My Dad's Journey

Hi Everyone,

This post is about my father. He is 60 Years old.

Date: April 2019
Blood work:
Total PSA: 11,88 ng/mL
Free PSA: 1,73ng/mL
Free/Total PSA Ratio: 15%

MRI findings:
Prostate Gland size: 47x28x40 mm, Prostate Weight: 20 grams, Prostate Capsule is intact.
Showed a dia. 12 mm sized PI-RADS 4 in the bottom-right
Showed a dia. 17 mm sized PI-RADS 4 in the mid-left

Biopsy MR-TRUS: 14 samples
Pathology Report Findings:
Gleason Score: 4+5=9 out of 10 (where Pattern 5 is consisting 10% of the samples and Pattern 4 is 80%)
Periprostatic fat tissue invasion: Not present
Seminal Vesicle invasion: Not present
Lympo-vascular invasion: Not present
Perineural invasion: Not present

Date: May 2019
PSMA Ga-68 PET/BT Scan:
PET Scan has seen a 1 mm lymph node on the backbone but It doesn't seem to be related with the cancer according to the doc, he says only a small possibility. So the report is considered "no metastasis with some suspicion" at the moment.

In the end, our doctor thinks that It is best to remove the prostate ASAP along with "the lymph area with 1 mm lymph node" to confirm with the pathology report that there is no metastasis outside the prostate.

Date: June 2019
Robotic Radical Prostatectomy: RP was performed with 12 lymph node dissection

Pathology Report Findings:  
Gleason Score 9 (4+5), Grade 5/5, Pattern 4 Ratio : 95%,
Tumor Type: Prostatic Adenocarcinoma, Tumor Volume: 4,5 cm3, Tumor Ratio: 14%
Positive Surgical Margin : Not Present
Cancer Spread Outside of Prostate : Not present
Bladder Neck Invasion : Not present
Vascular Invasion : Not Present
Seminal vesicle involvement : Not present
Lymphovascular Invasion : Not present
Perineural Invasion : Present
Lymph Nodes Metastasis : None out of the 12
Grading: pT2, N0

PSMA Ga-68 PET/BT Scan: The scan only caught a 1 mm size lymph node (as hot spot) near prostate area without any metastasis.

Date: May 2020

Considering my dad had by-pass heart surgery with a very strong family history of coronary heart disease; they decided to start radiotherapy without hormone treatment due to potential coronary side effects.

Date: June 2020

Salvage Radiotherapy: 36 sessions completed via IMRT. Total 66 gray : 45 gray to the pelvic lymph nodes + prostate-bed and later an additional 21 gray to the tumour area.

Date: September 2020

First PSA reading after radiotherapy PSA: 0,034 ng/mL