Prostate Cancer Survivors

 

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Re: Higher grade gleason - analysis/opinion

I'm a Gleason 9 who has had surgery, radiotherapy and 30 months of hormone therapy. I'd like to reinforce the previous messages about remaining hopeful, being positive and valuing life. Sexual function is important but a Pca diagnosis puts things into perspective. The past 4 years have sometimes been difficult but have also been some of the best years of my life.

Re: Higher grade gleason - analysis/opinion

Sorry to come in on this conversation three weeks late, but I am another who had a Gleason 9 and opted for RALP surgery. The G9 was confirmed by post-op pathology which also showed negative margins.

27 months since surgery and PSA is 0.01, sexual function not great, but not too bad either.

Re: Higher grade gleason - analysis/opinion

G'day Jack.

It is exactly one month since your original post.

Do you have an update or reply, especially to those who posted on this topic?

Brian

Re: Higher grade gleason - analysis/opinion

Hi yes, sorry didn't get chance to update yana.

I had pain in my bladder area and been for ultrasound, everything is fine.

As far as treatment is concerned all depends on first psa value if its <.2 then I will wait for 2 months for recovery and then start radiation however if its more than that then radiation in 3-4 weeks that will give more time to recover from surgery or if more time is needed adt injection.

However all based on psa due in 2 weeks time (6 weeks in total).


thanks

Re: Higher grade gleason - analysis/opinion

Jack,

Your question is a good one. You can go to: https://www.mskcc.org/nomograms/prostate/pre-op. You will find that you have around a 99% chance of having extra capsular extension with your gleason 9. So the real question is, Will surgery improve survival? Studies have shown that you improve your survival apx 3% if you have surgery first. You have to decide if that 3% is worth it given the chances of additional side effects. You will very likely require radiation and hormone therapy down the road to maintain control of your cancer.

Your urologist should have told you this and I am disappointed that most don't.

One of my pet peeves is urologist saying that they are treating you with surgery "with curative intent". What does that mean if 99% of gleason 9/10 guys recur.

Keep in mind that you can still live a long time with the addition of systemic therapy.

Fred

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