Got my pathology report and my first PSA test after surgery on 5/30.
Prior to this, In anticipation of any issues had formed a team for me: Added a Medical Oncologist and a Radiation Oconologist along with my Urologist/oncologist
Pathology report showed positive margins and small area of extraprostatic (sp?) extension. Tumor size was 23% of prostate. Prostate was 23g
focal extraprostatic extension was .5mm in diameter located on left posterior
Gleason: 4 about
80/90% 3 about
10/15% scored Gleason 4+3
PSA was 1.76
Urologist says no adjuvant radiation, go on ADT immediately, reassess later
Oncologist says go on ADT immediately for 6 months, adjuvant radiation 6/8 weeks after starting ADT, says all indications from pathology report show high probability of no spread beyond prostate bed. Disagrees strongly with Urologist approach
Radiation oncologist agrees with Oncologist, also disagrees with Urologist. Says high probability of cure with ADT/adjuvant radiation. Radiation would be 40 treatments, not sure of dose.
Both oncologist and radiation oncologist agreed that surgery did not hurt my situation but was a positive factor in treatment.
I am going to follow their recommendation and proceed with ADT for 6 months with radiation 6/8 weeks after starting ADT.
Still trying to figure out how to handle Urologist. Was disappointed with his approach and surprised by how strongly the other 2 disagreed with his approach.
There was no indication of PNI or seminal vesical involveme.nt and lymph nodes were clear
Not what I was hoping for but I always understood that adjuvant radiation and ADT were a real possibility.
64 Semper Fi Former Marine
PSA 3<4 from 2007 to 2/14
2/7/14 PSA 7.8 at Primary Care Dr.
2/28/14 PSA 9.6 at Urologist
DRE detected firmness on left side 2/28/14 Biopsy done 3/21
BIOPSY: 12 cores, 10 cores showed 95% involvement mostly 4's
Gleason 8 (4+4) confirmed by Epstein 2nd opinion
Staged as T2a
Surgery (DaVinci) done on Friday, May 31
Post Edited (dowstrategy) : 7/17/2014 10:30:26 AM (GMT-6)