Gleason 7

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0:28 Is the monitoring process for a Gleason 3+3 different than for Gleason 3+4?
2:13 Does the location of Gleason 7 cancer eliminate the use of brachytherapy?
4:12 Can focal treatment be considered if the tumor might have breached the prostatic capsule?
5:14 Is there a preferred method of focal therapy for a breached tumor?
6:20 After radiation treatment and ADT with an undetectable PSA can hormone therapy be stopped?
7:28 74 years old, Gleason 3+4, PSA 25, doctors want treatment. Is it necessary?
9:11 58 years old, PSA 10.8, Gleason 3+4, PET PSMA scans negative. Do I need treatment?
12:22 How should genetic testing be used as a diagnostic tool?
14:08 With a PSA of 10.3, Gleason 3+4 is a CT/Bone scan a good idea?
15:50 With a 1.75 cc lesion 10% Gleason 4 as it grows will the cells stay the same?
17:25 With a Gleason 3+4 diagnosis, low testosterone, is adding low dose testosterone ok?
19:31 Alex's conclusions
21:53 If you need more help
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Опубликовано:

7 июл 2024

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Комментарии : 31

@ThePCRI 13 дней назад

Meet Dr. Scholz, Alex, and world renowned prostate cancer experts at our 2024 Prostate Cancer Patients & Caregivers Conference: pcri.org/2024-conference

@rockycotugno5655 12 дней назад

3+4. Took my prostate out and did 17 biopsies and found all clear. No PSA for a year then started going up then Radiation therapy. Put me on Elligard 3 month injections. Good for 3 years. PSA going up. Started me on Casodex. Lasted 3 years and gave me afib. PSA around 5 started me on Nubuqa 2pills a day with continued Elligard. Stopped my pills for 3 months to get my sugar back to normal PSA went up to 13. Started Nubeqa again and PSA went to 6 Next bloodwork 3 months later PSA 11. I would like to send my surgical reports to you Doctor to review. Something is strange

@scottdavis5749 14 дней назад

55 yr old with one 3+4=7. Did 28 IMRT treatments that finished in May. Back to normal after 3 weeks and now can’t tell any difference pre treatment and post

@KB-tz1ow 13 дней назад

Very informative video. Dr. Scholz seems to be a voice of reason amidst a world of confusion.

@TheJS1951 14 дней назад

Been following PCRI videos as I will be making decisions this summer. Remarkable resource helping me with my decisions!!!!!!!

@MM-sf3rl 12 дней назад

Great job Dr. Scholz, Alex and PCRI.

@gary4451 12 дней назад

I am very relieved by the information that was provided in this video regarding the genomic test. I had the Decipher genomic test and my score was Low (0.17). The 5-year risk of metastasis was 0.7%; the 10-year risk was 1.7% and the 15-year risk of mortality was 3.2%. The doctor ordered the test to see if I should be treated "more aggressively" despite my intermediate risk PSA at 12.7 ; Gleason 4+3=7 and clean PSMA/PET, MRI, Bone Scan, PET Scan results. Thanks!

@TERRY-cb2ku 14 дней назад

Update. Had my biopsy and got the results. Although a lesion was seen on MRI earlier and PSA was 5.56 at one time, no evidence of malignancy was found after 14 samples were taken. My understanding was that 2 samples were taken from the lesion. However my prostate is much degraded. Diffuse acinar atrophy. Diffuse acinar hyperplasia. Acute inflammatory infiltration. I'm of the opinion that untreated prostatitis in years past could have been part of the cause. I've done some research but have found nothing definitive. Still, I'm very thankful that I don't have a cancerous prostate.

@ReachTim 13 дней назад

I wish they would do a video like this for someone who is diagnosed with Gleason score 7(4+3) & also with an EPE (extraprostatic extension), and with ADT hormone therapy (6 months), brachytherapy, and 5 sessions of SBRT (cyber knife) as recommended treatment.

@jimschlemmer 12 дней назад

Diagnosed at 45, 61 today. At diagnosis: 4/2008, PSA 9, Gleason 4+3, RP performed. PSA never hit undetectable so in 7/2008 I did salvage RT to the prostate and local lymph nodes, followed by 2 years of lupron, which I tolerated pretty well. PSA undetectable until 2014. Then began a slow, steady rise until now, 10 years later, it’s at 2.5. PSMA/PET revealed “a few” spots in pelvic lymph nodes in two different areas (low volume disease). Oncologist and original radiation oncologist recommend against radiation due to difficulty of hitting affected lymph nodes. Instead, a recommendation of ADT for 6 months has been made. I have an appointment to speak to another radiation oncologist. I was wondering about the efficacy of adding an ARPI, and even a chemo agent to the ADT at this stage. I’m in excellent physical and cardiovascular health with a BMI of 21. Thanks so much for doing what you do. I've leaned heavily on PCRI for timely and detailed information over the years.

@daisuke6072 14 дней назад

Regarding the patient with apical lesion I had one 3+4 apical lesion which had progressed from 3+3 (seems I am an exception to 3+3 not progressing) and was concerned about quality of life so had nanoknife. Just over a year later MRI shows cancer free though this reduced the volume of my prostate. Some urgency but does not affect my social life. You need to have sufficient margin round the lesion to do it. The first week difficult with urethral inflammation, catheter for 3 days, continued urgency afterwards but no incontinence, good recovery thereafter but don’t believe the claims you will be able to do manual work or return to work in a week just like before! Can get erections, though better durability with cialis. So I would recommend this as a less invasive treatment with good prospects of outcome. Other forms of focal therapy are not suitable for the apex and may have more complications. I hope this is helpful.

