Reduction of Gland size

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Hi all

After 5 years of active surveillance my PSA is gradually rising from 6.78 to now 16.2.

I have had 2 biopsies, 1 in 2020 picked up 1 area of 3+4, in 2024 only 3+3 was picked up.

I have had 3 MRI's first 2 gland size 69cc and no change. The third shows mild progression but 50cc Prostate gland.

I am reluctant to choose surgery and Radiation because of the possible side effects, especially Urinary.

Brachytherapy was ruled out, because of the gland size 69cc (max of 60cc), now 50cc. Flow rate is not quite powerful enough, was 7ml/sec but now 9.1ml/sec.

I am waiting to here whether I am suitable for Focal HIFU.

What caused the reduction in the gland size? I believe it was Biopsy trauma due to being fibrotic and not measurement variation as they were all done at the same place.

Regards

David2017 9 months ago

Hi Kezzer B , I don’t understand why the latest result shows a smaller size but ‘mild progression’. What do your team say about this? G3+3 sounds good as well, although you suspect 3+4 still. Either way, sounds pretty good. David

Best wishes, David

Please remember that I am not medically trained and the above are my personal views.

Millibob 9 months ago

Hello Kezzer B

I would think you are suitable for HIFU to the Prostate (however I haven't seen your TMN score). The issue with HIFU is it's not routinely offered by the NHS and isn't available everywhere.

I would still consider "conventional" Radiotherapy as in the last few years this has become much more accurate in it's delivery and targeting.

Best wishes - Brian.

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Kezzer B 9 months ago in reply to Millibob

Hi Brian

It's T2 NO MX

Regards Kezzer

Kezzer B 9 months ago in reply to David2017

Hi David

I have only been able to talk to the Nurse so far and she had no idea why it had shrunk as I take no drugs at all. My last Biopsy was October and I had blood in my system for 6 months, so I think the prostate is fibrotic due to Biopsy trauma. 3+3 in 8 areas, 3+4 in just one area and nothing in 3 areas is fine. The problem is that the PSA has kept on increasing, so I assume from mild progression, so before it gets too high, it needs to be sorted?

Regards Kezzer

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