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T3A and / or facing surgery - Don't Panic!!

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User

Posted 17 Dec 2022 at 11:06

Well stated Lyn. You may recall that I have posted more than once that my surgeon (now a Prof.) declared me 'cured' at my 6 week post op consultation. Being a fairly well read realist and having some unfortunate family history, whilst being pleased to know things had gone as well as could be expected (I was upgraded to T3a post op) I treated his pronouncement with due caution and whilst, if the cancer rears its ugly head again I will be deeply upset, I will neither seek recrimination nor place blame. But, if I was a sunny optimist relying solely on my surgeon, I would be shattered and that would be a huge price to pay for an ego trip, if that is what it was.

User

Posted 17 Dec 2022 at 11:27

I found this information very useful so many thanks for the detail.

I was diagnosed end August 2022 with the same situation, MRI result T3 stage breaking through the prostate capsule.

I have an appointment early Jan 2023 with a surgeon to discuss surgery but am concerned that with the potential delays including the nurses strike, that it could be some time before I receive the surgery. And during this delay the cancer has spread even further!

Question, do they do another MRI scan immediately before surgery to make sure things haven't changed too much causing surgery to then be in question and therapies now being the better option?

Of course the outcome of surgery can vary from patient to patient and it seems you're coming through it very well, so congratulations on being so disciplined with your exercises etc.

I am very anxious about making sure that I can make an informed decision and wondering if the surgeon will be biased towards advising surgery.

I'm wondering if at my consultation, I will also be given information/advice about therapies as alternative treatments so that I can make this important decision?

As you've said, the waiting is one of the worst things about all this, you have lots of time to think about everything and I mean everything!

Thanks again for telling us your story so far and all the best for 2023.

Cheers Grampy

User

Posted 17 Dec 2022 at 12:11

Originally Posted by: Online Community Member

My post histology staging was reduced from T3a to T2c.

That is very good news. We more often here of upgrades. Operations on a T2 are much more likely to lead to a cure.

Dave

User

Posted 17 Dec 2022 at 13:13

Originally Posted by: Online Community Member

I am very anxious about making sure that I can make an informed decision and wondering if the surgeon will be biased towards advising surgery.

Yes, urological surgeons have a tendency to prefer surgery, because that's what they do. That's why you should ensure that you also have an appointment with an oncologist to discuss non-surgical procedures. This should happen automatically, but if it doesn't, then ask!

Best wishes,

Chris

User

Posted 17 Dec 2022 at 16:41

Hi Grampy, I'm really gratified that you found my post useful.

I'm incredibly sorry that you are in this situation and the wait can indeed be very worrying. I can only speak to my personal experience which was that I only had the one MRI scan in the April or May as I recall and my surgery was in October.

I recall asking my nurse specialist this same question and she was very reassuring that the relatively short wait between diagnosis and treatment would not be material.

I believe that the aggressiveness of the cancer would be an important factor and this is normally revealed by the biopsy result but I'm not sure if you have had yours yet? If you have, then you could just check this with your nurse specialist who should hopefully be able to offer reassurance.

You certainly should be given treatment options at your consultation although within the NHS I believe that for T3 stage you are unlikely to be offered any alternative treatments. I would expect you to be offered surgery or radiotherapy but I am only speaking to my personal experience - I am not medically qualified.

I hope that my experience offers you some solace that it is absolutely possible for a T3 stage to be downgraded after the histology report following surgery. My MRI result was T3a and my final result was T2c following surgery.

I wish you the very best with your decision and with with your treatment and hope that you find some of my tips useful for your own situation.

Good luck and best wishes.

User

Posted 17 Dec 2022 at 18:39

"My MRI result was T3a and my final result was T2c following surgery."

Mine was also the same: T3a changed to T2c following surgery.

While on this issue - Does anyone has statistics on down grading and/or upgrading MRI and Biopsy following surgery?

User

Posted 17 Dec 2022 at 18:47

Apparently, 20% gets downgraded and 5% gets upgraded.

User

Posted 18 Dec 2022 at 09:42

Ascot , was your Gleason score regraded after your surgery/ histology.

Thanks Chris

User

Posted 18 Dec 2022 at 12:48

Hi Chris

Yes, that's correct - it was downgraded at my 6 week follow up in light of the pathology / histology following surgery.

Sorry, I misread your question - no I don't believe my Gleason score changed at all but I don't actually recall being told that one way or another but I may just have forgotten / not heard.

It was only the staging that I recall for sure was downgraded.

Is Gleason downgrading a thing?

All the best

Edited by member 18 Dec 2022 at 13:01 | Reason: Not specified

User

Posted 18 Dec 2022 at 15:14

Originally Posted by: Online Community Member

Hi Chris

Yes, that's correct - it was downgraded at my 6 week follow up in light of the pathology / histology following surgery.

Sorry, I misread your question - no I don't believe my Gleason score changed at all but I don't actually recall being told that one way or another but I may just have forgotten / not heard.

It was only the staging that I recall for sure was downgraded.

Is Gleason downgrading a thing?

All the best

My husband was downgraded on T grade from T3a to T2, but Gleason score was upgraded from 4+3=7 to 4+5=9

He had 6 months of Hormone treatment before his op so not sure if this affected his post op histology.

User

Posted 18 Dec 2022 at 17:26

HT won't change either your Gleason score or your grading. HT just slows the growth of the cancer - it doesn't kill it. Only RT will do that.

Best wishes,

Chris

User

Posted 18 Dec 2022 at 19:13

Originally Posted by: Online Community Member

HT won't change either your Gleason score or your grading. HT just slows the growth of the cancer - it doesn't kill it. Only RT will do that.

Best wishes,

Chris

Ah ok thanks Chris. There was talk initially that the HT may have shrunk the tumour to a T2 but wasn’t sure.

Someone also put a post on quite along time ago that I’ve never been able to find again. It was a link to some information about HT making Gleason score increase. I never had a chance to properly read it when I needed to.

Thanks for the info

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