Waiting 6 to 7 months for Prostate surgery
Hi friends I am new to this forum. Husband diagnosed with Prostate ca Gleason 7 (3+4) stage II. MRI and PSMA pet scan show it is contained within the prostate. We liven Canada and have a long Queque, so surgery will only 6 to 7 months frm date of diagnosis. Scared to wait so long for surgery. Amy opinions/advice? Has anyone waited this long and been ok? your inputs will be greatly appreciated!
Thanks!
Comments
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Hi there and sorry you and your husband are dealing with this. Do you have additional information such as size of prostate, psa value, number of cores positive and % positive (including % of gleason’s 4)?
These additional details may describe if your husband is Group 2 low, intermediate, or high risk which would add more to answering the delay question.
The good news is in most cases Pca is very slow growing and a six to seven month delay does not change the outcome. I had Group 2 intermediate risk and delayed my surgery for a year.
jc1 -
Hi,
I would ask the doctor(s) to look at the scans to determine the location of the cancer. If it’s deep in the middle of the Prostate or close to the edge. As stated above if its small and centrally located waiting for 6-7 months might not be bad. If it’s near the edge and waiting to break through the wall of the Prostate that time frame could be problematic. Is there a shorter wait time for some form of external beam radiation which has about the same remission percentage as surgery?
Dave 3+4
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Studies have shown regardless of diagnosis state, a 6 month wait from time of diagnosis until Surgery has shown no change in suvival outcome lengths. These studies were done because Doctors needed to know how long was a reasonable wait, because from actual diagnosis to scheduling PET Scans, genomic testing, more scheduling time for appointments for second opinions with Radiation and Surgical Doctors, then surgeons calendar. Certainly some patients get through this under 3 months, I was five, but waited for 6 and 1/2 to get daughter back off to college. I would not worry too much.
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Thank you so so much for taking the effort to upload this video! This was so helpful and has really reduced my stress levels! Thanks a million!
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Hello, thanks for replying! and for sharing your information. I have answered your questions below
Age 68. Gleason 7 (3+4) 3 out of 15 cores positive. 2 cores were 3 plus 3, 10% and 15%. One core was 25% positive with 3 being 75% and 4 being 25%. Report says 4 is less than 10%. but when i do the calculation it is 6%. No Cribiform. it is Acinar adenocarcinoma. On both sides of prostate but contained within the prostate. Not sure of the location. Looks like three spots on the prostate, largest one in 10mm. If the prostate is like an oval, one seems to be kind of in one corner, is that close? No spread seen in MRI or PSMA Pet scan. We were classified as intermediate risk. My Surgeon is one of the best in the city and so the waiting list is long. 6 to 7 months from date of diagnosis. Refused to prescribe ADT during wait.
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Hello Jc5549, Thanks for replying! and for sharing your information. I have answered your questions below
Age 68. Gleason 7 (3+4) 3 out of 15 cores positive. 2 cores were 3 plus 3, 10% and 15%. One core was 25% positive with 3 being 75% and 4 being 25%. Report says 4 is less than 10%. but when i do the calculation it is 6%. No Cribiform. it is Acinar adenocarcinoma. On both sides of prostate but contained within the prostate. Not sure of the location. Looks like three spots on the prostate, largest one in 10mm. If the prostate is like an oval, one seems to be kind of in one corner, is that close? No spread seen in MRI or PSMA Pet scan. We were classified as intermediate risk. My Surgeon is one of the best in the city and so the waiting list is long. 6 to 7 months from date of diagnosis. Refused to prescribe ADT during wait.
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Thank you for replying Clevelandguy! We have opted for surgery. Yes I will check out the location of the spots. That was a good point to consider I agree.
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Thank you so much for replying and giving me your information. Can you please let me know your Gleason score and stage if that is ok with you?
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Srry forgot to mention PSA was 8.5
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I was initially staged Gleason 8 (4+4). I had other cores Gleason 7 favorable (3+4). I also had cribriform but did not know until pathology after Surgery. After surgery I was also downgraded to Gleason 7 unfavorable (4+3). That was good that your Doctor did not want to do ADT prior to surgery in your husband’s case, it would appear unnecessary and subjected your husband to unnecessary side effects. Have you had genomic testing like Decipher or urine testing called ExoDx, both of these tests can provide information regarding the potential for the cancer being aggressive. I would not be concerned about the waiting time until your surgery.
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Prostate is enlarged measuring ~ 4 x 4.5 x 5.5cm (vol – 49.5ml).
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Thank you! yet to get the decipher and urine tests. Will ask for it during our next visit.
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I was in the same situation except with a Gleason 8. I chose robotic surgery. In eastern US I only had a 3 month wait. By the time I got my surgery the cancer had grown to the membrane of the prostate which means cells could have escaped. I have to get tested every 3 months for a minimum of 2 years as there is a possibility of it metastasizing. Sorry for this news but it must be said. Keep in mind that everyone is different. Mine was considered the worst type of pc to get. As of my first test my PSA is.03. I wish you all the best in this journey!!
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Oh no! Thanksod for letting me know. By God's grace my husband will be starting Orgovyx in a couple of days. Just keeping ourr fingers crossed for the best outcomes..
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Can you please tell me the pathology after surgery? were you downgraded or upgraded?
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Thanks! Can you please tell me if the pathology after the surgery was the same or upgraded?
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Shalom,
Did your doctor change his mind on prescribing the ADT drug Orgovyx? I don't believe Neoadjuvant ADT is a standard of care? I have been taking Orgovyx for about nine months and Zytiga for about 7 months. At least for me the side effects of Orgovyx (Relugolix) alone were very tolerable. Once I started taking the Zytiga (Abiraterone) the side effects amplified, but although very annoying, still tolerable. Seems logical that controlling the bandit while waiting for a prostatectomy would make sense. I'm wondering why it's not done routinely? At least I haven't heard of this being a usual approach.
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I think becuase we have already waited 3 months and it may take another 4 months at the least. Also we asked for it.
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