Posted 9/19/2016 4:04 PM (GMT 0)
Hello, again:
Results are in: "Gleason grade 3+4 = score 7, in 3 of 3 cores, involving 60% of tissue examined, and measuring 17 mm in length. Positive for PNI"
From signature below and previous posts, you will recall my persistent interest in staying on AS despite high volume 3+3 found earlier by standard TRUS biopsy. MpMRI in May located PIRADS 5 tumor site so that's what was being checked with the MRI guided biopsy.
I had decided before this latest biopsy that finding any G7 would mean I needed to shift to some definitive treatment. Even with just 3+3, I would not normally have met any standard AS protocol requirements. Too much 3+3 in too many cores in a small prostate with estimated 40-60% chance of ECE.
So I'm meeting with my favorite medical consultants this week to make some decisions.
1. I guess there is still some argument for continuing AS. I could get a second pathology reading and hope for a downgrade. Also, my initial report did not specify the % of G4 involved. If it is low enough that might also encourage sticking with AS.
2. My prior TURPS and relatively poor urinary function might argue for RP. I'm in good health and should recover well.
3. The chance of not getting clear surgical margins could argue instead for IMRT. Why risk possibly having to undergo salvage RT and then get all SEs from both options?
I'm even thinking (but not very hard, because of the inconvenience) about possible participation in the Proton beam vs. IMRT trial or a trip to UCLA, say, for SBRT.
The ProtecT results are obviously getting lots of attention right now. Might they provide some useful input? What about the thoughts of my fellow HealingWell participants?
Thanks,
Whippoorwill