Hello once again,
I have now received from the urology specialist at the Alexandra hospital, Redditch (face to face meeting today) the results of my recent biopsy and as I thought I do have prostate cancer.
My stats are:
Aged 66 in May with no previous health issues, no previous operations, good physical health with spot on blood tests and blood pressure/resting heart beat etc.
PSA 3.2 Sept 24 which had increased to 4.7 by 22nd Feb 26. DRE confirmed one side harder than it should be and a multi parametric MRI revealed a lesion of 15mms classified as a Pirads5 in the peripheral zone towards the rectum. Volume of prostate = 32cc with a PDA density of 0.15
Biopsy has now confirmed the following and your comments and advice would be welcome:
Samples taken - left lobe 17 of which 7 were cancerous. Right lobe 12 of which 3 were cancerous.
Gleason score = 3+4 = 7 with 90% of samples scored as a 3 and 10% scored as a 4. (T2N0).
No spread outside of the capsule confirmed.
Whilst there is a portion that is against the capsule edge, there is no bulging of the capsule wall. Graded as a 2 on the scale of 5 where 90% of the cancer cells are likely to grow very slowly and 10% are likely to grow at a moderate quick rate.
The answers given to me by the urology specialist to the treatment option questions were:
do I need a PSMA pet scan or bone scan? No, as there is no evidence of leakage and nothing showing in seminal vessels, lymph nodes or bones.
Can it be dealt with by ongoing monitoring? No, as there are 10% of cells graded as a 4 above. If they were all a 3, then monitoring would be an option.
Surgery - no as I have a rare condition that I didn't know about until I had the MRI. Basically I have a vascular malformation in the pelvis from birth which renders me too high risk for prostate surgery. Await referral now to Vascular AV department for further tests etc. Had it for 66 years and never knew I had it.
So, that leaves external radiation with or without hormone therapy or Brachytherapy (awaiting oncology to call me in to discuss these options).
Any thoughts on the above. I seem to be more drawn towards Brachytherapy if ongoing surveillance is not an option).
At least I know where I am now and how fast growing it is, so I am trying to remain positive, even though the lack of a surgery option is limiting.
The specialist says it is totally curable and so who am I to question that.
My concern with external beam radiotherapy is the side effects and I can't ignore the fact that in years to come it may cause cancer elsewhere. Brachytherapy appears more focused insofar as limiting damage to other areas around the Prostate compared to external radiation and it lessens the side effects. The long term effectiveness of both seems similar if not slightly improved for the Brachytherapy option. Also, would hormone therapy work in holding what appears to be a slow growing cancer at bay to buy me time to undertake more research. I don't want to rush into a decision.
Thanks once again
Best wishes to all
Murphy 22.
