I Was Diagnosed With PCa Gleason 4+3=7

Sw1218

Here is an informative video that discusses your treatment options.  Before making any decision I would probably seek further tests to confirm the cancer has not, and will not, spread.  In short, if the cancer is highly unlikely to not spread then you have a very good chance of a cure.  All is certainly not lost.  If you have not already done so, I would also suggest you dramatically change your lifestyle and eating habits.

https://www.youtube.com/watch?v=wsFPNLqlE2A

Sw1218 said:

Tests

what tests should have done to confirm whether or not it has or will spread? the MRI i had wrote that there were no central gland abnormalities, no extraprostatic tumor exrtensions and my seminal vesicles were normal. urinary bladder normal, pelvic lymphadenopathy normal and no enhancing pelvic bone lesions. do you think it was caught early?

SW,

A gleason of 7 indicates "intermediate" aggressivity, neither mild nor severe. The percentages reported indicate a fair amount of "volume," or how much room within the gland the cancer is occupying.

The result of "perineural involvement" means that PCa is inside the sheathing, or nerve coverings, inside the gland. It does not mean that it is outside the gland, but it is not something to ignore.   I would meent with both a surgeon and a radiation oncologist to begin planning curative treatment.  It remains a GUESS if there is spread, but very  possibly there is not.  Meet with your doctors and discuss these issues. PCa is always very treatable, and in most cases, curable, or at least cure is a reasonable prospect.  Also, PCa advances very slowly.  The is absolutely no reason to panic because of this.

max

You can look at this study on PNI:  http://cebp.aacrjournals.org/content/26/5/719.  There is data to support the hypothesis that perineural invasion creates a microenvironment that promotes cancer aggressiveness.  You have some decisions to make.  Just do your homework.  Educate yourself.  No need to be afraid or depressed, but be sure and tell your doctors that.  You are still you and you need to address the issues.  The routes to attack this cancer are many, but can limit each other if you have to backtrack and there are side effects to every treatment.  I elected the RP route.  I call it AT (active termination).  You will need to make your own decision on what route you want to take based on the information provivded to you. Good luck on your journey.

SW,

I am sorry for the positive diagnosis. Six out of eight indicates a voluminous case and the Gleason grade 4 refers to an aggressive type in need of an aggressive approach. The MRI doesn't show spread but this sort of exam only verifies deformations. I think that you should pursue a PET examination (68Ga-PSMA) that checks at celular levels therefore more precise in terms of identifying the location of the cancerous cells. You could then decide on a therapy. Any one you chose involves risks and side effects which doubles the consequences if two therapies are to be done.

Your young age will take most doctors to suggest you having any treatment but young people with long expectancy of life are the ones that may lose quality living for many years. Choose wisely what to do. Do your researches on therapies and involve your family in the decision process. In any case, you should receive a clinical stage from your doctor before advancing with anything. PET would be my next approach if in your shoes.

Best wishes and luck in this journey.

VGama

Hi Everybody,

It is fair to say that Steve has been very unlucky, some people have radiation and they recover well.
If you are lucky then you can recover from all the treatments very well and the chances are better if the cancer is small and limited.
Prostatectomy has a high risk of erectile dysfunction, even a skilled surgeon will have around 30% of fit 50 -60 year olds with no previous problems with no erectile function afterwards, other groups, older, etc will fare even worse.
90% of fit 50 - 60 year olds will recover almost total or total continence but that last ten per cent has a few that will have a lot of problems, there are treatments but they have mixed results. Older patients wil fare worse.
A lot of doctors are advocates for the treatment that they practice, you have to do your research on your case and try and make the best decision for you, it is you that will have to live with it for good or ill for the rest of your life.

Best wishes,

Georges

Dr J Hwang's brag sheet seems extremely impressive: over 2,500 R.P.s (a huge number).  Also, he is a professor at Georgetown University Med Center.    

L1917 said:

robotic prostatectomy in dc

anyone know dr Jonathan Hwang?

I did not do surgery but if I did...Dr. Patel has performed 13,000+ Robotic Prostatectomies, Orlando