Age 73 just diagnosed with Gleason 3+4=7. Surveillance or removal?

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Plus PSA 7.6 and 9/21 cores positive for cancer. I would appreciate any insights from people who have had to make this decision, and  anyone who started on surveillance and then switched to removal.

  • Hi Out of Blue,

    Last year I was diagnosed with Gleason 7 (2+4) with 9/21 positive for Cancer.

    I was unsuitable for surgery and opted for Hormones and Radiotherapy (20 fractions).  

    3 + 1/2 months after the Radiation treatment ended I am in Biochemical Remission.  As long as my PSA levels can stay between 0 and 2 (0.09 at last reading in February).

    Have you been offered this option?

    I had been on surveillance for about 4 years.

    Don't regret that decision, came out of this a better person, stronger mentally.

    This time last year I was all over the place (my head).

    After the Radiation treatment ended I had counselling sessions through a charity called 'Coping with Cancer'based in Newcastle.  They done me a world of good.

    You should get more replies from men in your situation, see what decisions they made.

    It's down to you in the end.

    Did your Oncologist advise any of the options?

    Steve (SteveCam)

  • Hi OOB

    I was on AS for 4 years until 2017 and then had RT. . As long as your stats are lowish, u don't

     say what your Gleeson is, and tumour is not too large or near the gland edge then AS should be ok. I presume that u have been offered this?

    Steve

  • Hi Stevecam thanks for your comments and advice. I am Gleason 7(3+4). I saw my MRI photos this afto and the tumour is kept inside the prostrate capsule but it looks big to me stretching from near the edge to the middle of the gland in about I guess a 20 degree arc. I am thinking I need to get rid of it in the next couple of months with surgery. It also has one of the nerves running over it so the doc thinks he  will almost certainly have to remove that nerve and hopefully save the other but cannot be sure until he is doing the op.

    I see you did over four years of surveillance but I am pretty sure I could not do that and would cave in after the first quarter!!  So I am planning to go for an operation and hope for best on the ED!

  • Hi Grundo

    My Gleason is 7(3+4) and just seen the MRI photo this afto and the tumour is too large for AS so will be going for the surgery removal with one of the nerves removed  as it runs over the tumour area. After that  step will be working out what to do about ED I guess.

    6 weeks ago I never knew this thing existed but I certainly do now! It certainly changes your life and made me think about hings I never did before.

  • Yes, looks like treatment is needed, just caught it in time

    Stats look lowish so hopefully not an aggressive type

    Potentially still curable once removed.

    Wish you all the best for the op and recovery afterwards.

    Steve

  • OOB,

    The only thing that puts a shiver down my spine is "the the doc thinks he  will almost certainly have to remove that nerve ."

    I know (well I don't know) it's not the end of the world, but those nerves are yours.

    At the Freeman Hospital in Newcastle we have Prof Soomro, one of the best in Robotic Surgery.

    Anyway, I'm starting to waffle.  Best of luck with the surgery.

    Keep up with the Forum letting us know how you are progressing.

    Steve (SteveCam)

  • OOB,

    Something I forgot to mention.  Apparently now, (at the Freeman anyway), after a Prostatectomy you can get Viagra prescribed.

    Due to cuts now it's probably a tube of Smarties.

    Seriously though, I can't thank the NHS enough for the way my treatment went.

    Steve (SteveCam)

  • Hi OOB, every cancer is different so we can only tell about our own experiences but you can only decide with your urologist and the multidisciplinary team what is the best for you.

    Things I learned during 4 years of AS that might be coming to the end: 

    This cancer is new to you but it has been developing for may be 10 years so a few weeks to make the right decision will not change much

    Gleason 3+4 is better than 4+3 so your cancer if localised inside the prostate should be highly treatable

    Prostatectomy vs RT or local treatment like HIFU. What choices did they give you. It sounds that they choose surgery. They take these sort of decisions not only in regards of your cancer but also of your general health and life expectancy. The benefit of surgery is having the possibility to add RT after if some cancer cells are left behind. 

    I'm 63 Gleason3+4 with AS for 4 years and having an appointment soon since in my last MRI they noticed a slight cancer increase. So my guess is they will offer me treatment.

    AS is OK if you can cope with having cancer and do nothing. Try mediation and relaxation techniques. 

    Keep us posted  

    Erick

  • Thanks Steve for all your comments. I live down in Bath so I dont think the Freeman is a possibility - But Smarties instead of Viagra is slowly  beginning to look a good option.

  • Hi Erick - I am told the tumour is contained inside the gland. I have been offered AS or RT or removal. I am taking my time to get as much info/feedback as I can but it is looking to me like going for removal is the best for me. I have this feeling which I think a lot of people have that there is something inside that I want to get rid of and try to go back as close as possible  to the old pre-prostate days. . That said if I had a much lower Gleason ( ihave 3+4) and I was younger I would probably go for AS but going to have a talk with the specialist nurse soon and still turning ideas over. Thanks again all.