The pathology report following my biopsy earlier this year scored me at a G7 (3+3, 20% of one core, and 3+4, 40% of one core). Heeding the suggestions received in this forum, I had my slides sent to Dr. Epstein at Johns Hopkins for a 2nd opinion. Earlier today I received the results of the Epstein review.
The good news for me (and now also the quandry) is that Hopkins came back with a 3+3 and a 3+3, with same percentages involvement initially noted (I'm calling the improved score a downgrade, but maybe it's an upgrade?). Both are rated only as a Grade Group 1 (most favorable). An earlier Decipher test categorized me as low risk for progression (albeit at the higher end of low risk).
At this point, based on the initial pathology and Decipher testing, I'm pretty far down the path a treatment selection process, having already had consultations with a RP surgeon, an IMRT RO, and a LDR Brachytherapy specialist. My planned remaining consultations before making a final treatment decision are with a SBRT specialist and a HDR Brachytherapy specialist, these latter two being the finalists I had narrowed by treatment choices down to.
My updated Gleason score sort of screams AS at me. I am supposed to talk to my Urologist later today to get his take on the 2nd opinion and whether I should treat or not. The immediate questions that came to mind is whether or not it is safe to ignore the initial pathological scoring of G7 and just safely assume I'm now a G6, or should I go with a tie-breaker and send the slides out for yet another review?
Assuming the G6 status is valid, I'm wondering how many folks pursue some form of treatment anyway (to nip this devil in the bud)? Or do I now opt for AS and make every effort to improve my diet and exercise regime?
If I thought I had too many options before, it just became more confusing. Help!?!?!?!?
Dx: @ age 65
PSA: 2.5 ng/ML
Biopsy: 2 of 12 cores positive (3+3, 20%) and (3+4, 40%), G7, T2a
Staging: Low Intermediate Risk
Treatment: Pending, currently evaluating options
Post Edited (Boosted) : 6/6/2018 9:57:59 AM (GMT-6)