Diagnosis confusion

Hi !

I did question to ChatGPT. REMEMBER !! ChatGPT is ONLY a tool and NO medical expert. However, you can always use the answer as discussion points together with your MO / Medical team / ONCO and they will probably tell you what is possible or not.

BUT. Still important; don’t TRUST ChatGPT as the ABSOLUTE TRUTH !!

Question: 

Is T2 and N1 with Gleason 4+5 even a possible diagnos? Can it be possible to be treated with curative intent?

Answer:

Yes, T2N1 with Gleason 4+5 is a possible diagnosis, although it is less common. Here’s a breakdown of why this staging can happen and the approach to treatment:

Understanding the Diagnosis

1. T2 means that the cancer is still confined to the prostate and hasn’t invaded surrounding tissues, though it can occupy more than one lobe of the prostate.

2. N1 indicates that cancer cells are found in nearby (regional) lymph nodes, which shows a localized spread within the pelvic region but not to distant sites.

3. Gleason 4+5 (score of 9) reflects a high-grade, aggressive tumor that has a greater potential for spread and recurrence.

While it may seem unusual for a tumor that hasn’t extended beyond the prostate (T2) to have lymph node involvement (N1), it is possible. This could occur due to the aggressiveness of the Gleason 4+5 cancer cells, which can spread microscopically to lymph nodes even if the tumor remains confined within the prostate.

Curative Intent

For T2N1, Gleason 4+5, curative treatment is indeed possible and commonly pursued, especially if no distant metastasis (M0) is detected. The goal is to treat both the prostate and regional lymph nodes aggressively to maximize the chances of long-term remission.

Standard Curative Treatment Approach

1. High-Dose Radiation Therapy: Typically, this includes external beam radiation therapy (EBRT) targeting both the prostate and the pelvic lymph nodes. The prostate itself may receive a higher radiation dose (a boost), which is essential for aggressive cancers.

2. Androgen Deprivation Therapy (ADT): Long-term ADT, often for 2-3 years, is commonly combined with radiation in high-risk cases to reduce androgen levels, which fuels prostate cancer growth. ADT can improve the effectiveness of radiation and help lower recurrence risk.

3. Systemic Therapies: In some cases, additional medications like Abiraterone or even chemotherapy might be considered, especially with a high Gleason score and lymph node involvement.

Prognosis and Curative Potential

While the N1 status increases the complexity of treatment, T2N1 cancers are still considered treatable with curative intent if managed aggressively. The combination of radiation to both the prostate and lymph nodes, plus ADT, has shown success in achieving long-term remission for many patients with high-risk, locally advanced prostate cancer like this.

Like I Said. ChatGPT is a TOOL and NOT a MEDICAL EXPERT. With the information you perhaps may have a more two-sided dialouge with the MO / Medical team / ONCO of what is possible and not.

Best wishes - Ulf

Ult ( Ulfhbg ) that is impressive.  David

Hi !

I think so to and as you always have in mind that ChatGPT (or Copilot or etc) is a TOOL and not a medical expert and the information gathered is collected from lots of sources, you may use the information in your dialouge with the experts to get there view.

I’m rather good in searching information with the help of ’Dr Google’ but manytime it’s extremely different, as a amateur as myself, to really be able to validate all information ( unless you’re the amazing person Alwayshope  )

I thought it was difficult with these AI apps but it’s really trial and error and after a while it’s actually easy to use.

Best wishes - Ulf

Any advise about food ,drink,exercises ,whatever you think is helpful to my journey? Thanks, stay safe .

 Murcao , diet is not my specialist subject but the consensus here seems to be eat healthily- plenty of fruit and vegetables, reduce red meat and dairy, lots of water and keep to guidelines on alcohol.  We think the fitter you are at the start, the easier to maintain fitness and feel better through treatment.  As I said, I am not an expert on this but just being sensible with food and drink intake and keeping fit seems to make sense.  When it comes to specific treatments like RT then there are lots of recommendations.  Above all, I think it is essential to stay positive.  David

There's one thing I have cut out , sugar and most things with it in.

In theory feeds cancer, don't know if true but sounds plausible.

Also cut right back on red meat , alcohol, takeaways.

Steve