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What is my clinical staging?

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Prostate Cancer
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Posted 3/25/2018 7:20 PM (GMT 0)
I have a PSA of 5.2 and a Gleason score of 4+4 = 8.

I had 2 of 12 cores come back positive. One left mid (4+4=8) and one right apex lateral (3+3=6).

No palpitation upon DRE. Cancer only found during biopsy due to elevated PSA.

Am I a TIC or a T2C?

I consulted with a radiation oncologist and he said I was a T2C. But isn't that definition for someone

who's tumors were palpitated on DRE.

Can someone clarify.
Posted 3/25/2018 9:46 PM (GMT 0)
You are right. cT2 only applies when a tumor is palpable by DRE. For a while it also applied if identified by image, but I think this second criterion has been recently removed.
However, bilateral involvement in biopsy increases risk and sometimes it is taken into consideration to decide treatment in low risk cases. But, with high grade, radiation treatments usually includes adjuvant ADT anyway (others more ackowleged may correct me if I am wrong) and the pathological stage decides if you need adjuvant treatment if you follow the surgery path (>pT2). Therefore I think clinical stage is not so much relevant.
Posted 3/25/2018 10:24 PM (GMT 0)
"Am I a TIC or a T2C? I consulted with a radiation oncologist and he said I was a T2C. But isn't that definition for someone whose tumors were palpitated on DRE."

You are correct - you are stage T1c. clinical staging is only based on the DRE, not on any biopsy data. Otherwise, you would be double-counting the risk. here's an explanation:

/pcnrv.blogspot.com/2017/03/prostate-cancer-staging-update.html
Posted 3/26/2018 11:54 AM (GMT 0)
Thanks for article Tall that's good information to know.
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