Advanced Cancer & Options

[YetiGemma]

sorry some of the notes got cut off enlarging print.

Looking to see my best options

Urologist has January surgery scheduled but i am having second thoughts

Was done 10-3 biopsy

OSTATE, NEEDLE BIOPSY-XX

SEE NOTES

VAL DIAGNOSIS:

Prostate, right apex, biopsy: Prostatic adenocarcinoma, Grade Group 1

Leason Score 3-3-6), involving 30% of one core (see comment) .

Prostate, right mid, biopsy: Rare atypical glands.

Prostate, right base, biopsy: Prostatic adenocarcinoma, Grade Group 1

Leason Score 3-3-6), involving 10% of one core (see comment) .

Prostate, right lateral apex, biopsy: Prostatic adenocarcinoma, Grade up let eason Score 3-3-6), involving 15% of one core (see comment) .

Prostate, rigbt lateral mid, biopsy: Benighn prostate gland tissue.

Prostate, right lateral base, biopsy: Rare atypical glands (see

mment) .

Prostate, Left apex, biopsy: Prostatic adenocarcinoma, Grade Group 3

Leason Score 4-3-1), percentage of pattern 4 - 10%, involving 60% of two res (see comment) .

Prostate, Left mid, biopsy: Prostatic adenocarcinoma, Grade Group 2

Leason Score 3-4-1), percentage of pattern 4 - 20%, involving 20% of one re-

Prostate, Left base, biopsy: Benighn prostate gland tissue.

• Prostate, left lateral apex, biopsy: Prostatic adenocarcinona, Grade oup 3 (Gleason Score 4-3-1), percentage of pattern 4 - 10%, involving % of one core. Perineural invasion present.

• Prostate, Left lateral mid, biopsy: Prostatic adenocarcinoma, Grade oup 4 (Gleason Score 4-4-8), involving 90% of one core.

• Prostate, Left Lateral base, biopsy: Prostatic adenocarcinoma, Grade oup 4 (Gleason Score 4-4-8), involving 80% of one core.

INICAL DESCRIPTION:

eOp Dx: Elevated prostate specific antigen -PSA-.

state Volume: 25 GM-ML PSAD: 1.09 PSA: 21.38 Prostatic Urethral

My PSA is 31 not 21

[YetiGemma]

i am in excellent health besides this with no previous surgeries

[Tall_Allen]

So, high risk.

Fill out this nomogram:

mskcc.org/nomograms/prostate

As you can see, your odds of success are not very good with prostatectomy. Talk to one or more radiation oncologists. Especially consider brachy boost therapy.

[YetiGemma in reply to Tall_Allen]

Thanks for your help

The numbers are bleak. How much better with brachy boost therapy

[contrktr]

I had up to 4+4 in both sides, and was close to the margins in 2020.

First, get a PSMA PET SCAN to see where it’s at, and a TEMPUS test to see if it has any mutations.

My PSA was 24 in 2000, a lot of doctors wanted to just do surgery, so I went to three others.

Eventually did wide beam radiation which got it down to .67.

Now they have a new hormonal therapy if it has spread (XTAND is one) which is not as harsh as ADT therapy, but gives you options to use as a mono therapy, with ADT, and radiation.

My doc told me since it was close to the margins it wasn’t going to do the job just removing it, not to mention I didn’t want the two major effects from surgery (incontinence and loss of sexual function).

Get several opinions, make sure you get a PSMA PET, and get in touch with Dr. Sartor at Mayo Clinic, you can do telephone visit.

He is pretty much top guy on prostate cancer in the US and beyond, and is known to all docs.

He will give you a no bullshit assessment.

Most docs just want to remove it without thorough testing.

I went to Mayo (virtual), and had my biopsies reviewed by 4 others including MD Anderson.

It’s all about the equipment they have, the first prostate MRI I had was laughed at by the others because it was such low quality.

Same goes with surgery, (old school or robotic), which you want someone who has done thousands, and radiation machine that is newer and very targeted. You have to ask these questions, they don’t volunteer and I’ve found most doctors do not like to be challenged.

I’d schedule with Sartor, he is top doc in this field.