Gleason 7

[EETOFF]

I have been told my condition is localised and my Gleason score is 7. I am meeting with the Nurse in 1 week. I am considering asking for Active surveillance if it is available. I am wondering has anyone opted for this and how they are finding it.

I know it is a personal thing but other people's experiences would help

[jimreilly]

I did opt for it, which meant a biopsy every year to check up on things. But after two years the biopsy seemed to indicate a possible change (sorry to be so vague, but it was kind of vague) and with that possibility, I opted for an RP. I don't regret the two years of waiting, and I seem to be OK (i.e. cancer free as far as I know) five years now after the RP. One obvious thing to remember is that watchful waiting does permit you to change your mind; an immediate RP (or some other treatment) doesn't.

[Scruffybut1]

If I had your diagnosis I would have chosen it. I think PCa patients were the forerunners of the 'new' NHS experiment whereby Doctors have to let patients decide treatments. Just take advice based upon general health and age - even call Macmillan nurses and PCa charity for further advice. At the very least they will arm you with questions to ask. Good hunting.

[Aussiedad]

You need to have a PSMA scan - preferably a Gallium 8 nuclear which can detect particles down to 2 microns (before this the range was only 5-10 microns), a biopsy - but make sure that you are covered by antibiotics 24-48 hours either side of the biopsy

You don't say what the make up of your Gleason score was ... e.g., 3+4 = 7 or 4+3=7 etc., which is very important information because it points to how aggressive your prostate cancer is - if you have prostate cancer ... which seems highly likely.

If and when you decide to have a radical prostatectomy make sure that you are covered by Zoladex or similar before during and after for the radiation of the bed of the prostate that is used to follow the RP.

Cheers, Aussiedad

p.s. You don't seem to have researched prostate cancer in depth which I'd recommend. See the PCRI website - they are one of the highest funded prostate cancer sites in the world. They will also send you regular bulletins which are helpful - just ask.

Get on to Astragalus 8 which will boost your immune system, check out diets which boost your immune system and steer clear of testosterone which is the ideal for for free radical cells which can proliferate as cancer cells. As one old time specialist Physician said to me 'It's like during benzene on a fire.!!!

[Aussiedad]

Correction from Aussiedad ... the autocorrect changed pouring to during.

As one old time specialist Physician said to me 'It's like pouring benzene on a fire.!!!

[Aussiedad]

Final thought from Aussiedad ...

An endocrinologist prescribed testosterone 'because I looked tired ' - I'd been send to him for a check on my thyroid functioning.

There's no history of prostate cancer on either side of my family test wishing the magical period for tumour formation - 12 to 18 months - I had prostate cancer which had broken the capsule and I was in real trouble ... a radical prostatectomy followed with all the side effects and follow-up treatments and medications - appalling.

[telboy15]

You do not give other details (age and PSA for example). I was 75 when I had a random psa test in August 2015. That was 5.0 which is on about the maximum 'normal range' for a man in his 70s. Rectum exam showed a small outer lump on the prostate. I had a biopsy which showed a gleason score of 5+3=8 in one core. I then had a CT, MRI and full bone scans. All were negative and clear. The Urologist said that I was 'fit and healthy' enough for radical prostatectomy by Da Vinci robot controlled keyhole surgery although many hospitals have a 'cut-off' age of 70. I opted for that rather than lengthy radiotherapy. The op was on 24 Nov 2015 and went absolutely great. No pain during op or after. Bag for a week the pads for about 6 weeks. PSA readings sine are 0.1 (in-recordable). I did not opt for a 'wait and see' as I wanted surety. OK so no more erections or ejaculate. Not a REAL problem for me but would be for a younger man. Having said that, there are ways of getting erections (pills, pumps, injections, etc)

All that said, each of us must make his own decision. I simply hope that your treatment and decision go very well.

Terry

[HughG]

Gleeson 7 is a grey area. 6 and below, Active Surveillance would be the treatment of choice. With Gleeson 7 there may well other factors to take into account. Active Surveillance could well be an option, but you might find that you need a more proactive approach.

This is something you need to discuss with you consultant. If there are no reasons against active surveillance then it would be a very good option, but please take the advice of your consultant and medical team. There might be other options which would serve you better.

Best wishes

Hugh

[TinCanDel]

Here is something you may want to consider. Cyber therapy is a good way go, if you enough evidence your cancer did not metastasize. I went the route of 41 MIRT radiation treatments and all was well for a while, followed by active surveillance and then cyber therapy. Unfortunately, I delayed the cyber too long and my cancer is in the spine and lymph nodes. I am now on 6 month injections of Elgar/Lupron treatments reducing the psa from 37.7 to non detectable and holding, after 3 treatments. The most important factor if cyber is considered now or in the future, is that the surgeon is very experienced in this procedure. My doctor was Dr. Polascik at Duke University in Durham NC, his experience is extensive. My journey began in 2009. May I add, what ever choice of treatment you select, insure that your final decision is 100% your choice. Best of everything on your road with your prostate cancer.

Del

[Hidden]

Hi you seam to have had some good advice, and I'm sure you must be feeling confused. All I will add is my consultant told me because my Gleeson score was the same as yours I should go for active surveillance. But my wife is a senior theater nurse and requested a template biopsy, they then found a true reading of my pc was aggressive, so I've opted for 4D Brachyeraphy. Am now waiting for my second PSA test. Good luck with your decision.

[Desanthony]

You need to know your Gleason score and grading/staging. My Gleason score is 7 (3+4) and original grading or staging on DRE was T2. Then after MRI a bulge was found on the prostate and the urologist changed the grading/staging to T2b. This bulge could be the cancer "breaking out" of the prostate. However, the oncologist changed the staging to T3a which I found out quite by accident as this was never communicated to me. I am a very fit 73 year old was 72 when diagnosed. Although active surveillance could have been an option for me I discarded the idea earlier on due to my experiences within the NHS before, during and after diagnosis. There have been so many mix ups that I just do not trust the system to be able to provide ACTIVE surveillance. This is just my personal experience. I have researched a number of treatments and have found the best for my circumstances that the NHS has to offer is IG IMRT with the use of gold seeds implanted in the prostate to guide the beams to be as accurate as possible to hopefully suffer minimal side effects. I already have an overactive bladder and bowel problems from a fistula following an infection back in 2006 where again the NHS was not up to standard with my care so need to have the most successful well known treatment with minimum side effects. I have had quite a few private consultations with oncologists to get to my decision and started hormone therapy on July 7th - again a lot of mix ups from the NHS. I will have the gold seeds implanted on Nov 23rd when I will also be given the dates to start my radiotherapy which will be sometime in January I believe. I have found a really great oncologist to organise my treatment he has already fought with NHS Wales to get my treatment moved to his hospital and has explained that if he were unable to offer me treatment on the NHS he would not recommend that I pay privately. Coming from Yorkshire I had to trust him as he was advising me against providing him with an income.

We are all different and must come to our own decisions but these decisions must be informed decisions so you need to get as much information as you can. You can contact Macmillan cancer and prostate cancer UK - look them up online and get their contact numbers.

Good Luck