Extraprostatic extension - Absent. Meaning?

Thank you all for your comments. So, we had a very good discussion with the oncologist. They did biopsy the area where they thought that the tumour might have gone through the prostate and did not detect any cancer cells outside of the prostate but that does not mean there are not any - they just did not find any! To be sure , they are irradiating that area with a main for error. This is really reassuring as we were told yesterday that they were only blasting the prostate itself.

Hi WW

My MRI report also showed "No convincing extraprostatic tumour extension" which I took to be good news. The PET CT report was a lot more in depth and changed the initial diagnosis from T3C to T2C and stated definitely that there was no spread outside of the prostate. Did your OH have a PET Scan.

Best wishes to you both

Ian

Hello Ian, no , the PET scan was not offered - only MRI. Would the PET scan show more?  I will do yet more googling!

I queried the grading T3a if there was no extra prostatic extension. We were told that the treatment offer would be no different. We were also told that the Gleason 4+3 was sound because it’s the percentage of higher grade cancer cells in each biopsy core not the number of 3s and 4s. The consultant we saw originally said 6 mts ht but is now coming down very heavily on 18 mts. He said this is a once only chance of cure and 6 mts only at his stage would increase the risk of relapse  but there is little research to support either length of time at thie stage my husband is at. . I asked our long the cancer cells, deprived of testosterone, live and was told this is complex but insufficient research.

So, why are men being prescribed such a devastating drug with insufficient research in a NHS which leans so heavily on evidence based medicine? I am not at all sure, but I suspect breast cancer research has been far and away better funded.

we did receive some answers, we were taken seriously and we were given a lot more information about what is and what is not being irradiated - the review yesterday and what the radiotherapist said  led us to be very concerned but our fears were allayed on that score.

my husband seems happier today although still struggling to get up the hills when we went for a walk this pm.! Half way point in RT tomorrow!

many thanks for your reply!

Hello Worridwife, there is evidence that shows 18 months of HT is the best period to provide longer term remission. I was on HT for 27 months for salvage radiotherapy. This study shows 18 months provides the same benefit as longer duration. Hope this helps. 

Prostate cancer foundation on HT duration

https://www.health.harvard.edu/blog/hormonal-therapy-for-aggressive-prostate-cancer-how-long-is-enough-2019012815879

Radar trial results

Hi Ian

i am so very grateful to you for posting these links. It’s really good to see some hard evidence on which to make decisions!  My husband seems to think he will go with the 18 mts as per the oncologist recommendation and this evidence.

many, many thanks!

Hi WW

My MRI report took up a third of an A4 sheet with information and the PET scan report took up a whole page so lots more detail. I am not sure what prompted the PET scan as I don't think this is normal and it also led to another 2 months wait for the MDT meeting so perhaps they thought it more important to start your OHs treatment?

I think that reading what your husband is going through along with others under RT is what is nudging me towards surgery, even with the known side effects, just to get it over and done with.

Thinking of you both and hoping your husband is feeling better as soon as possible.

Ian

You’re very welcome, there’s so much to navigate. Hope all goes well.