Decision Time

[NickyDJr]

Getting ready to make a treatment decision now that all my tests are in.

Age 64

Good health

Stage T2C

Gleason 6/7 (3+3 and 3+4)

Total body bone - nothing indicated

Genomic - high risk

Consulted with a surgeon and radiologist

Thoughts?

Experiences?

Thank you all!

[GP24]

You write "Genomic - high risk". What does that mean in your case, what makes you high risk? Also, what do the surgeon and the radiologist recommend?

[NickyDJr in reply to GP24]

The genomic test indicated a 33% chance of recurrence and a 10% chance of the cancer to metastasize. The radiologist and surgeon say that I am a good candidate for both treatment options.

[GP24 in reply to NickyDJr]

A 10% chance to metastasize is no high risk. Did you discuss active surveillance with your doctors? It depends on how many biopsy probes are 3+4 and how much 3+4 tumor the probe contains.

There is no need to hurry. You could think about your decision for the next three to four years without changing your prognosis. Hard to believe, I guess.

[addicted2cycling in reply to NickyDJr]

Did you obtain a second opinion?

Did you have a 3TmpMRI??

If biopsy results were from a TRUS method, be aware that VERY LITTLE of the prostate is sampled thus leaving much UNKNOWN and possibly deadly.

AS Active Surveillance can still be an option

[GDeG]

No other treatments(RP, radiation,...)? When was it diagnosed? What's your PSA?

[Cooolone]

You leave a lot out... Biopsy results indicating the amount of Gleason present in which cores, how many cores, etc. MRI results, PSA history, general health and family history. What type of genomic test was performed?

And there's no such thing as having 2 different Gleason scores, it always defaults to the higher grade. So you have G7 (3+4), again, what percentages...?

In my opinion, Gleason 4 is a game changer as there are no recorded deaths from patients having G6 (3+3)... It's not an agressive subtype and is why AS is the best path forward for those patients having identified G6. And to be sure, diagnosis is the most important part of the game you're in right now. If you haven't had your slides and scans 2nd opinioned, that would be a mistake, prior to making any decision! Of course, John Hopkins is the Gold Standard for this and even out of pocket is affordable and well worth it. And as constantly noted, with PCa there is time to make a decision, so don't feel rushed just because "CANCER"... Not sure why you've chosen "Advanced" as G7 truly is not in this category. But that's ok, the information is all the same. Lastly, if you aren't already there, find a Major Cancer Center, and one of Excellence for your treatment! Results are the best, with the most skilled oncologists being at these institutions, as well as having access to trials and testing not always available locally. Understand that the diagnosis, the tech or doctor viewing the scans is directly proportional to the accuracy. And sending the tests for a second look, especially by someone not vested in the treatment modality provides the ability to make sure you're getting an objective opinion based on what's seen, not that they have an opening next week on the table! Anyways...

Best Regards

[bluesnjazz]

Whatever you decide, don't allow yourself to be pushed into anything quickly and without doing your own research!