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To have surgery or not

User
Posted 08 Mar 2023 at 08:05

Hi,

I have had PC since 2010 ( low grade Gleason  3+3 ), more recently after biopsy there are a few more tumors and my Gleason is now 3+4 and recent PSA 8.6, I am still on active survailance, the consultant feels it is still safe to be on AS but I would be gratful to hear from anyone who is in a similiar situation, I am 68 and have had prostatitis since 2010 when after getting an infection from the biopsies.

Thanks

User
Posted 08 Mar 2023 at 10:26

Very similar situation to mine, Reg, albeit over a longer period. . I was on AS for 4 years, initially G3+3, then a biopsy showed many more affected cells (up to 75% from 5%) and I was graded G3+4. I should say that the original biopsy was not so extensive. The urologist said, and I more or less  quote, 'it seems like it is on the move and in cases like this we need to do something. If we continue with AS we will likely just be watching it progress until it is no longer contained and then it is a different ball game' . I opted for RP and the post op histology report showed that my tumour had already breached the prostate capsule but had not yet invaded the lymph glands or seminal vesicles. So for me, it turned out that the treatment was very timely. 

Peter

 

 

Edited by member 08 Mar 2023 at 10:30  | Reason: Not specified

User
Posted 08 Mar 2023 at 23:43
I think you are right to consider your position in the light of upgraded findings. In your position, I would seek an opinion from another Urologist of good standing who would need to review your histology, scans and tests to check whether he/she agrees with the opinion of your present one. This may help you decide if the risk of continuing with AS is small enough for you to continue with it, at least for some time. Another consideration is that whilst you might well cope well with RP now, this might prove an increasing challenge in another year or more. Certainly, you wouldn't want to delay treatment until the cancer had broken out of your Prostate.

Do let us know how you proceed and get on.

Barry
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User
Posted 08 Mar 2023 at 10:26

Very similar situation to mine, Reg, albeit over a longer period. . I was on AS for 4 years, initially G3+3, then a biopsy showed many more affected cells (up to 75% from 5%) and I was graded G3+4. I should say that the original biopsy was not so extensive. The urologist said, and I more or less  quote, 'it seems like it is on the move and in cases like this we need to do something. If we continue with AS we will likely just be watching it progress until it is no longer contained and then it is a different ball game' . I opted for RP and the post op histology report showed that my tumour had already breached the prostate capsule but had not yet invaded the lymph glands or seminal vesicles. So for me, it turned out that the treatment was very timely. 

Peter

 

 

Edited by member 08 Mar 2023 at 10:30  | Reason: Not specified

User
Posted 08 Mar 2023 at 23:43
I think you are right to consider your position in the light of upgraded findings. In your position, I would seek an opinion from another Urologist of good standing who would need to review your histology, scans and tests to check whether he/she agrees with the opinion of your present one. This may help you decide if the risk of continuing with AS is small enough for you to continue with it, at least for some time. Another consideration is that whilst you might well cope well with RP now, this might prove an increasing challenge in another year or more. Certainly, you wouldn't want to delay treatment until the cancer had broken out of your Prostate.

Do let us know how you proceed and get on.

Barry
 
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