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Since you say you have twelve positvie cores, that would indicate a high possibility of a large tumour. There are some studies that imply a higher probability of the disease having spread beyond the gland or the casule where the tumour is large.
For that reason, having confirmed that all biopsy results are positice and are graded correctly, I suggest that you try to establish more accurately the size of the tumour. Whilst MRI and CT scans are unreliable for very small tumours, they can usually detect large ones. If you can, perhaps a Color-Doppler would give an even more clear picture.
The point of this post is that, if there is a large tumour and a higher probability of escpe from the gland, surgery may not be the most appropriate choice.
Thanks,
I am scheduled for an Endorectal MRI in 3 days.
The doc said the same thing, but wanted to make sure I had a date, so that i may have surgery if he suggests it proper after looking at the MRI.
Lets just say that surgery may not me the best option, what do you think would be?
Thanks for any info.
Will
I don't know if you have read any of the E-Letters I try to send out from month to month. If not perhaps you'd like to just have a quick read of the short piece headed Metatasized Disease in E-Letter 9 .
The reason I am suggesting this is because if the tumour is as big as the current pathology report implies, there MAY be a greater chance that the disease is possibly out of the gland or even "systemic" or "micrometastatic". The difference between "systemic" and "micrometastatic" being that in the former, inactive cancer cells might be lodged in remote parts of the body: in the latter cancer cells might be active even if they were unidentifiable. Size is a factor in trying to estimate the probability of escape from the gland, but this is less likely with low Gleason Scores - hence my repeated suggestion to have a review of your pathology.
IF there is this greater probability, then it may be better to consider a wider therapy - radiation: proton or photon/ brachytherapy or EBRT (External Beam Radiation)which would deal with the gland and the capsule and/or ADT (Androgen Deprivation Therapy).
I think it unlikely that there willbe any clear evidence guiding you to one specific therapy, but I do think that having surgery on November 29 may be rushing into a life changing treatment (all prostate cancer treatments are life changing) before you have fully explored the diagnosis or your options. I say that, not critically, because I fully understand the kind of reactions we all have to the word 'cancer' being applied to us, but I also know that many men wish they had spent more time gaining a better understanding of their options and the likely outcomes.
I don't know if you have been through the site page by page, starting at the page labelled DON'T PANIC but it may be worthwile spending some time doing just that. If that is more than you want to do, then can I suggest you follow the pointers in the page labelled SURVIVING PROSTATE CANCER and especially the section on that page headed ASSESS STATUS BEFORE DETERMINING STRATEGY.
Good luck to you whatever your decision - keep asking questions. Oh and please let us know how you go by sharing your story with us .
