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I Am 75 Old Year Male Recently Diagnosed With Grade

Posted on Wed, 10 May 2023

Question: I am 75 old year male recently diagnosed with Grade 2 Adenocarcinoma, XXXXXXX score (3+4=7), 65-70% involvement of cores, 20% of component 4. PSA 14.7. Not measured prior to this but in last 12 years has had two TURPs. Has severe LUTS as measured by flow (IPSS score of 24) and symptoms (highly frequent urination, needs to use abdominal muscles). Otherwise healthy with controlled blood pressure for decades.

PET shows PSMA expressing locally advanced mitotic mass involving prostate and loss of regional fat planes with bladder and rectum and suspicion of contiguous involvement of confluence of seminal vesicles. MR recommended for better evaluation of locoregional extent of primary disease. No evidence of locoregional lymphadenopathy or distant metastases.
Please advise your thoughts.

Answered by Dr. Dr. P. T. Patil (27 hours later)

Brief Answer:
Read answer as detailed below.

Detailed Answer:
Hello
Thanks for query .Based on the facts that you have posted you seem to have developed Locally Invasive Carcinoma Of the Prostate with Gleson's score oof 7 and PSA of 14.7.

Inview of above findings I would suggest you following modality of tratment .
1) Surgical Catrsion (Bil Orchedectomy) followed by Radiation theraphy followed by Chemotheraly after monitoring PSA levels frequented at monthly interval.

I would suggest you to consult qualified Medical Oncologist for further treatment .

Hope I have answered your query ,please feel free to ask if you have more questions, I shall be happy to help you
Thanks and Regards.
Dr.Patil.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. P. T. Patil (15 hours later)

Thanks for your reply.
My doctor is recommending removing the prostat. Is this same as your recommendation. Thanks.

Answered by Dr. Dr. P. T. Patil (6 hours later)

Brief Answer:
It is different from what I have suggested

Detailed Answer:
Hello
Thanks for follow up. There are various modality of treating Carcinoma of the Prostate . what he has suggested isa Radical Prostate surgery .(Removal of Prostate) The modality is decided by the concerned Uro Oncologist depending upon other morbidities and health of the patient

Thanks and Regards
Dr Patil

Note: Consult a Urologist online for consultation about prostate and bladder problems, sexual dysfunction, kidney stones, prostate enlargement, urinary incontinence, impotence and erectile dysfunction - Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar