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PSA 7, Adcnocarcinoma of the prost:rte Gleason score 3+3

CLINICAL DIAGNOSIS: DRE – Normal prostate

NATURE OF SPECIMEN: Prostate biopsy

GROSS MORPHOLOGY:

1l Left. slde: Specimen of 7 cores ranging in size from 1.5-1 cm. AII embed-A

2) Right side: Specimen of Tcores ranging in size from 2.5-1 cm. A11 embed-B

MICROSCOPIC DESCRIPTTON & IMPRESSION:

1 , ProstaLe, left side (core biopsy) : * Adenocarcinoma of prostate, acinar tlpe.

– Gleason score is 3+3 = 5, out of 10.

– Tumor invo1ves all cores, with an overal-1 average of 20%.

– Perineural invasion is present.

2 ,Prostate, right side (core biopsy) :

– Adenocarcinoma of prostate, acinar trce.

– Gleason score is 3+3 = 6, out of 10.

– Gleason score is 3 out of 7 cores, wlLh an owerall average of <10%;.

– Perineuraf invasion is present.

MRI PELVIS :Urinary bladder is normal in size and signal intensity. No focal mass lesion,/

calculi. Wall thickness is normal.

Prostate is mildly enlarged in size. Lateral aspect of the peripheral gland

on both the sides appear hyperintense on T1, turning hypointense on T2-

suggestive of bleed. Post contrast study demonstrates minimal

inhomogenous enhancement.

/ ,llowever, no extracapsular spreadr/seminal vesicle extension/neurovascular bundle involvement.

Solitary lymph node is seen adjacent to the external iliac artery on either

side. Largest on the right side, measuring 9.0×6.0rnm in size.

Seminal vesicles appear normal.

Pelvic bones and joints are normal.

No free fluid seen in the pelvis.

Spermatic cords show normal signal intensity.

No evidence of focal lesion.

Bilateral testis and epididymis are normal.

No evidence of hydrocoele.

IMPRESSION: KnownIMPRESSION: Known case of Ca prostate, post biopsy.

Present study shows:Haemorrhage in the lateral aspect of peripheral gland on both sides .

solitary lymh node adjacent to the external iliac artery on either side-? Metastatic .

No scinitigraphic evidence of skeletul metastases.

what treatment should I opt. Till now I have  no symptoms . . when I went for regular medical check up before 60 days this result came out

7 Replies

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  • Thanks for sharing. Good luck in deciding what treatment to follow. You did not say your age. Different treatments are recommended for different ages. For me I had surgery. I am 62.

  • I am also 62 . same age .

  • TSKD I recommend surgery. It has to be your choice. 

  • How old are you? I was 52 when I was diagnosed with PC. I did have several symptoms. I elected to have surgery. That was in 2011. Non detectable PSA since then.

  • At minimum..., DO NOT IGNORE WHAT YOUR BODY IS TRYING TO TELL YOU!   Prostate Cancer is curable, but only if taken care of early.  Once the cancer is out of the prostate gland, it's a whole different and far more serious illness. 

  • I am not a doctor and don't even pretend to understand all the information from your biopsy which you provided. In my case, I was a Gleason 7 (3+4) in one core and 6 (3+3) in five others in my first reading of my slides, and 7 in three cores and 6 in three in the second reading. In both cases the concentration (right term? Density? % cancerous?) was relatively low. There was no indication of spread beyond the prostate  

    My best friend (who is also a physician) strongly recommended "cold, hard steel", i.e. Surgery. Nevertheless, I researched and spoke to radiologists as well as surgeons, paying attention to what is really involved in preparing for and undergoing the various procedures, AS WELL AS LISTENING TO THE EXPERIENCE OF MEMBERS OF PROSTATE CANCER SUPPORT GROUPS, particularly as to the side effects of each course of action. 

    I chose to have a robotic laparoscopic radical prostatectomy at Memorial Sloane  Kettering with Dr. Laudone. However, as mentioned, I also spoke with the head of the MSK Radiology practice, as well as with other physicians and others who had undergone either brachytherapy or external beam radiation in one or another of its forms. 

    There is an article by Dr  Zelefsky (et al.) about quality of life several years following each of the major treatment alternatives, published in a professional urology journal recently.

    Also, one fact about MSK which was important to me was the high degree of coordination among the doctors and departments -- their doctors are all on salary, rather than looking at each patient as their next fee --, with everybody aware of what everybody was doing, test results shared, etc.  While the choice was mine, I felt that everyone was motivated to determine the best course for me.

    At another hospital -- also eminent -- I called the number given for a center which was focused on coordination among treatment methodology practices (eg, "the XY&Z Center for Treatment Coordination" or some such), and the person answering the phone did not even know what it was!

    The whole experience was also remarkably un-bureaucratic, which is amazing, given the complexity of hospitals. AND, MSK doctors will follow my condition for 15+ years to come. 

    Best of luck in determining the right treatment for yourself. 

  • I should have added that you should have at least two readings of your slides (which everyone will tell you). At MSK, I was surprised that the surgeon was hopeful that the second reading would come back LOWER than the first, which would have made Active Surveillance an option.

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