@hitechrr 22 часа назад

I had a 4+3. I did radiation in 2020. I did a PSMA Pet-scan. I still have active cancer in the same location. I'm told that I can't do radiation or removal now that I already had radiation.

@kevinparker2324 14 дней назад

43 year old diagnosed 3+7 a month ago.

@foropera 9 дней назад

Oh..! If I am right, this was my comment.Thank you for the answer about the brachytherapy/cyberknife risk in the case of an Apex location in a located Gleason score 3+4 tumor. ( I am in France). Finally I didn't listen to this Surgeon who was predicting a terrible burn of the uretral sphincter. I did my brachytherapy a month ago. I am waiting to see if light urinary problems do increase or not. It would be normal. At the moment they are manageable with some medications. There remains strangely a retrograde ejaculation, and orgasm is either very weak- or painful, at the level of the urethra( as it exits the perineum, perhaps the after-effects of the urinary probe, or the muscle relaxant medications. I am given low dose tadalafil for 6 months. We'll see.

@ratanpurohit7862 14 дней назад

I am 68 years old. Had radical prostectomy for 4+3 Gleason score CA prostate. No mets at that time (PET scan) Present PSA is 0.07 . Post surgery level was 0.001 Any cause of worry

@RH-xd3nx 14 дней назад

I'm no doctor, but no worry. If you had nerve sparing surgery. Believe it or not,NSS produces a small amount of psa from benign microscopic prostate tissue left on the nerve endings after surgery. If it holds steady under .2 you should be in the clear, also doubling time is a good indicator. Always ask a physician brother.

@cabacronulla 14 дней назад

I have 4+3..recently finished SABR Radiation Treatment..My PSA was at 7.7 Now after 1st test after Radiation it is now 3.2? is this OK/.. Thankyou fromAustralia.Also my Oncologist said see you in 3 months.. I'm just woried about did the Therapy work completely in eradicating my enclosed cancer? I'm 65...

@ransomcoates546 10 дней назад

The PSA can lower gradually over a year’s time after radiation. I had exactly your situation and after three years PSA is below 1.

@cabacronulla 10 дней назад

@@ransomcoates546 Thanking you...

@MM-sf3rl 12 дней назад

You can manage what you don’t measure. “Active” Surveillance.

@helper2888 11 дней назад

I was recently diagnosed with 3+4 in MRI/Ultrasound fusion biopsy (in 12 standard cores, 1 core 3+3, 1 core 3+4 with 5% of 4; in 6 targeted cores, 1 core 3+3, 2 cores 3+4 with 5% of 4). My PSA was 8.01, with PSA density of 0.16. I checked some of the Active Surveillance eligibilities, and I find I should be in the AS. But my doctor suggests focal therapy treatment because my MRI showed growth of the tumor of 21x5 mm this year, comparing to 9x6 mm last year, and 6x5 mm the year before. My question for Dr. Scholz and others, am I still a good candidate for Active Surveillance? I remember watching a video from UCSF, department of urology and their study showed the Gleason Score and the amount of 4 matters most in deciding the AS candidate, and size of the tumor didn't make big role down the road. A doctor from Uni of Maryland, department of urology also uses if the tumor size is less than 1/5 of the total prostate size to determine if the tumor is too large for Active Surveillance.

@raichandsoni287 14 дней назад

74 years old diagnosed wih gleason score 3+3=6 what should be done

@scottdavis5749 14 дней назад

Watch it with active surveillance.

@TERRY-cb2ku 14 дней назад

Probably active surveillance, wirh frequent testing.

@89itis 13 дней назад

Maybe make sure it’s real 3+3. Random biopsies can miss aggressive cancer. Transperineal in bore MRI-guided targeted biopsy is the safest and most precise. If it’s true Gleason 3+3 you’ll most likely just go on active surveillance and continue with you life. Check with experts however, as I’m not a doctor 🙂

@ralphjordan8852 14 дней назад

69 w/m gleason 4+3, is it same as 3+4, and what would you recommend

@markusrose9667 14 дней назад

It’s not the same. 3+4 is “intermediate favorable.” 4+3 is “intermediate unfavorable.”

@itsaboutdebbie8479 4 дня назад

My dad is 79, recently diagnosed 3+4=7. PSA of 5.92. Based on your previous video, I urged him to pursue Oncatype testing which came back 13%, low risk. Lives in an area without great options for medical care and feels a bit forced into having surgery, radiation or proton beam therapy as his doctors are not presenting additional options. Is he a candidate for active surveillance?

@MM-sf3rl 12 дней назад

Sorry to disagree with Alex, but some times, run like hell from your doctor. My doctor would raise his finger and exclaim how often he had found cancer. My 3+4 was all on the left side. Per his notes it was on the right side. The pathology report showed the right side cores were benign.

@ThePCRI 10 дней назад

Wow! I am so sorry you went through that. In cases like this, I agree with you! - Alex