Advanced PCa

[marmigs]

I was diagnosed with PCa (T1C) in June. PSA 10.2, MRI PRad 4, Gleason score 8 (3 cores 88, 95, 100% grade 5, 2 cores Gleason 6 and 1 core a 7) with pereneural invasion. No detectable Met since Bone and CT scan negative.

After multiple opinions and after Reading the book, The Key to Prostate Cancer (color code Azure) decided upon combo therapy. Hormone (Casadex/Bicalutamide) + radiation via SRBT since I have a high chance of micro Mets.

Looking for similar diagnosis/ treatment experiences from the group.

[Tall_Allen]

How can you have Gleason 8 with '100% Grade 5"? 100% Grade 5 is Gleason score of 10 (Grade Group 5).

SBRT for high risk is available in clinical trials:

pcnrv.blogspot.com/2017/03/...

It looks good so far but you should be aware that it is experimental and most insurance will not cover it outside of a clinical trial.

The standard of care is for high risk is brachy boost therapy (along which you probably will NOT need hormone therapy).

[marmigs in reply to Tall_Allen]

Thanks for your reply. My insurance will cover the SBRT. I will also look into Brachy boost therapy.

I erred typing my biopsy results. I had 3 cores in the target area that were 3+5's. Cancer in each core was 70%, 80% and 100%, perineural invasion identified. Patterns 3, 4, and 5 were identified with Gleason pattern 5 as the minor component. Two cores were 3+3, one 3+4, all 3 of which were outside the target area.

The RO I met with stated there was a high risk of micro mets and recommended SBRT and Casadex for 6 months, starting the drug 2 months prior to SBRT. I have a second opinion meeting with another RO before finalizing my decision.