainer with a Gleason 6. You will need to defer to your experts at Emory regarding Gleason 6 and the perineural invasion. If they determine AS is somehow an option, then don’t necessarily feel you are playing with fire. AS is active PSA testing, additional biopsy’s, and MRI’s. Generally it is to catch it before it leaves the capsule which again seems it may have so I am not sure about AS.

Wheel

please post an update with your discussion with your Urologist on Thursday. If it is a recommendation for treatment as opposed to AS please feel free to bounce that off everyone. Again sorry you joined us, but everyone here is more than willing to share with you, and Emory is good. All the best.

billblack2692

Thank you, Wheel. I appreciate the feedback and will update this thread after my doctor’s appointment on Thursday.