perineural Invasion

[Worked_the_World]

My prostate biopsy has discovered perineural invasion (cancer along nerves) in 4 out of 6 sites with Gleason Score 9 in half of my prostate. This is associated with a significantly worse prognosis for survival. What are experiences of other men with this diagnosis? I am 84, in good health, and preparing to begin ADT in January 2024 and SBRT in April.

[Tall_Allen]

Did you get a PSMA PET scan?

[TJGuy]

Congratulations that your 84 before entering this group, get scanned to see the total involvement first. Don't put it off, have that done in the near future.

[Worked_the_World in reply to TJGuy]

Getting 3 T MRI today, January 9, 2024. Good advice. Biopsy did show Gleason 9 in half of prostate and most regions with Perineural Invasion.

[OsloN]

Same diagnosis in Oct 2019 - 56 months ago. Study BAT + ARSi.

[Worked_the_World]

That is encouraging. I am getting my gold markers inserted this Friday, April 12, 2024 to guide my SBRT starting on April 29. I will have a CT and MRI scan between them. My cancer according to the scans is limited to my prostate, but my Gleason score is 9 for 6 cores on one side and a single 6 on the other. My outlook seems good, but I am starting at 85 very healthy years old. I am unsure of my body's recuperative powers. We will see. The perineural invasion scares the shit out of me.