What are my chances of recurrence? - Advanced Prostate...

Advanced Prostate Cancer

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What are my chances of recurrence?

5_plus_4 profile image
5 Replies

With a Gleason score of 9, PSA 8.7, SVI+, Positive margins, extra-capsular extension, Stage T3b, what are the chances of recurrence? I've had RALP and 37 days of radiation.

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5_plus_4
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5 Replies
MichaelDD profile image
MichaelDD

July 2016 had Gleason 8, PSA 12 exactly what you have/had but 39 radiation sessions and I had persistent PSA after prostate removed at .024 . Went into radiation at .042 and came out .080. Doubling every 2.9 to 3.4 months. Today I am 1.350 expect in October to be 2.5 to 3. Getting GA68 Scan and after starting HT .

fredfrange profile image
fredfrange

with medical treatments around 100% -seen this to many yrs-- Fred

Tall_Allen profile image
Tall_Allen

Here's a nomogram that shows the odds that salvage radiation will be successful:

riskcalc.org/ProstateCancer...

Break60 profile image
Break60

If like me, Very high. See my profile.

Bob

maack1 profile image
maack1

With the pathology report following surgical removal of your prostate gland indicating positive margins and extra-capsular extension, I'm not even sure SRT should have been the next step without first imaging to determine if already metastatic. But be that as it may, sounds just like my pathology report way back in December 1992 when I, too was followed with SRT because the Urologist wasn't sure he "got it all." My Gleason was only 3+4/7 and three years later I experienced recurrence and on ADT ever since. I would certainly see ADT prescribed in near time for at least a year and during that time see if PSA drops in the ultrasensitive range to near undetectable. Or, while under ADT treatment, if you find your PSA not dropping below 1.0ng/dl, you might should look into imaging to determine if metastases can be detected either within the prostatic bed or external elsewhere. Several locations now have the radiotracer/isotope fluciclovine (Axumin) available to be injected then imaged with F18 PET/CT. This is a very sensitive product that travels only to prostate cancer cell activity thus locating where further treatment may be necessary. Medicare covers the product. Or, if living near Rochester, Minnesota and the Mayo Clinic there, C-11 Choline PET/CT imaging is available there also covered by Medicare. C-11 Sodium Acetate PET/CT, another form of precise imaging is available in Phoenix, AZ and at the University of Kansas, but the last I was aware the actual sodium acetate product was not yet covered by Medicare though the PET/CT imaging was. The product cost in Arizona was being charged at $3000 out-of-pocket and at the UK at $2500 our-of-pocket.

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