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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Lab Report Shows Extraprostatic Extension Present. Have Hep C. Options?

I have a Gleason score of 9 (4+5) post radical prostatectomy, my lab report indicates that the tumor was 25% of the prostate and that I have "extraprostatic extension present," with the margins neg and neg for lymph nodes. I'm 64 yrs old and this is Agent Orange related from my service in Vietnam 68-69. What are my best options now, given that the cancer is still present? Additionally, I have Hep C, also from military service.
Wed, 24 Apr 2013
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Orthopaedic Surgeon 's  Response
How much is your PSA level?
.

Your surgeon/urologist may be co-relating both gleason score and PSA level and also staging of tumor to evaluate you for further line of treatment (hormones + radiotherapy)

As you say it is only locally spread so far, chemotherapy may not yet be indicated ( unless spread to far places),radiation might help a lot.
With modern treatment there are hopes for suppression and most important the will and courage, make all therapies have far more positive outcomes, so trust your treating doc.
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Oncologist, Radiation Dr. Subhas Pandit's  Response
Hello;
Welcome to HCM;

Be asured that you do not still have cancer.Extra capsular spread means cancer has extended beyond prostate but negative margin ensures that surgeon has removed all of the cancer tissue.

Your gleason score is high and you also have Extra capsular spread which are high risk feature.Discuss with your oncologist regarding adjuvant radiotherapy.The decision also depends on PSA levels which you have not mentioned.

Wish you a speedy recovery.
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Lab Report Shows Extraprostatic Extension Present. Have Hep C. Options?

How much is your PSA level? . Your surgeon/urologist may be co-relating both gleason score and PSA level and also staging of tumor to evaluate you for further line of treatment (hormones + radiotherapy) As you say it is only locally spread so far, chemotherapy may not yet be indicated ( unless spread to far places),radiation might help a lot. With modern treatment there are hopes for suppression and most important the will and courage, make all therapies have far more positive outcomes, so trust your treating doc.