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Newly Diagnosed with Prostate Cancer 10-29-2020

Jay2512
Posts: 1
Joined: Nov 2020

I am 53 and I was diagnosed with PC on 10-29-2020. I have a Gleason Score 3 + 4 = 7. 12 samples were collected and 5 came back positive. I need information on what treatment I should choose. Bone Scan negative and CT scan negative.

     PSA                      9.20                09/22/2020          
     PSA                      2.55                11/26/2018          
     PSA                      2.63                03/15/2017          
     PSA                      1.92                02/18/2016          
     PSA                      1.56                09/05/2014          
     PSA                      1.90                06/06/2013   

Final Diagnosis
A. Prostate, right base, core biopsy:
- Prostatic adenocarcinoma, Gleason score 3+3=6 (Prognostic grade group 1) involving 5% of the length of one core
- One of two cores involved

B. Prostate, right mid, core biopsy:
- Prostatic adenocarcinoma, Gleason score 3+3=6 (Prognostic grade group 1) involving 5% of the length of one core
- One of two cores involved

C. Prostate, right apex, core biopsy:
- Small focus of atypical glands, suspicious for adenocarcinoma, see comment

D. Prostate, left base, core biopsy:
- Prostatic adenocarcinoma, Gleason score 3+4=7 (10% pattern 4)

(Prognostic grade group 2) involving 70% of the length of one core discontinuously. 


- Prostatic adenocarcinoma, Gleason score 3+3=6 (Prognostic grade group 1) involving 80% of the length of one core discontinuously
- Two of two cores involved
- High grade prostatic intraepithelial neoplasia

E. Prostate, left mid, core biopsy:
- Small focus of atypical glands, suspicious for adenocarcinoma, see comment

F. Prostate, left apex, core biopsy:
- Prostatic adenocarcinoma, Gleason score 3+3=6 (Prognostic grade group 1) involving 30% of the length of one core  discontinuously
- One of two cores involved

Prostate Grade Group
The highest Gleason score is 3+4=7 (Prognostic grade group 2)

  

Clevelandguy
Posts: 693
Joined: Jun 2015

Hi Jay,

The treatment plan to choose is the best one for your chance of being cancer free.  The 3+4 is on the slightly agressive side(more than a 3+3).  With that being said you need to study the two basic forms of treatment most people choose which is some  form of radiation or surgery.  The American Cancer Society has some good basic info on all of the types currently being offered.  Each different treatment offers it own unique side effects and benefits.  The only other way is with Active Surveliance which means monitoring the cancer growth via biopsy every so often but at 3+4 if it was me I would not go that route. With my cancer I wanted to know where in the prostate my cancer was ie; deep inside or right at the edge of the gland which gave me an idea on how fast I needed to move.  The choice is between you, your doctor(s) and family based on the diaganostic tests done so far.  Great doctors + great facilities = great results.  I have included some links to get you started.

https://www.cancer.org/cancer/prostate-cancer/treating.html

https://www.webmd.com/prostate-cancer/guide/prostate-cancer-treatments#1

 

Dave 3+4

 

hopeful and opt...
Posts: 2331
Joined: Apr 2009

A CT scan is not the best scan. A preferred scan is T3 MRI which may show extracapsular extension, that is if cancer has escaped the capsule. This is important to determine the best treatment. 
Also the American Urological Association does not recommend a bone scan for men who do not have a Gleason 8 or above since the results arehighly like  to be negative. 

SBRT aka Cyberknife is a high dose radiation treatment that you may wish to consider among other treatments . Depending on the doctor there are 4 or 5 treatments within two weeks. 

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3666
Joined: May 2012

Jay,

A CT is of little value in spotting PCa, at least until it is widely metastatic and the tumors have gotten large, and your results thus far do NOT suggest such a scenario for you.    A CT will not ordinarily spot tumors smaller than around 4 MM, and early PCa tumors are almost never that big.   An MRI is much more useful in spotting early PCa, as Hopeful noted.    I learned most of this through (1) my own PCa journey, and (2) LOTS of CTs and PETs during my 10 year journey with Lymphoma.

Tech70
Posts: 69
Joined: Nov 2017

With only one of the positive cores being scored Gleason 3+4, I would strongly suggest you get a second pathologist to evaluate your slides.  I have twice had a biopsy sample rated at G 3+4.  I had the sample sent to Dr. Epstein at Johns Hopkins for re-evaluation and both times the result was a re-rating of 3+3.  If your cancer is Gleason 6, you might be a candidate for Active Surveillence. I have been on AS since being diagnosed 3 years ago, and my cancer shows no signs of progressing.

Old Salt
Posts: 808
Joined: Aug 2014

In addition to the advice given above, 'regulars' on this forum typically emphasize to get second opinions on proposed treatment plans. Also, urologists are surgeons and often recommend surgery. To get good advice on radiation therapies, you should definitely consult with a radiation oncologist.

PS: my urologist (bless his heart) actually recommended radiation for me...

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