Tylex Intro

[TylexGP]

Just realized I never completed my profile so here is what brought me here. After waiting 8 weeks for a MRI Fusion biopsy the results showed mostly Gleason 9 (4+5) and one Gleason 9 (5+4). Bone Scan was negative and CT showed a suspect pelvic node when reviewed by Memorial Sloan Kettering radiologists. I met Medical Oncologists, Radiation Oncologists and Surgical Uro-Oncologist.

PSA = 4.1

Gland ~ 4.0 x 2.7 x 5.0 cm.

Volume = 28.0 gms.

PSAD = 0.14

PSA2 = 20%

DIAGNOSIS

A PROSTATE, LL APEX; CORE BIOPSY: INVASIVE PROSTATIC ADENOCARCINOMA, GLEASON

SCORE 3 + 4 = 7, GRADE GROUP 2, (5% CRIBRIFORM GLANDS), INVOLVING ONE OF ONE

CORE; 9 MM TUMOR LENGTH (80% OF PROSTATE CORE); PERINEURAL INVASION PRESENT.

B PROSTATE, L APEX; CORE BIOPSY: INVASIVE PROSTATIC ADENOCARCINOMA, GLEASON

SCORE 3 + 4 = 7, GRADE GROUP 2, (5% CRIBRIFORM GLANDS), INVOLVING ONE OF ONE

CORE; 12 MM TUMOR LENGTH (90% OF PROSTATE CORE).

C PROSTATE, LL MID; CORE BIOPSY: INVASIVE PROSTATIC ADENOCARCINOMA, GLEASON

SCORE 4 + 5 = 9, GRADE GROUP 5, WITH INTRADUCTAL CARCINOMA, INVOLVING ONE OF ONE

CORE; 12 MM TUMOR LENGTH (85% OF PROSTATE CORE).

D PROSTATE,

L MID; CORE BIOPSY: INVASIVE PROSTATIC ADENOCARCINOMA, GLEASON

SCORE 4 + 5 = 9, GRADE GROUP 5, WITH INTRADUCTAL CARCINOMA, INVOLVING ONE OF ONE

CORE; 13 MM TUMOR LENGTH (90% OF PROSTATE CORE).

E PROSTATE, LL BASE; CORE BIOPSY: INVASIVE PROSTATIC ADENOCARCINOMA, GLEASON

SCORE 4 + 5 = 9, GRADE GROUP 5, WITH INTRADUCTAL CARCINOMA, INVOLVING ONE OF ONE

CORE; 12 MM TUMOR LENGTH (80% OF PROSTATE CORE).

F PROSTATE, L BASE; CORE BIOPSY: INVASIVE PROSTATIC ADENOCARCINOMA, GLEASON

SCORE 4 + 5 = 9, GRADE GROUP 5, WITH INTRADUCTAL CARCINOMA, INVOLVING ONE OF ONE

CORE; 13 MM TUMOR LENGTH (90% OF PROSTATE CORE).

G PROSTATE, RL APEX; CORE BIOPSY: INVASIVE PROSTATIC ADENOCARCINOMA, GLEASON

SCORE 3 + 3 = 6, GRADE GROUP 1, INVOLVING ONE OF ONE CORE; 1 MM TUMOR LENGTH

(10% OF PROSTATE CORE); PERINEURAL INVASION PRESENT.

H PROSTATE, R APEX; CORE BIOPSY: INVASIVE PROSTATIC ADENOCARCINOMA, GLEASON

SCORE 4 + 5 = 9, GRADE GROUP 5, WITH INTRADUCTAL CARCINOMA, INVOLVING ONE OF ONE

CORE; 3 MM TUMOR LENGTH (20% OF PROSTATE CORE); PERINEURAL INVASION PRESENT.

I PROSTATE, RL MID; CORE BIOPSY: BENIGN PROSTATIC TISSUE.

J PROSTATE, R MID; CORE BIOPSY: BENIGN PROSTATIC TISSUE.

K PROSTATE, RL BASE; CORE BIOPSY: BENIGN PROSTATIC TISSUE.

L PROSTATE, R BASE; CORE BIOPSY: BENIGN PROSTATIC TISSUE.

M PROSTATE, RO1 #1 LM AXIAL; CORE BIOPSY: INVASIVE PROSTATIC ADENOCARCINOMA,

GLEASON SCORE 4 + 5 = 9, GRADE GROUP 5, WITH INTRADUCTAL CARCINOMA, INVOLVING

TWO OF TWO CORES; AGGREGATE TUMOR LENGTH 20 MM (95% OF PROSTATE CORES).

N PROSTATE, RO1 #1 LM SAG BASE; CORE BIOPSY: INVASIVE PROSTATIC

ADENOCARCINOMA, GLEASON SCORE 5 + 4 = 9, GRADE GROUP 5, WITH INTRADUCTAL

CARCINOMA, INVOLVING TWO OF TWO CORES; AGGREGATE TUMOR LENGTH 22 MM (95% OF

PROSTATE CORES).

Due to the intraductal component, I chose to go with ADT plus Zytiga with HDR Brachytherapy (7/26/2021). EBRT scheduled to start 8/23/2021.

[Tall_Allen]

Good choice!

[Fightinghard]

Welcome. Treatment plan sounds like a good starting point. Stay strong