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Oct 08, 2017 - 3:35 pm
Im 63 white male with a PSA of 4.31, clinical stage T2a and Gleason score of 4+3=7. Biopsy showed 5 of 12 cores, all on right side. PTI was 1 to 5% for 4 cores and 60% for one. All came back as perineural invasion not identified. Currently scheduled for RP surgery by Davinci in 6 weeks. A friend's father swears by Cryotherapy as a success after a reoccurence following radiation treatment ten years ago. Given my condition is cryotherapy an option or is it reserved for reoccurence after radiation? Is there any other imaging performed now that would assist surgeon in operating room? |
Joined: Apr 2009
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Bill,
Diagnostic tests that I think will be appropriate for you.
what did the digital rectal exam reveal in your case (finger wave that the doc did in your rectum)
What is your psa history.
Your age
Determining Gleason scores are subjective, so you may wish to have your slides sent to a world class pathologist for a second opinion. For the most part your treatment is based on the pathology of your slides. A few world class pathologist are David Boswick, VA, Francisco Civantos, Fl, Jon Epstein Maryland, David Grignon Michigan, John McNeal CA, Jon Oppenheimer Tennessee Dainon Laboratories.....I have these telephone numbers if you so wish.
Image test....it is very important for you to have a 3T multiparametric MRI. This image test may show if there is extracapsular extension, that is, if the cancer has spread outside the capsule..this information is critical in treatment choice.
Also if necessary a PET scan.
..............
There will be 100 percentchance of eretile dysfuncion with cryotherapy.
Come back to us with the details of your case.
I strongly suggest that you consider a form of radiation. a raadiation oncologist has the ability to extend the perimeter of the treatment beyond the prostate. In your case there is a high chance that the cancer has escaped the prostate. One form of radiation that men on this board have had a lot of success with, with limited side effects is SBRT.
Surgery is for localized cancer, within the prostate. The results are age related, older you are the more side effects.
The side effects from surgery versus other treatments are the greatest and most severe; erectile dysfuncion, incontinence, etc
Come back with more info and questions
we are here for you.
Joined: Jun 2015
Get the tests done
Hi,
The MRI should guide the doctor(s) doing what ever proceedure you choose. Talk with a urologist and see if he reccomends any additional testing if you are sticking with surgery. Also might not hurt to get a second opinion with another oncologist or urologist to see what they recommend. Both radiation & surgery have side effects mostly incontinence & ED, check out other posts on this forum to get the straight story.
Dave 3+4
Joined: Mar 2010
Risk of ED Higher
FWIW, the risk of ED from cyrotherapy is reportedly even higher than for surgery, so if avoiding ED is a concern of yours, you should probably avoid pass on cyro.
Joined: Jun 2015
Choice?
Hi,
If you want to do the cyro then I would do a lot of study on it and also see if you doctor can let you talk to some cyro patients to get their viewpoint. Need to also look and see what is after(treatments) cyro if that fails to keep the cancer at bay.
Dave 3+4
Joined: Aug 2014
The 'official' word from the AUA
Whole Gland Cryosurgery