Here's a link to Stillers piece on his diagnosis, decision making, and treatment. He does give the impression that a Gleason 7(3+4) is more aggressive than we consider it to be in the absence of other information, but then again that other information is
absent in his story. He doesn't mention the number of positive cores or his actual PSA readings and there are values for those other indicators that would have made a Gleason 7(3+4) sufficiently risky to easily justify treatment./medium.com/cancer-moonshot/the-prostate-cancer-test-that-saved-my-life-613feb3f7c00#.qdwhbnjmc
And I should point out that he does touch on the controversies of PSA screening and the overtreatment of low-risk disease.
In his writeup he said...
The criticism of the test is that depending on how they interpret the data, doctors can send patients for further tests like the MRI and the more invasive biopsy, when not needed. Physicians can find low-risk cancers that are not life threatening, especially to older patients. In some cases, men with this type of cancer get “over-treatment” like radiation or surgery, resulting in side effects such as impotence or incontinence. Obviously this is not good; however it’s all in the purview of the doctor treating the patient.
So I give him high marks for at least mentioning the controversies, even if some here might wish he had come down on the other side of them. And we have no way of knowing that his decision making was flawed. We'd need to know more about
his PSA value, the number of positive cores in his biopsy, and what his MRI showed. There are certainly some
cases of Gleason 7(3+4) disease that require aggressive treatment -- we have no way of knowing (at least from the article I read) if Mr. Stiller was one such.
63 Slow PSA rise 2007-2012: 1.4=>8
4 bxs 2010-2012: 1&2 neg, 3 pos 1/14 6(3+3) 3-4% (2nd
opn. 7(3+4)), 4 neg
DaVinci 6/14/12. "some" nerve sparing on left
Path: pT3a pN0 R1 GS9(4+5)
Pos margins on rt
24 mo ADT3 7/12 - 7/14
Adj IMRT 66.6 Gy 10/17/12-12/13/12
8/2012-3/2015: Incont., Trimix, VED, PSA<0.015.
AUS & IPP installed 3/5/2015Forum Moderator - Not a medical professional