Recent Diagnosis

Hello Markopoly 

A warm welcome to the group although I am so sorry to find you joining us.  The information you have received is:

PSA 5.9 - This is a blood test result - elevated levels tell your team how your treatment is doing.

PIRAD2 - Usually means a low chance that you have prostate cancer - looks like that was wrong.

Gleason 7 (3+4) This shows how aggressive the samples from your biopsy are.

CPG2 (Cambridge Prognostic Group) Shows a low to intermediate risk of localised cancer (cancer still in the prostate gland).

Cribriform - This is something you don't want as it can indicate that you have an aggressive type of cells within the cancer and treatment is urged.

As it's looks to have been found in the early stages of growth I would have thought you would have the choice of treatment between surgery to remove or hormone therapy/radiotherapy. I would advise before you make any treatment choice you speak to both a surgeon and an oncologist. Don't forget you can make the choice of treatment having spoken to your team.

I hope this helps - please do come back to us with any questions.

Best wishes - Brian.

Hi Markopoly , so you know you have PCa, but it sounds to have been caught fairly early.  When you get to meet, make sure they tell you all the options as surgery is likely to be 1 of many available.  Don’t be rushed but look at the pros and cons of each before choosing.

I had a prostate biopsy that came back with Gleason scores 4+3 and some in the 3+ range, 18 cores. Cancer is somewhat small, about 60cm. PSA is in the 8 range. I’ve been given the option of the Cyberknife radiation therapy (5 sessions over 5 days) or surgery with recoup time around 2-3 weeks to a month. I’m opting for the radiation at this point having done the research and I’m 68 years old in pretty good health. The surgery with leaking and all just doesn’t sound appealing. Just finishing up 6 sessions of chemo for small B cell lymphoma. It’s going a lot better than I thought. Oncologist is pleased with my numbers so far, but this prostate thing has me kinda worried. What option did you all have and why? Thanks in advance. 

My cancer was more serious than yours, and I had the standard radiotherapy treatment 

As far as I can tell the Cyberknife treatment has the same intent as mine, it "simply" delivers a very high dose to a smaller area.

So, on that basis I can tell you that side effects are there, but for most of us are smaller than we feared.

Because you receive a higher dose in a shorter time some of the short term side effects might be greater. Talk with your oncologist about this.

As I say, I had the longer term higher dose radiotherapy because my whole pelvic area needed to be nuked.

I have recovered well and the signs are good.

Looking at the information I can find the treatment you have been offered should have the same effects.

Thanks. Glad to know of yours and other’s successes. Gives me hope for both of my cancers. I know from reading many of yours and others experiences, mine is a much smaller problem than the major ones told. I truly appreciate any and all input concerning this issue. I haven’t gotten to the decision phase yet of which to have done. Literature and both the surgeon, radiologist and my oncologist are very good about explaining the procedures but leaving it up to me. Funny enough thing is even my oncologist says he doesn’t know what he would do! I’m weighing the “after” issues of each- surgery with longer recoup time, wearing a bag strapped to my leg and then pads, training my stomach floor to keep from pissing all over and possible long term incontinence or radiation and taking hormones. Both have possible erectile dysfunction. Just looking for input. Thanks again.

Hello Big_Guy 

It's a very personal choice is making a treatment choice. So here are a couple of links that you may find of help:

This is a link to the NICE guidelines - pay attention to the figures at 1.3.7

NICE Guidelines - Prostate Cancer.

Have a look at my post in this thread - it's the 2nd post:

 New here 

Feel free to ask any questions - happy to help.

Best wishes - Brian.

Millibob said:

Cribriform - This is something you don't want as it can indicate that you have an aggressive type of cells within the cancer and treatment is urged.

Just spotted this from Millibob reply 13 days ago (I was probably flying back from somewhere).  Anyway, I’m commenting just to put some context on that rather scary statement, which is technically true.  
The presence of cribriform is a factor when deciding whether to stay on active surveillance (AS) or commit to treatment. That is to say, the cancer cells themselves are the same as any other prostate cancer cells, but they are arranged in a looser formation than Gleason grade 3 (tightly packed) and Gleason grade 4 (starting the get gaps in the pack or lesion). Cribriform derives from Latin meaning “basket weave” (that’s also where the name crib for a baby’s basket comes from). So the looser “weave” means that cells are more likely to break off and get out of the prostate gland and into the pelvis, lymph or blood. I spoke to a surgeon who told me that cribriform is sometimes not recorded on biopsy (back in the day there was no requirement to do so, and would simply be graded Gleason 4).  He said that even nowadays needles can also miss the presence of cribriform in samples taken during biopsy. However, he said that once a gland is removed by prostatectomy and dissected in the lab, 70% of glands have cribriform structure. So, in summary, Cribriform - if found - will drive the MDT to decide that the cancer is likely to spread if not treated, thus ruling out AS. Just remember that, once treated, a cancer cell is dead whatever the grade.   AW