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User
Posted 15 Apr 2018 at 19:31

Hello,

Recently diagnosed;   T2c/NO/M0   Gleason 6  with PNI.     At biopsy results meeting the nurse specialist described the tumour as more "pussycat" than "tiger".  Subsequently, they have recommended active surveillance as best treatment option. 

However, I also have BPH (benign Prostatatic Hyperplasia / enlargement) which cause my urinary symptoms and the acute retention which started this "ball rolling".  The nurse was a bit embarrassed that the MDT meeting overlooked this factor when making selecting the best  treatment option for me.  In addition,I note that the PNI may be a factor in the cancer (even a pussycat like mine) migrating out of the prostate capsule.

I was initially comfortable with active surveillance but, realise it wont solve my urinary issues and with the presence of PNI being a potential risk factor I;m thinking of surgery.

Anyone with a similar diagnosis/issue/questions?       

thanks...

User
Posted 15 Apr 2018 at 20:56

I was diagnosed at 54 with 3+3 T2B, I was told to take some time and think about my options (inc active survellance) but having watched my dad due of the disease I was determined to "have it out" .

The post op pathology was still 3+3 but staging was upgraded to T3A. I felt this justified my decision.

But you can read many statements on the internet that imply 3+3 is "harmless" so ultimately you need to do what will make you happiest. This is part of the problem with PC there are few definitive answers!!

User
Posted 15 Apr 2018 at 21:31
Good explanation and potential significance of PNI https://malecare.org/perineural-...dvanced-prostate-cancer/

Edited by member 15 Apr 2018 at 21:32  | Reason: Not specified

Shut down the voices of doom and spend your time living.
User
Posted 15 Apr 2018 at 22:08

Some interesting thoughts in that link. Unfortunately neither scans nor biopsies are 100% reliable as removed Prostates show in the lab. Whilst some under more careful dissections show a lower Gleason score and or less extensive extension than originally thought, where it is not as originally assessed, in a greater number of cases the Gleason/spread is more often the experience.

Barry
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User
Posted 15 Apr 2018 at 20:56

I was diagnosed at 54 with 3+3 T2B, I was told to take some time and think about my options (inc active survellance) but having watched my dad due of the disease I was determined to "have it out" .

The post op pathology was still 3+3 but staging was upgraded to T3A. I felt this justified my decision.

But you can read many statements on the internet that imply 3+3 is "harmless" so ultimately you need to do what will make you happiest. This is part of the problem with PC there are few definitive answers!!

User
Posted 15 Apr 2018 at 21:31
Good explanation and potential significance of PNI https://malecare.org/perineural-...dvanced-prostate-cancer/

Edited by member 15 Apr 2018 at 21:32  | Reason: Not specified

Shut down the voices of doom and spend your time living.
User
Posted 15 Apr 2018 at 21:54

Was it definitely PNI and not PIN? These are different things found in scan results and biopsies and have dramatically different implications. It is a bit worrying that the MDT would recommend AS with evidence of PNI :-/

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 15 Apr 2018 at 22:08

Some interesting thoughts in that link. Unfortunately neither scans nor biopsies are 100% reliable as removed Prostates show in the lab. Whilst some under more careful dissections show a lower Gleason score and or less extensive extension than originally thought, where it is not as originally assessed, in a greater number of cases the Gleason/spread is more often the experience.

Barry
User
Posted 16 Apr 2018 at 07:08
Thanks for your reply. It was PNI - I quote, “evidence of Perineural invasion”

From my research, it appears the significance of PNI as a risk factor is not yet established & accepted by the Uro/ Oncon medical community - it seems significant to me;)

User
Posted 22 Apr 2018 at 21:52
Old Barry makes a good point. We were upgraded on pathology from Gleason 3 plus 4 to Gleason 5 plus 4.

Quite a jump, and as our surgeon said, if ever you needed confirmation you’d made the right decision...

 
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