I am 62 and just was diagnosed with favorable intermediate Gleason 7 (3+4) two days ago. Which after waiting a month post-biopsy was actually somewhat of a relief. My PSA was 5.114. PSA density 0.165. My MRI showed a PI Rad 4 lesion with MRI capsular convexity. The biopsy showed I had <10% Grade 4, It showed 44mm total cancer. There were 41% positive cores, the one where the lesion was had 3/3 at 22mm. Overall relieved, as it could have been much worse! I am waiting for the Decipher score the end of the month. I am leaning to surgery, but hoping to get a PMSA PET scan too before decision. I did not realize how much stress I had waiting for the results. I slept 10 hours, which I never do. I have been very tired since getting results. I was surprised by the psychological toll this has taken. I thought I would log on here and be with men traveling the PC journey. Hard to share my concerns of possible ECE / treatment side effects with wife and children/grandchildren - don't want to upset them!
Hello Pomfather
A warm welcome to the group although I am sorry to find you joining us under these circumstances.
Do I detect you are not in the UK and possibly in the USA - I am only asking as I am aware of the Decipher Test but so far I was only aware of it being used across the pond - also with that PSA/Gleason Score I can't see you getting a PSMA-PET scan on the NHS I don't find many UK patients using the term ECE for the cancer going "walkabout" in the UK too!!
Having said that with that Gleason Score, The Cancer being contained in the gland I would have thought surgery a little over the top when both radiotherapy and brachytherapy are less invasive and easier treatments. Just my thoughts, have you considered these two treatments?
Best wishes - Brian.
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Hi Millibob,
Yes, I am over the pond, as you say 
Thanks for your comments. I was looking over your profile Millibob. Your sense of humor and grit are truly inspiring. Thank you for sharing your journey. I have a very light load compared to you and so many others with PC!
One main reason I am leaning towards surgery is that I have a bladder obstruction, which is probably the tumor. My MRI also had shown the tumor abutting against the capsule with convexity. The risk of cancer getting out of the capsule is already there. I am really just thinking dealing with this decisively, and hoping for negative margins. I am very paranoid about having hormone treatment for the reasons you described. I will certainly hear what the best recommended course of treatment will be for my case, but the bladder obstruction will probably be the deciding factor.
Not sure if I will qualify for a PMSA Pet scan over hear either at this stage.
God speed and may you continue to make progress.
Don
Hello Don (Pomfather)
Thank you for your kind reply - perhaps I have missed my vocation and indeed should have trained as a detective!!
My thoughts then are:
* Is it a bladder obstruction?or as in my case has the Prostate grown and tried to close the urethra - my issue being sorted by way of a TURP operation.
* Surgery as you say would be good IF you get clear margins around the area. Her's a link to our notes on Prostate Surgery:
Prostatectomy-for-prostate-cancer.
* As you are no doubt aware there are 2 bundles of nerves around the Prostate. These control your ability to have an erection and your urinary function. It's a good idea to check if your surgeon can perform "nerve sparing surgery".
* I don't know what the "rules" in the States are for Brachytherapy - have you considered this? Much less invasive. - Link here:
Brachytherapy-for-prostate-cancer.
I hope the above helps - they are of course my personal thoughts.
You are more than welcome to stick with us -keep us posted as to how you get on and we are happy to chat.
Best wishes - Brian.
Macmillan Support Line - 0808 808 00 00, 7 days a week between 8am-8pm
Strength, Courage, Faith, Hope, Defiance, VICTORY.
I am a Macmillan volunteer.
