It depends on if the cancer is contained or not. With a Gleason 9 or 10 there is a much higher probability of the pc having escaped because the cancer is agressive. There is no way of telling 100%, but you can get closer. A PAP test can indicate micromets. A MRIS or Color Doppler can identify the tumor
location of the tumor is probability the most important indicator that surgery will or will not work. The Combidex, which is no longer available, was the best diagonostic tool available to see small amonts of PC in the Lymphnodes. Dr Myers talks about
a certain blood test that can indicate pc cells in the blood stream. Using all this information plus information from nueral networks and partin tables you can come to a better decision as to if it is contained or not.
With high risk PC most oncologists would recommend a combination treatment, surgery or RT plus Hormone Therapy for a period of 24 months. This combination is the most effective as it addresses the tumor as well as any PC cells that may have escaped.
64 years old.
PSA rising for 10 years to 40, free psa 10-15. Had 5 urologists, 12 biopsies and MRIS all neg. Doctors DXed BPH and continue to get biopsies yearly. 13th biopsy positive in 10-08, 2 cores of 25, G6 less than 5%. Scheduled for surgery as recommended by Urological Oncologist.
2nd Opinion from Dr Sholtz, a Prostate Oncologist, said DX wrong, pathology shows indolant cancer, but psa history indicates large cancer or metastasis. Futher tests and Color Doppler confirmed large transition zone tumor that 13 biopsies and MRIS missed. G7, 4+3, approx 16mmX18mm.
Combidex MRI in Holland eliminated lymphnode mets. Casodex and Proscar reduced psa to 0.6 and prostate from 60mm to 32mm. Changed diet, no meat and dairy. All staging tests indicate that tumor is local and non agressive. (PAP, PCA3, MRIS, Color Doppler, Combidex, tumor reaction to diet and Casodex, and tumor location in transition zone). Surgery a poor option because tumor is located next to the urethea and positive margin is very likely; permanent incontenance is also high probability with surgery.
Seed implants on 5-19-09, 3 hours door to door, no pain, minor side affects are frequency and urgency; very controlable with Flowmax and lasted 4 weeks. Daily activities resumed day after implants with no restrictions. Gold markers implanted with seeds to guide IMRT.
25 treatments of IMRT 6 weeks after seed implants. No side affects at all.
PSA at end of treatment 0.02 mostly the result of Casodex. When I stop Casodex next week expect PSA to rise. Next PSA in November. Treatments and side affects have greatly exceeded my expectations. Glad to have this 11 year journey finally conclude.