experience with AS at MSK

[cspat]

hi!

I was diagnosed with a gleason 3+3 , 2 of 12 positive cores worst being 17%

My psa is 5.1 I’m 69 years old I had a consult with an oncologist at a local cancer specialist and am scheduled for another consult at MSK

What can I expect at MSK? Will they go over all the options? The first oncologist touched on surgery and radiation but did not discuss them in depth and went right to AS. I want to make sure I know all the optipns and pros and cons before committing to AS

[pd63]

Get a 2nd opinion on your biopsy results and a decipher check but initially your results are very much in the AS domain

[cspat in reply to pd63]

thanks for advice

[Azbound in reply to pd63]

Exactly. And research on your own.

[Tall_Allen]

MSK does a team approach.

[cspat in reply to Tall_Allen]

Will MSK do a genomic test automatically? Do you know if they'll review the slides from the biopsy to conform the gleason score?

[Tall_Allen in reply to cspat]

Yes and yes.

They do germline on all patients.

[cspat in reply to Tall_Allen]

thanks! Good to know

[GrnPndr]

I was in a similar situation. Consider this, you have cancer. Why wait to treat it? Early detection and treatment produces the best results. If any of the horses get out of the corral (outside of prostate) then you’re looking at an entirely different scenario. I have been in a PCA support group for 3 years since treatment and there have been several AS men who regret waiting. I’m not a doctor and not giving medical advice. Just for consideration. Good luck.

[cspat in reply to GrnPndr]

thanks for the advice

Did you opt for surgery or radiation?

[addicted2cycling in reply to cspat]

cspat - You had this reply in your other thread --

" ... NanoMRI-2 days ago-My initial Gleason opinion was 3+3. Second and third opinions 3+4. Final after RP, 4+3, with spread. All the best!... "

I bolded the HIGHER Gleason score + spread that resulted for NanoMRI following removal of his prostate AND IMO it behooves you to be aware that a TRUS biopsy even if guided by MRI can MISS HIGHER GRADE GLEASON.

Men begin AS believing they only have 3+3 and later find that *4's* were present and sadly often when metastasizing occurred. PLEASE go to greater lengths to assure that you ONLY HAVE 3+3.

Good Luck

[cspat in reply to addicted2cycling]

thanks

It’s something to consider before choosing a treatment

[Rbourn]

My experience at MSK is that they are very thorough and will provide you with recommended options and explain them. Great experience with prostate cancer at that hospital.

[cspat in reply to Rbourn]

Good to know!

[GrnPndr]

I had Proton radiation treatment at California Protons in San Diego, CA..

[Laguy01 in reply to GrnPndr]

What is your prognoses after proton therapy.

[GrnPndr in reply to Laguy01]

For my situation the doctor said statistically, 99% cure rate without the side effects of photon radiation.

[minnowman]

Proton therapy. I had mine at HUPTI in Hampton Roads, VA...

[Laguy01]

awesome. I finished Proton treatment. Waiting to go back to doctor for check-up. I am on ADT meds. Not happy with them but I have minimum side effects.

[rocketman42]

I was treated at MSK with SBRT by Dr Michael Zelefsky in 2017. No ADT. He and his team were terrific but he has since moved to NYU. Prior to making a treatment decision I also consulted with renowned MSK surgeon Dr James Eastham.

After reviewing the "long term" studies available at the time, it showed the success rates of prostatectomy and SBRT were about the same for my favorable intermediate dx. Armed with that knowledge it came down to the side effect profile which, IMO, was more favorable with SBRT radiation.

I had a Gleason 3+4. My pre-op PSA was 7. It dropped to 2.13 at my 6 month test. It has steadily decreased at each subsequent follow up test and is now .05.

Good luck on your journey. You're in good hands at MSK.

Question for Tall_Allen - fast forwarding to 2025, do you think that my 3+4 was still best treated the way I did it or would Active Surveillance be an option ?