Now Have My Biopsy Results

Glad you’ve got the results now as the waiting is the worst,onto the treatment now and I’m 3+4 as well and will probably be getting RT and HT,surgery ruled out because off RA and they also mentioned AS but I think I will go with the treatment,hope your coping alright as it’s a waiting game until the treatment starts,take care Rab

Sorry I can't answer your question but I am pleased you have your results and now know what you are dealing with 

Hi Dedalus  T2a = The cancer is in one side of the prostate only.   T2c= the cancer is in both sides of the prostate. All T2's are contained within the prostate.

You are 78 - You don't want Hormone Therapy - I think your only choice is Active Surveillance and hope the cancer grows slowly.

My personal choice would be the HT/RT route with a view to prolonging my life -....... but that's me.

Best wishes - Brian.

Hello Dedalus, regarding your possible T2c staging, as they have altered the staging classification recently and don't use sub stages anymore with a T2 tumour staging, a b or c, it seems are not relevant to treatment. The T2 score is the most important result  and should mean what ever treatment you choose it will be done with intent to cure, take care, 

Eddie

Thanks Eddie

I noticed the staging classification had changed.  IIRC AS was not recommended with T2c in the old staging but curiously it is in the new.  I am also puzzled why the consultant is opting for T2a when there is PCa on both sides of the prostate. albeit he said a tiny amount on the right side ie 1 1% core out of 6 being 3+3.  

Dedalus

Thanks Rab

I am interested to know your reasoning for excluding AS.

Dedalus

Thanks Brian

I am trying to balance successful treatment without impacting QOL.  A difficult balancing act I know!

At the moment I am looking at IMRT without HT or LDR Brachytherapy which may not be available due to my HOLEP.

Dedalus

Hi Dedalus i would guess if you got 3 consultants to analize your results you would get 3 slightly different answers, I recently got my oncology notes and the difference with what's on the notes and what they tell you is unbelievable, and if my notes are typical they round down results, sorry can't help you with IIRC AS as have no first hand experience of it . take care, 

Eddie

Good morning Dedalus.

You have done well getting your results which are on the more positive side eg. Gleason 3+4 is better than 4+3, you have no cribriform features, and it is localised.

Re. Brachytherapy after HOLEP, it looks as if it depends on the margins.

https://onlinelibrary.wiley.com/doi/full/10.1002/iju5.12453

It is normal to have RT after the hormone therapy has reduced the size of the area to target in order to reduce collateral damage. It is worth asking the question whether you can have RT without prior HT - my husband started it within 3 weeks of initial diagnosis, it had already erupted out of the prostate with lymph node involvement and so far it has put everything to bed in that area.

Hi D

I had RT without the HT, it is possible if stats are low but specialists do seem to like to run the two together

Not sure about AS in your case because looks like the tumour size is quite large at 14mm.

I was on AS for  4 years and my tumour size went from 3mm to  13mm before starting treatment.

So I would check to see if the tumour is getting near the capsule edge before considering AS although one would have thought 

that the specialists have checked all that and I believe they are offering AS as an option

Best wishes

Steve