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10 out of 12 question

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Posted 7/6/2015 7:07 PM (GMT 0)
So with a 10 out of 12 cores positive should I even consider brachy or not? or would it depend on the amount they found in each core.

To me it might make sense to go the surgery route as it was all over the prostate.

Still have plenty of questions for the docs but would like you guys view.

Posted 7/6/2015 7:24 PM (GMT 0)
Gleason score, staging, size of the prostate and location of the tumors are bigger factors in that decision.

Number of cores is only part of the puzzle.

Andrew
Posted 7/6/2015 7:55 PM (GMT 0)
Whosnext: If you could provide us with more info like you see on the signatures provided by most of the HW brothers it would be most helpful. Take a good look at the sticky note and you will see great info including having a second opinion on your biopsy reading.

i would not rule out seeds until a very good seed RO told me otherwise. Remember that treatment specialists know a great deal about their area of expertise but not as much as they might think about other thearapies.

Take hold of your life a be your best advocate, read the experiences on this forum, talk to friends and acquaintances who have dealt with the Beast, and make the decision that will affect the rest of your life. We are here for you and ready to help. Keep us posted.
Posted 7/6/2015 7:55 PM (GMT 0)
As I said in my post on your previous thread, I also was 10-12 core positive and they thought it was Gleason 6. I went straight for surgery.

You may have your biopsy slides sent for a second opinion, I didn't.
Two heads are better than one, as they say.

After my surgery, the pathology upgraded by Gleason to 3+4=7 and the tumor was 50% involved in the prostate. Some of the tumor was beginning to leave the capsule (prostate). I don't think I would have changed my mine but this is a life changing decision. Your sex life and continence issues will be affected for sometime if not forever.

The more you know before making your treatment the better.

I was born in South Carolina, by the way. Don't be afraid to travel to get the best treatment. My surgeon had done over 5,000 surgeries when I had mine 3 years ago this month. Currently he is at over 8,000 completed surgeries. Lucky for me he was in Orlando, 3 hours away.

Bill from Floridacool
Posted 7/6/2015 8:47 PM (GMT 0)
From a previous post: PSA 6.7, 10 cores positive from 12, Gleason 6.
Posted 7/6/2015 8:50 PM (GMT 0)

whosnext said...
To me it might make sense to go the surgery route as it was all over the prostate.

If it is contained within the prostate, then any of the mainstream mono-therapies is likely to cure you at equal rates, i.e. surgery, LDR Brachy, HDR Brachy, SBRT and IMRT. You should meet with experts in each.

Jim
Posted 7/6/2015 8:53 PM (GMT 0)
I don't see why the 10 of 12 cores would make you unsuitable for brachy since it radiates the entire prostate. I'm sure an experienced brachy therapist can explain more about this...
Posted 7/6/2015 9:21 PM (GMT 0)
Thanks guys

Big Mac yes you had the same as me, kinda scary when they hit you with 10 out of 12 :-) but the more you read about it the better you feel.
Thanks Peter for adding my info, I will add to my signature, just waiting for my mri Friday.

brilliant site, just wish I didn't have to use it is all ;-)
Posted 7/6/2015 10:27 PM (GMT 0)
If you're high volume as I was you might want to be more open to RT. It seems to me that the chances of positive margins increase with volume of PC, dependent upon the skill of the surgeon. The risk of recurrence increases with positive margins, hence, also the chances of future SRT.   As we have been learned before by TA, the SE of SRT are typically worse than initial RT.   So, with that in mind, I would be open to initial RT, or at least get comfortable with the surgeons skill to cut it all out.   The MRI might be able to help make that decision.
Posted 7/7/2015 1:01 AM (GMT 0)
I agree with Jim - Surgery, SBRT, LDR brachy and HDR brachy are all good options and have equivalent cure rates for your type of prostate cancer. PC is almost always a multifocal disease, so the fact that it's in a lot of cores is common and doesn't rule out anything. You can even do active surveillance under some protocols.

- Allen
Posted 7/7/2015 1:16 AM (GMT 0)
For another perspective, I had 3/12 positive cores, all G3+3, all on the left side. My post surgical pathology was G3+4, in all 4 quadrants, 15-20% total involvement. So I could ask why I DIDN'T get 10/12 positive cores? It works both ways.
Posted 7/7/2015 4:31 PM (GMT 0)
I was 12 of 12 and 5 different docs all said BT would be preferred over surgery. The number of positive cores does not determine whether BT should be used.
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