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Lorraine is a nurse specialist and sex therapist and volunteers here to answer your...
Had my biopsy result today. Gleason 7. I had 14 core samples taken the majority showing a mixture of 3+4 and 4+3, in both left and right side. Bit of a shock to have found what seems a lot of cancer. Now waiting to see if the Consultant wants me to have CT scan and bone scan to make sure it hasn't spread out of the prostate before a decision made on either radiotherapy or Radical Prostatectomy. Hoping this does not take long. I prefer the surgery at this poing in time and would greatly value any advice.
Hi Ian and welcome
If u could give some more info, this will help u get the best advice.
ie. : Age, psa results, have u had a MRI?
Gleeson 7 is not particularly aggressive by the way so that is some good news.
I'm 64. My P.S.A is 11.3 and I had an MRI scan and Transperinium Template Biopsy. they took 14 samples from both sides and the majority show cancer with scores of 3+4 and 4+3, so more than the MRI suggested. I was told from the MRI that I had an area of suspicion in the apex right hand side about a centimetre square, and some nodularity elsewhere. So now I am waiting to see if the consultant wants me to have a bones scan and CT scan to check it hasn't spread before we decide on treatment options, I must say though I have no symptom's of spread. i.e. pain, pelvic pain, weight loss, fatigue.
Thanks for the welcome and reply
Also what other numbers should I have, I only know Gleason 7 made up of some 3+4 and 4+3, plus my PSA of 11.3. Reading other posts on here some of you guys seem to have more info and details than I have been given
You have the main ones, Gleeson , Psa , Mri say it all really. Sounds like u may have a bone scan at some stage. With a PSA of 11 its unlikely to have spread outside the prostate, I know that it does happen but would be unusual especially with your lowish Gleeson.
It does sound like it is contained and therefore should be easy to treat either with surgery or RT.
Just to put the tumour(s) size into context I went on active surveillance for 4 years and in that time my largest tumour size went from 4mm to about 1.3 cm. I started treatment at that point.
Just make sure that the tumour is not about to break out from the capsule or not too near the capsule edge, if it is then starting treatment sooner rather than later pref. but then your specialists would know all that.
Do u have any previous psa results or is this the first and only?
all the best
Many thanks for your reply. I found it very reassuring and helpful. This is my first and only PSA result to date.
I was also told that if I had Radiotherapy and my cancer returned later I would not be able to have surgery to remove the prostate as it would be too difficult after radiotherapy. Is this the case. I'm just trying to weigh up all the options before a treatment is decided upon.
As Steve has said it’s important to know if the cancer is well contained.
I would also suggest that with some Gleason 4+3 there treatment will probably be necessary.
Yes thanks, the nurse yesterday didn't seem to know if it was contained, I guess further scans will sort that one out, although I thought the MRI would show it too. But I'm still coming to terms with all this. I have been told that treatment is a definite thing. I need to calm down I think and wait for the next step.
Surgery after RT is more difficult although not impossible but beware of possible extra side effects.
My feeling is that RT can be simpler than surgery with potentially less problems/side effects with ED but there are many on this site happy with their surgery.
Take your time to decide and see what others say.
Age is also a factor in making a decision. I was 71 when I was diagnosed and offered surgery or radiotherapy. After a long discussion with the nurse consultant specialist I chose RT. His opinion was that, in general, surgery is more appropriate for younger men and RT for older. RT can cause long term collateral damage which is less important in older men; whereas surgery can lead to stress incontinence in older men (when doing sports etc) but less so in younger men who tend to have stronger bladders and sphincter muscles.
It's a difficult choice and you need to seek out as much information as you can.
Surgery following RT is generally not possible but RT following surgery is common.
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