Treatment. Two choices, or no choice really? Please comment.

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60 yrs old. Very Recently had total hip replacement.

Just prior, had had an PSA test, MRI then Biopsy. Results came back from prostate. 

GLEASON 3+4=7

Group 2

T2
N - 0

M - X
Appointment with Urology Surgeon today says I am not suitable for removal of prostrate as hip surgery too recent and risk of dislocation whilst in theatre and that also my bmi is too high … 35. Seems I would have to wait at least six months and get BMI to 30 before being reassessed. The hip dislocation seems to be the major worry. 

Seeing Radiologist in a few days to hear their take. Advised by nurses this would likely be 3 to 6 mths of HR, then 20 days of radiology 5 x4 after that. 

Given I seem to be in the earlier stages for which I am very grateful- and it is encapsulated - don’t want to give it another six months growing time, whether actively monitored or not. Especially as the six month minimum clock for surgery seems set in stone. 

Tempted by the the radiology and as quick a start on hormones as possible. … 

I realise many will be in much worse positions but I hope someone will give some feedback.

many thanks. 

  • On my biopsy it says Gleason score 7, 3 plus 4, then … 2/5 9%

    radiologist is suggesting …

    As already have BPH in One side and the large prostrate bulging into bladder … and cancer score low …. May be better to do active monitoring for six months, get BMI down, then persuade surgeon my hip replacement  is stable and have radical prospectomy thus solving cancer and urinary problems in one go. 
    Scary thought waiting 6 months despite assurances it will not break out in this time. 

  • On my biopsy it says Gleason score 7, 3 plus 4, then … 2/5 9%

    please reply with what that means. 

    radiologist is suggesting …

    As already have BPH in One side and the large prostrate bulging into bladder … and cancer score low …. May be better to do active monitoring for six months, get BMI down, then persuade surgeon my hip is stable and have radical prospectomy thus solving cancer and urinary problems in one go. 
    Scary thought waiting 6 months despite assurances it will not break out in this time. 

  • Hi Deekay

    As you have to wait 6 months anyway why not go for RT and they will then start u on hormones which should keep it from spreading in the meantime. Having said that your stats seem fairly low so hopefully non aggressive.

    Prostate bulging into bladder presumably down to BPH , what does Mri say about size of tumour and location within the gland.

    just my thoughts obviously, doesn't mean it's the best way forward

    Regards

    Steve

  • Thanks Steve. Does this mean anything t o you. 

    Radiology: Right paramedial apical PZ. 

    Small lesion

    Prominant median lobe

  • Yes the bulge into bladder is the benign prostrate left side not Ca. 

  • Think the last sentence PM. Lobe refers to the BPH.

    Right P. apical PZ refers to the tumour, says small lesion.

    I would say, obviously no expert, that it doesn't look particularly aggressive based on the stats.

    As long as the tumour is not near the capsule edge about to break through, unlikely.

    Obviously the bulge is not due the cancer but BPH or that's the way I read it .

    Times on your side 

    Good luck, keep us posted

    Steve

  • Hi Deekay. 2/5 9% could mean a couple of different things. Is there more context included with those numbers?  If not, add their meaning to your list of questions for your doctor.

  • hi , what's ADT and BPH mean ? 

  • ADT = Androgen Deprivation Therapy

    BPH = Benign Prostate Hyperplasia

    I hope that helps.

    Yesterday is history, tomorrow is a mystery and today is a gift.
    Seamus
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