Treatment options for gleason 6

Interesting that nearly all of the consultants suggested treatment at Gleason 6. That's really useful feedback to help me decide, thanks.

Hi Duggie

I was also Gleason 6 when first diagnosed and opted for active surveillance as my oncologist said some people can remain on AS for many years if their cancer is a slow grower.  It meant regular blood tests an annual MRI and in my case what turned out to be annual biopsies (not to be recommended!). As soon as I moved up to Gleason 7 I was encouraged (but certainly not pushed) to have treatment and given the choice of HT/RT, surgery or HIFU.  My MDT actively tried to put me off surgery and steer me to HIFU.  In the event, after yet another biopsy it was determined that my cancer was too well spread for HIFU and I had to revert to one of the other two options.  I chose surgery but that was my choice and I wasn't influenced in any way by the doctors. It has worked out well for me and I am now hopefully cancer free and getting on with my life but I guess the point I'm getting round to is AS will only delay the inevitable and if you are like me it could end up limiting your options.  Also if you did go for surgery, the earlier you have it the more likely that you can have nerve sparing surgery which improves your chances of avoiding ED afterwards.

Best of luck whatever you decide.

Cheers

Dave

Thanks Dave. I'm at an earlier stage but I kinda sense that my experience might pan out like yours, ie I might be simply delaying the inevitable. My Gleason was 6 but my Pi-RADS was 4, which I've now discovered is unusual and might indicate an over-estimated PI-RAD or an under-estimated Gleason.

I'll be getting a second opinion tomorrow from an oncologist where I'll explore the pros and cons of all the options. Then it'll be decision time - I won't go for AS against the advice of two professionals so it really depends on what he says. Fingers crossed but I'm getting mentally prepared to bite the bullet!

One thing that would help is from the biopsy how many cores were taken and how many had Gleason 3? If for example all the cores had it then it is very different to say only one core having it

I had thought 12 cores were requested and taken but the result only mentions ten "fragments", six on the right and four on the left. All showed Gleason 6 (3+3) present in 15% of the fragments on the right and 10% on the left. I'm not sure how you can get those percentages from six and four, so that's a question for the oncologist today!