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Gleason 8 Ductal Crib form De Novo Pelvic Lymph Node 3 Lytic Lesions Radiology Prostatectomy, Can I
Going through the stories here on this site, just about every Gleason 8 that had RP is alive, so is a few I talk to that had RP after metastatic spread…
Please give your advice, experience and research…
My Story
Bio
Caucasian Male DOB: 1961
Has Severe Plaque Psoriasis since 2003
Has received Embrel, Stelera and Tremfya biologics but, no longer on an immune suppressant as of 03/18/2022 due to concern of advanced metastatic prostate cancer.
Diagnosed
By PSA Score 942.40 06/24-2022-07/06/2022
Advance Metastatic Prostate Cancer with Ductal subtype
with focal cribform architecture in carcinoma (it is rare, unfortunately aggressive)
4 cores out of 15 with another questionable core with necrosis and questionable atypical cells
Stage 4 Gleason 8 3 Lytic Lesions (unusual or rare)
CT Scan, Pylarify Pet Scan, Bone Scan,
3T 3D guided MRI with write over
07/15/2022 Transperineal Biopsy
Biopsy 07/15/2022
Prostate cancer (C61)
DIAGNOSIS :
A. Prostate core, left anterior apex, biopsy:
Prostatic adenocarcinoma, Grade Group 4 (Gleason score 4+4=8) with ductal features, involving 5% (1 mm) of 1/1 core.
B. Prostate core, left anterior base, biopsy:
Prostatic adenocarcinoma, Grade Group 4 (Gleason score 4+4=8) with ductal features, involving 95% (13 mm) of 1/1 core.
E. Prostate core,midline apex, biopsy:
Prostatic adenocarcinoma, Grade Group 4 (Gleason score 4+4=8) with ductal features, involving 70% (9 mm) of 1/1 core.
O. Prostate, MR target prostate core x5, biopsy:
Prostatic adenocarcinoma, Grade Group 4 (Gleason score 4+4=8) with ductal features, involving 30%, 10% (2 mm, 1 mm) of 2/5 core fragments.
K. Prostate core, left lateral apex x2, biopsy: Benign fibromuscular tissue with hemorrhage and rare atypical cells; cannot exclude reactive myofibroblasts.
Started Firmagon 7/6/2022
Zytiga with Prednisone 7/20/2022
and Docetaxel Chemotherapy on 08/11/2022
Ductal Prostate Cancer is
aggressive, it cannot be monitored by psa score alone.
As it can still spread by low non existing psa numbers.
PSA 942.40 7/6/2022
To 2.87 08/03/2022
To 1.07 08/11/2022
To 0.41 09/01/2022
To 0.34 09/13/2022 Testosterone <7
To 0.24 10/18/2022 Testosterone <7
To 0.20 11/08/2022 Testosterone <7
Started Otelza for psoriasis and that May of moved my PSA up, I hope to God I’m not failing already, MO is not concerned
Up To 0.26 11/29/2022 Testosterone <7
Re: Gleason 8 Ductal Crib form De Novo Pelvic Lymph Node 3 Lytic Lesions Radiology Prostatectomy, Ca
Hi Jam,
Given your circumstance, conventional medical thinking would be toward a systemic treatment focus. RP as you are no doubt aware is a localised treatment for a tumour that has not either breached or just breached the walls of the prostate. So I am not to sure what the rationale of your medical oncologist would be if they are recommending RP?
Re: Gleason 8 Ductal Crib form De Novo Pelvic Lymph Node 3 Lytic Lesions Radiology Prostatectomy, Ca
Well, I had the surgery as it was offered through a trial, but since I qualified I decided to go ahead and have Davinci Radical Prostatectomy with lymph node removal, 8 lymph nodes removed no pcs cancer, one showing resolved by chemotherapy. I am now per John Hopkins a Gleason 9, bladder neck and positive margins in some areas…the oncologist doesn’t want me to do radiation but John ahopkins, Dr Epstein states I should once my light leakage very now and then stops all together or clears up.
