Decisions,
I am basing my statement on GC's pathology.
GC Gleason 6 said...
Got my final pathology report a bit early.
Good news but scary!
prostate was 35g. Final gleason score 7 (3+4).
tumor was 2.0cm and was extensively involved bilaterally, 90% of prostate slides
extraprostatic extension-not present
seminal vesicle invasion- not present
margins all negative for tumor
lymph-vascular invasion-not present
lymph nodes examined 2--0 involved by tumor
stage pT2, pN0
the scary part--perineural invaision present, intraprostatic
The cancer was beginning to leave the prostate.
Thank GOD I decided on surgery.
Thank you to all on this forum that helped me through this, especially davidg.
I will try to do for others what you guys did for me.
I agree with him. If he had known that he had a 2cm 3+4 index tumour and cancer in 90% of his slides at the time of diagnosis I don't believe he would have made a decision to wait two years and biopsy again. He would have gone for definitive treatment. And I think most doctors would have supported his decision.
I don't have anything against AS, it is a sensible course of action for most in his circumstances but it is a game of statistics and it is only in retrospect after surgery that you can see where you sat on the bell curve of possibilities. Most people on AS have indolent cancer, but some don't. There are occasionally people here with a biopsy of a single core of 3+3 cancer who actually had 4+5 cancer. AS is a very reasonable course of action given the stats - the flip side of this are the many people with less than a 20 year projected lifespan who proceed with definitive treatment and find they have a small amount of Gleason 3+3 in their post surgery pathology and are unlucky to also suffer incontinance and ED.
Regards,
An