My MRI Ultrasound Fusion Guided Biopsy results just came out: 1 out of 14 cores was found to be cancerous:
• Right Lateral Base: Prostatic Adenocarcinoma (PC), GS 7 (4+3, Grade Group 3) involving 55% of one core. Perineural invasion (PNI) identified.
• Right Lateral Mid: Benign fibromuscular tissue and adipose tissue.
• Right Lateral Apex: Benign prostatic tissue with focal chronic inflammation.
• Left Lateral Base: Benign prostatic tissue with focal atrophy.
• Left Lateral Mid: Benign prostatic tissue with focal mild chronic inflammation.
• All the rest cores are benign prostatic tissues.
Before biopsy, my MRI has identified two lesions (4mm and 8mm PI-RADS 4) in prostate. The biopsy core which contains cancer is from the 8mm lesion. The lesion is in contact with prostatic capsule, but no definite extraprostatic disease is seen. No evidence for seminal vesicle invasion.
The bx results have been sent to Myriad Genetics for a genetic testing to find out the aggressiveness of the PC before making treatment decisions.
My questions are:
1. Is PNI a significant factor in my decisions to choose treatments among surgery, non-surgery and AS options?
2. Should I deal with the two inflamed areas first through medication before doing any non-surgery treatment on the cancer? I am thinking of dealing with the inflammation first to see how this part has contributed to my increased PSA.
3. With my Gleason scores and other factors listed above, would EBRT or SBRT be a viable option?
I thank you in advance for your advice.
Age: 55, active and in excellent health
PSA: 4.8 - 11.5 (9/2014 - 6/2017)
Post Edited (dafight) : 8/3/2017 10:33:56 PM (GMT-6)