I am 50 and have been recently diagnosed with a rare form of prostate cancer - Pure neuroendocrine carcinoma of the prostate. The tumor was graded as T2b, my PSA is normal, 1.4, and I don't have a gleason score as I don't have adenocarcinoma. However, it is still prostate cancer and the same therapies apply. This type of carcinoma is highly differentiated (good) and all scans thus far, bone scan, CT, and transrectal MRI all show that it is confined to the prostate. It was caught very early thanks to a post chemo CT scan for Leukemia that showed a small tumor on the prostate ( The leukemia has been in remission for over a year now). Two of the twelve biopsies tested positive.
I was referred to a radiation onc. that recommended one of two different therapies, 8.5 wks of IMRT (Intensity modulated radiation therapy) or 5 wks of IMRT followed by Brachytherapy (seeds). He pretty much dismissed surgery when I asked.
I was also referred to a neuroendocrine carcinoma specilaist who said that in 23 yrs. I was the first patient that he had ever seen with pure neuroendocrine carcinoma of the prostate without having adenocarcinoma. He said that surgery and radiation would probably have about the same effect with respect to the cancer, however, with surgery, if you know that it is isolated to the prostate, which all tests indicate, then you know that you are eliminating it.
I am having one more test, an octreoscan, that will let us know if there are any cancerous cells anywhere other than my prostate. (A radioactive isotope of Indium attaches to the cancerous cells and the entire body is scanned).
The GU surgeon, the radiation onc., and the tumor onc. then meet next week to develop what they think is the best plan for treatment. However, I was told that hormones are ineffective, chemo is not applicable to my situation, and the only real options are surgery and radiation. So, I would appreciate any advice that you have to offer.
I am treated at a major NCI so I have all of the confidence in the world in the expertise and skill of he Drs. there. I have been a patient there now for almost two years due to the leukemia and I am still in remission.