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Posted 1/3/2018 11:44 PM (GMT 0)
My hubby was dx with Gleason 9 after TURP. Why has RO or URO not requested a biopsy? Is the pathology enough to go ahead with treatment. Hubby did have bone scan and CT of pelvis with neg mets. Just curious because everyone else here has a more thorough description of their PCA. Hubby will be going for simulation in a few weeks, then what RO called a "run through" a week after. My understanding is RO will be treating the entire prostrate. Am I just worrying for nothing? His PSA is low.
Posted 1/4/2018 12:26 AM (GMT 0)
Hey bjj...
I am not the most knowledgeable on this forum, those guys will be along, but I wanted to respond.

No need for a biopsy since it appears the pathology on the tissue removed from the TURP procedure is positive for prostate cancer. If he has a low PSA with a Gleason score of 9, that could be a sign of an aggressive form of PCa unfortunately. I don't mean to alarm you but it is best to know the facts and know what you are dealing with.

Good that the CT did not show mets but they're gonna need to get that prostate outta there. (I would imagine, don't know that any form of radiation would be recommended in this case.)

Sorry you need to be here but you have found a great place with a lot of very knowledgeable folks that will be able to give you great information.
Posted 1/4/2018 12:40 AM (GMT 0)
I agree with GeetarMan. Biopsy just means removing tissue for pathological examination. They already did that with his TURP tissue. In fact, they got more tissue to examine than they would have from an ordinary biopsy. I guess the recent TURP precludes brachy boost treatment. I expect he will be getting about 2 years of hormone therapy along with the radiation.
Posted 1/4/2018 12:45 AM (GMT 0)
Oops, I misread. Looks like some sort of radiation is the treatment plan. Sorry. Didn't know in this situation if that was an option. Now I know!
Posted 1/4/2018 12:45 AM (GMT 0)
Bjj


I didn’t know it but TURP is used when the Urethra is restricted to determine if it’s bph or PCa causing it. They apparently have equivalent diagnostic efficiency. So if PCa is found with TURP a bx is unnecessary. Others may disagree. RP provides full and complete evidence of the extent to which the PCa is contained in the capsule which is why pathology results are so detailed compared to RT where the bx , which is just a sample of the prostate, is the only evidence of stage. It seems to me that you should get a second opinion of the TURP bx slides from Epstein at John Hopkins to confirm the Gleason score. That could impact the treatment decision. I had bph before getting PCa so I was not considered a Brachytherapy candidate. I’m Not a doctor.
Bob
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