What are the chances?

User

Posted 17 Feb 2022 at 00:15

I am guessing that if my consultant cannot answer this question then nobody here can but I would appreciate people's input.

I am 63 years old and have recently been diagnosed with prostate cancer. My PSA is 13, my Gleason score is 3 + 4 with no bone or node involvement.

I have no idea how many samples had grade 4 cells as it just says 3/6 on one side and 1/1 on the other.

There is a suspicion/suggestion of seminal vesicle involvement though the consultant can not definitely say that this is the case because 'a scan is a scan' and can only suggest things.

I know that all of this looks bad and it is more or less definite that I will be trying to get this treated.

But .....what if I just didn't do anything? My consultant refused to be even drawn into this conversation and this has left me wondering why. I am obviously not looking forward to 2-3 years of hormone and radiotherapy but will do this if I think my life will one day be free of cancer again. However it seems a bit strange that nobody can give me any indication that how long it would take if left untreated for this cancer to spread into incurable areas like bones and lymph nodes etc. Maybe this would not happen for 20 years or ever? Or maybe it would happen next year? I just wanted to have some idea of the likelihood/probability of all this. Is this a futile question?

I apologise if this question is covered in other threads. But I am new to this forum.

User

Posted 17 Feb 2022 at 06:51

With a 3+4 and possible seminal vesicle involvement you might get 15 years or it might be 3 the problem with PC is it's very unpredictable and the answer could be the same even after treatment.

Google prostate cancer nomograms there may be one that gives you an answer you are looking for.

Have you seen a urologist too? Is surgery or brachytherapy an option? Also what about a PSMA scan? These are used to stage men now and often change treatment recommendations.

User

Posted 17 Feb 2022 at 08:15

Thanks Francij1 for your reply - It was the Urologist I saw yesterday. I will have appointments in the next week or two with a surgeon and then the radiotherapy/radiology consultant.
I will try and get as much information from them as I can and then make a decision.

Right now I am just a bit stressed, depressed, overwhelmed and bewildered but I guess this will change and certainly I think I will feel better when I make a committed decision to follow a course of action.

I would like to think though that treatment would increase my probability of living longer!

LJ

User

Posted 17 Feb 2022 at 11:05

I had PSA 2.19 and Gleason 3+4=7 with 5 out of 20 cores positive with the choice of Robotic surgery or Brachytherapy at the age of 70 in September 2016. My PSA is down to 0.05 and have been signed off in 2021.

I can't tell what to do but of you click on my Avatar you can see my journey and i am happy to answer any question you have.

Good Luck John.

User

Posted 17 Feb 2022 at 15:24

Hi,

I doubt that anyone can or will give you a definitive answer. Sure, there are averages to be found, but they are made up of highs, lows and all instances in between. I was 69 when a TRUS biopsy and MRI scaled me at Gleason 3+3 on 1% of cores taken and stage T2a. My consultant, a urology surgeon, told me that this was not unusual for a man of my age and that probably, it would not progress and I would die with it (not of it) and without any severe problems, as do many men. I was put on active surveillance, as a precaution. Five years later, a TP biopsy and MRI scaled me at Gleason 3+4 on 75% of cores taken and staged me at T2b. Subsequently, I had a RALP last November at age 74 and the post op pathology scaled me at stage T3a.

My point is that diagnosis is sometimes indicative as opposed to definitive and this has to be taken into account when consulting and in decision making. At 63, you are by no means an old man and there should be plenty of mileage left in you. If treatment is recommended by the experts and no matter what treatment that may be, sooner is surely always in with a better chance of success than later.

Good luck

Peter

Edited by member 17 Feb 2022 at 15:25 | Reason: Not specified

User

Posted 17 Feb 2022 at 21:07

Thanks John and Peter.
Yes - I am pretty sure I will get treatment.

It is all new to me and right now I am just not quite sure which option to go for but maybe I will know more after my next two consultations.

None of the options look attractive and at the moment I just feel appropriately depressed.

I have just in October become divorced after a 20 year marriage. I was looking forward to a new chapter in my life I really enjoy tennis and sex (in no particular order) and I have a feeling that my ability in both of these areas is going to be affected as will my identity as a man.

I hate hospitals and I hate medical consultations and I really hate people messing about with my body, telling me that there might be some minor side effects when in fact these side effects are enormous.

Anyway - rant over. I am sure it is nothing that you forum stalwarts haven't heard 100 times before.

This is a club I did not want to join but at the same time I am very glad it is here.

Laurence

User

Posted 17 Feb 2022 at 21:23

Originally Posted by: Online Community Member

I am 63 years old and have recently been diagnosed with prostate cancer. My PSA is 13, my Gleason score is 3 + 4 with no bone or node involvement.

I have no idea how many samples had grade 4 cells as it just says 3/6 on one side and 1/1 on the other.

[text removed]

Firstly, a Gleason 3+4 doesn't mean that some of the cores were a 4 and some were a 3. It means that when they looked at your cancerous cells under a microscope, the most prevalent pattern was 3 (the least aggressive form) and the next most prevalent pattern was 4 (poorly differentiated and more aggressive). The 3s and 4s could be in the same core - they could be in all 7 cores - there might have been almost all 3s but a little bit of 4.

Some men don't die because it went to bone or lymph nodes; they die because the prostate becomes enlarged and completely blocks the urethra causing urinary retention and then kidney failure or other complications like that. My father-in-law (G3+4 T2) refused treatment because he didn't want to wreck his sex life - he lived for 4 years. It spread to his liver and kidneys and caused oedema which stopped his heart.

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

User

Posted 17 Feb 2022 at 21:25

PS it is rare but a G3+3 can spread (metastasise) so in the big picture, it doesn't really matter how much 4 you have - the fact that the majority of your cancer is a 3 is a good thing but not a guarantee.

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

User

Posted 17 Feb 2022 at 23:24

Thanks Lyn.

Yes - I have lots to think about.

I will speak to the consultants and then decide.

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