As Rob indicates the T3b places you in the high risk category and indicates that surgery alone may not be enough to be curative. That your Gleason score indicated more than 50%of the PCa is G4 is also significant. I suggest that you prepare yourself for more treatment both mentally and physically.
For most men even high risk PCa can be managed for a long time if it wasn’t initially cured. The worst situation is when distant spread is evident at diagnoses. That does not seem to be your case. If the PCa is confined to the area that can be radiated then you have the possibility of a cure and the PCa would not have a direct effect of limiting life expectancy. If any PCa has spread outside the area, then it is generally not curable and has to be managed indefinitely.
When is your next visit with your urologist? Was there direct discussion when you learned of the surgical pathology? After surgery, it is normal to have a PSA test at the 90 day mark. Ideally the PSA should be undetectable. If there is PSA it usually indicates that there is cancer left that was not removed by the surgery and salvage radiation and ADT drug therapy is indicated.
Hal’s suggestion to use the MSK nomograms is good. Make sure you answer the questions regarding the extent of the PCa based on the T3b and full pathology report regarding the margins and any evidence of the cancer escaping the capsule. There are three specific questions to answer. These conditions can have a significant effect on the expectation of needing additional treatment. It will also ask about
lymph node involvement. Were any lymph nodes removed during the surgery? If so, what does the pathology report identify?
PSA 59 on 8-26-2010 age 60. Biopsy 9-8-2010 12/12 positive, 20-80% involved, PNI in 3 cores, G 3+3,3+4,and 4+3=G7, T2b.
Eligard and Jalyn started on 10-7-2010. IMRT to prostate and lymph nodes started on 11-8-2010, HDR Brachytherapy December 6 and 13, 2010.
PSA < .1 since February 2011. Located in Cumming Georgia north of Atlanta
Post Edited (JNF) : 7/13/2019 7:24:33 AM (GMT-6)