Radical in July/ gleeson 9 psa 55

Thanks for the reply.

It was mentioned that it may be a possibility but not a certainty.

The consultant said it may be a good idea (just in case) because was aggressive but at not point said "I strongly advise that you have salvage", straight away.

Im just struggling with, do I wait and see?

Or do I have salvage when he may have removed all, and may have not spread.

The never ending decision making and waiting continues.

All the best.

Hi Scotty

My husband had RP in June 

His pathology was T2c Gleeson 4+5

Pre op PSA5.6 

Post Op PSA >0.01

His consultant has said just 3 monthly PSAs until and if a rising PSA 

I had done some research prior to the meeting to see what was likely to be the next step and came across Dr Scholtz in the US he does talk about hitting high Gleesons with locally advanced (which I think you are with the lymph node spread) hard early on to give the best outcomes. I’m not medical and it’s not advice but it may be worth you having a look at what he says and see how you feel about it when you’ve done a bit of digging! 

As far as my husband was concerned he was going to ask for early intervention should his pathology of been higher than T2c 

I hope you get some more replies that can give you a bit more of an in-depth knowledge. 

All the best 

M 

Welcome to the team!!!!

Seems i'm just a couple of month behind you as had surgery on 1st October and have follow up consultation on 5th November.

The surgeon has not said to me that I will need SRT but the little hints he has given regarding the size of the tumour and the fact he took out (I think he said 9 lymph nodes) I fully expecting further treatment.

PSA was 4.1 pre-op and biopsy returned a Gleason score of 8 4+4.

Continence is quite frankly driving me nuts at the moment but I keep reminding myself that catheter only came out 10 days ago.

Good luck mate

Thanks Dave

Think I should have expected further treatment based on my pre opp results, think I had 16 nodes removed in the end with 2 full of disease, my continence returned to near normal so try and stay patient mate.

All the more reason I'm worried about salvage as I hear that can mess it up again, hope that's wrong.

I suppose its talk to oncologist and go from there?

All the best in your recovery Mate.

Thanks Derek

You too.

Was just saying to wife, only 3 months since opp and seems like a lifetime/ seems like every result and event makes you more anxious and triggers upset??

Trying to snap myself out of it.

All the best mate

Scotty,

I am a little surprised they were not more open about a very high possibility of adjuvant Radiation Treatment (ART) which includes hormones as soon as healing from surgery in your case. You mentioned the PET which typically would show if your nodes were involved. That and with the aggressive high Gleason 9 I believe standard  protocol is ART. That being said I understand the hesitance. My Gleason was 8, and Gleason 8 ‘s protocol for considered aggressive is also that and with a high intermediate decipher score they told me it was a strong possibility. Fortunately, although the cancer had focally left the capsule, I was able to have negative margins and post pathology lowered my Gleason to unfavorable 7 which left me open if my post PSA was low to go on the PSA monitoring which it was <.4. This now further down if my PSA rises would then need SRT(Salvage Radiation Treatment). I am 71 and can look at and treat in a different manner than someone in their early 50’s. Having gotten to the lymph nodes it may likely need the more aggressive additional treatment. You can read about many people on this site much older now than when they were diagnosed 15 years ago and had radiation treatments and are going strong. I would research the various hormones as their are different ones and agree with Derek and try to keep to a shorter duration if possible.