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Is it safe to take radiation treatment for aggressive prostate cancer?

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Oncologist, Surgical
Practicing since : 2008
Answered : 576 Questions
Dear MD, My dad is a 74 year old male, in excellent health, except for a most recent diagnosis of Prostate Cancer. I understand that this cancer is treatable, but I have to say I am very worried that my dad may have an atypical, aggressive cancer. He is going for a bone and CT scan next week, but his biopsy results are not looking that great; with high Gleason scores, and also a possible perineural invasion. I am attaching his results, and am hoping that someone could let me know what to do next (i.e. prostectomy and/or radiation, and/or hormonal therapy, etc). Also, does radiation work well with aggressive prostate cancers; as equally as it would with less aggressive ones? Final Diagnosis: 1.) Prostate-left apex-biopsy -Prostate tissue with a small focus of atypical glands. 2.) Prostate-left mid-biopsy -benign prostate tissue 3.) Prostate, left base, biopsy -Adenocarcinoma of the prostate. Gleason score 4 +3= 7 involving 20% (1.5 mm in length) 1 of 2 core(s) 4.) Prostate, right apex, biopsy. -Adenocarcinoma of the prostate. Gleason score 4 +5=9 involving 95%, 95%, and 60%). (5.5 mm, .5mm, and 4 mm in length) of 3 of 3 core(s). -Perineural invasion is identified. 5.) Prostate, right, mid, biopsy -Adenocarcinoma of the prostate. Gleason score of 4+5=9 involving 95% (7 mm in length) of 1 of 2 core(s) -Adenocarcinoma of the prostate. Gleason score of 4 +3=7 involving 80% (8.5 mm in length) of 1 of 2 core(s) - A total of 2 of 2 cores involved in carcinoma. 6.) Prostate, right base, biopsy -Adenocarcinoma of the prostate. Gleason score of 4 +4=8 involving 85 and 70% (10 mm and 7 mm in length) of 2 of 3 core(s). Thanks! XXXX
Posted Mon, 10 Feb 2014 in Cancer
Answered by Dr. Rohan Khandelwal 9 days later
Brief Answer: Decision will be based on the staging CT Detailed Answer: Dear Sir, Sorry to hear about your father's illness. The reports which you have shared clearly show the presence of cancer in his prostate, which is of high grade as evident with the high Gleason's score. Unfortunately, the treatment cannot be decided without knowing the extent of the disease, which will be evident on the CT and bone scans, which are scheduled for next week. The various modalities of treatment are surgery (for localized disease in a patient with a good performance status), radiotherapy and/or endocrine therapy. Once we know the extent of the disease, the appropriate treatment can be planned. Hoping for the best. Please feel free to clarify any other queries.
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