Advice / Opinions needed for My Brother Biopsy Results GL 6

[Shorehousejam]

I understand this may be the wrong group to post in,

After my husband’s diagnosis. I had my brother do a PSA test it was 12…

It Rose from 11 to 12 in a month.

So these are his biopsy results….What should he do to treat?

A.  Prostate, Target #1, Core Needle Biopsy:  - Benign prostatic tissue.  

B.  Prostate, Target #2, Core Needle Biopsy:  - Benign prostatic tissue.  

C.  Prostate, Target #3, Core Needle Biopsy:  - Prostatic adenocarcinoma, Gleason score 3 + 3 = 6/10 (Grade group 1), measuring 6.5 mm in total length, discontinuously, present on 2 out of 2 tissue cores, accounting for approximately 26 % of total volume of biopsy tissue.- The maximum tumor length in a single core is 3 mm in a 14-mm core. 

 D.  Prostate, Left Base, Core Needle Biopsy:  - Prostatic adenocarcinoma, Gleason score 3 + 3 = 6/10 (Grade group 1), measuring 7 mm in total length, discontinuously, present on 2 out of 2 tissue cores, accounting for approximately 36 % of total volume of biopsy tissue.- The maximum tumor length in a single core is 3.5 mm in a 11-mm core.

  E.  Prostate, Left Mid, Core Needle Biopsy:  - Prostatic adenocarcinoma, Gleason score 3 + 3 = 6/10 (Grade group 1), measuring 3.5 mm in total length, present on 2 out of 2 tissue cores, accounting for approximately 14 % of total volume of biopsy tissue.- The maximum tumor length in a single core is 2.5 mm in a 12-mm core.  

F.  Prostate, Left Apex, Core Needle Biopsy:  - Benign prostatic tissue.  

G.  Prostate, Right Base, Core Needle Biopsy:  - Atypical small acinar proliferation (ASAP). 

 H.  Prostate, Right Mid, Core Needle Biopsy:  - Benign prostatic tissue.  

I.  Prostate, Right Apex, Core Needle Biopsy:  - Benign prostatic tissue.  

NOTE: Prior treatment with Finasteride is noted.

Immunostain for the basal cell markers (CK903 and p63) was evaluated for part C, D and G of this case, supportive of the above diagnosis. 

The selected slides of this case were reviewed by one or more pathologist(s) in the Division of Surgical Pathology, who concurred with the diagnosis. Electronically signed out and reported at MOSES.I certify that I personally conducted the diagnostic evaluation of the above specimen(s) and have rendered the final diagnosis(es).

[Shorehousejam]

Thank you

[Tall_Allen]

Active surveillance, defin.itely

[Shorehousejam in reply to Tall_Allen]

His PSA rose from 11 to 12 in 40 days, do you still think AS, plus when dos he decide on Radiation or RP, at what mile stone does He decide more aggressive therapy?

[Tall_Allen in reply to Shorehousejam]

His PSA is attributable to his BPH. He opts for treatment upon grade progression. He should be enrolled is an AS program rather than do it on his own.

[Shorehousejam in reply to Tall_Allen]

Would that be at his hospital? Montefiore? They also have a prostate cancer center…Thank you again

[Tall_Allen in reply to Shorehousejam]

I would assume Montefiore has an active surveillance program. He can ask.

[tango65]

Consider getting a second opinion of the diagnosis with Dr Epstein at John Hopkins. You just need to contact them and send the slides to his lab. One has to be sure the classification of the cancer is correct.

hopkinsmedicine.org/profile...

[Rocketman1960]

Second opinion followed by RP. Kill the host.

[Gl448 in reply to Rocketman1960]

RP for a GL 3+3=6 seems extreme. The side effects of an RP could be worse than the disease.

Shorehousejam, how old is your brother? Many “older men” with GL<7 will die with PCa, not from PCa…

[Rocketman1960]

except a large percentage of Gleason scores are upgraded post RP. I don't have a crystal ball. Only saying what I would do. Robotics have gotten very good.