Gleason 3+4 Prostate Cancer

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Royal Berkshire NHS Foundation Trust

Күн бұрын

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@MyRetroWatches 9 ай бұрын

This is asuperb video for anyone facing this decision. I was 49 at diagnosis and treatment. PSA7.1 Gleason 7 (3+4) T3A I took the radical prostatectomy route . I saw it as the fastest way to a cure and was also advised due to my young age this is a more favourable option. I lost half my nerves as a result and sadly still suffer with ED 18 months on. I was incontinent but after 3-4 months I regained most of it and as of typing this I am now a good 95% with just some minor mishaps here and there. Make the decision that’s right for you and consider all options. Life will go on afterwards so keep that at the front of all your thoughts. I thought this consultant in this video was fantastic and wish he had been mine. Hope this comment helps the reader.

@DarrenYoung-vt9ic 2 ай бұрын

How long did you wait for surgery

@MyRetroWatches 2 ай бұрын

@@DarrenYoung-vt9ic 3 months to diagnose , 4 weeks after I am on the slab.

@DarrenYoung-vt9ic 2 ай бұрын

@@MyRetroWatches I'm 3plus 4 he put me on active surveillance but I want it out

@johnhirst4673 12 күн бұрын

@@DarrenYoung-vt9ic I am 3-4 on AS and wonering about the same decision. What made you decide on such a definite decsiion/ Many thanks

@DarrenYoung-vt9ic 12 күн бұрын

@@johnhirst4673 just nervous I suppose

@oldhounddog57 11 ай бұрын

Coming from a urological surgeon, this is a surprisingly balanced explanation. Very well done, Sir! He refers to alternative treatment options such as radiotherapy (brachytherapy and external beam) and the complications associated with surgery (incontinence and impotence). I wish all urologists were this objective.

@ACTIVEPAIR 9 ай бұрын

Had result of biopsy this morning 3+4=7. Found this video just the tonic this evening. I’m a very fit healthy 58 year old. Think I’m going to ask for Active Surveillance as I’m looking to alternative therapies. Thank you 👍🏽

@shamrock8561 5 ай бұрын

I also have 3+4 and chose to do active surveillance. I had my biopsy sent to decipher for a genomic test which came back as a very low grade . The results gave me a 1.87 percent chance of spreading in the next 10 years so I chose to do active surveillance. I get my PSA checked every 6 months and a 3T MRI once a year. I brought my information to a cryotherapy specialist which is the path I was thinking of taking before the genomic tests results and he told me based on all the information about my Gleason score and my genomic test results that I should do no treatment at this time and may never need treatment. He told me the treatment would be worse than the cancer at this time.

@ACTIVEPAIR 5 ай бұрын

@@shamrock8561 thanks. Just had the result of my PMSA PET scan, no metastasis so really happy! Still not taking NHS standard of care route! What Genomic tests did you get done? 😁

@shamrock8561 5 ай бұрын

@@ACTIVEPAIR glad to hear you are taking the proper steps and not jumping into treatment like some others out of fear of the word cancer. I’ve done a ton of research since I found out I had prostate cancer. Look for the PCRI videos on KZbin regarding prostate cancer. Dr Schultz gives out some great and helpful information. He specializes in just prostate cancer information. To answer your question I used decipher for my genomic test. It gave me the information I needed as to how aggressive my 3+4 prostate cancer was. I was able to make a confident decision after the results of the test. Good luck on your journey

@peterruddick1952 Жыл бұрын

Excellent summary, wish i had heard it b4 my prostatectomy, it would have provided clearer expectations

@davidgallie1365 7 күн бұрын

I have Gleason 3+4 and have been referred to a cancer centre. Thank you for this video. So much more helpful than my conversation in the clinic of my local DGH yesterday.

@iaintoms7071 Жыл бұрын

Gleason 9. Thanks - this the best and most clear explanation I’ve had. Mine had already spread on diagnosis and immediate hormone injections with interesting but acceptable effects followed by 160 mg/day pills. Onward with the bucket list while still fit …….. considering all the current pressures, lots of praise for the way the NHS has handled all this.

@ricdavid7476 Жыл бұрын

Look at the site how to starve cancer naturally i have prostate cancer its an imvakuable site to use in conjunction wirh your yreatment plan

@WalterThorne-h5k 3 ай бұрын

I had the radio therapy .. PSA still undetectable …THANK YOU FOR THIS EXCELLENT REVIEW…this NHS looking good.

@peterb2346 Жыл бұрын

3+4=7, Age 66 w/ PSA rising....4-6, then hitting 7 over 2 years. Was thinking surgery but after reading Robert Marckini's book; "You Can Beat Prostate Cancer" (2nd Edition), I will be going in for Proton Beam Radiation this winter. Survival rate is the same as both surgery and standard radiation; but with less side effects. Best of luck to all~~~

@lindamastropietro4429 10 ай бұрын

My boyfriend has prostrate cancer. He’s in the intermediate stage 3+4 = 7. I’m so scared.

@MikeSanz-qw5cq 9 ай бұрын

Hi is Proton Beam Radiation covered by Medicare insurance? Which location did you choose? Do you have an overall cost.?

@peterb2346 9 ай бұрын

It is covered 80% by Medicare. Then our secondary insurance covers the remaining 20%. Contact your own insurance company to ask. The book that I highly recommended above has a chapter on "Insurance" and why the Insurance companies are fighting it. We chose the UF Health Proton Therapy Institute in Jacksonville, FL They are excellent. @@MikeSanz-qw5cq

@TERRY-cb2ku 8 ай бұрын

@@lindamastropietro4429 Prayers for you both.

@craigsawyer5063 Жыл бұрын

This was excellent consultation with all the options for treatment. I had 3+4 =7 with 75% of the prostate cancer . Had prostatectomy In January and doing ok . Staying dry from day one which was my worry so pleased with that and still having erection issues which may take some time but all in all glad I chose to have my prostate removed.

@Jack-2day Жыл бұрын

All options for treatment? What about Proton beam, Hifu, Tulsa pro etc? Anyone? Thnx

@boblongmore907 10 ай бұрын

You have an update, 8mos later?

@anthonyford8049 Жыл бұрын

That is most informative and helpful, thank you. No reference to natural therapies?

@nickcarton1564 Жыл бұрын

Thanks this was really helpful. I have Gleason 3+4 =7 No evidence of spread beyond prostate. Initially the support team were very reluctant to advise on the type of treatment so I chose Radiotherapy, as it is less invasive and asked to discuss with the Radiologist. However he said as I have two hip replacents fitted it was not the best choice as the metal in the replacement hips restricts access for the external beam and would cause higher dose radiation to the bowel and bladder with significant risk of damage and complications. Although replacement hips is actually fairly common with elderly patients this complication was not discussed with me by support team and not mentioned in the literature provided by Prostate Cancer Research, until I met the radiologist. My research suggested radiology by IMRT was poor with two replacent hips but a Radiation by VMAT procedure avoided complications caused by two hip replacements. My radiolgoist said this was not true and it was just a different method of delivery and was NOT better for two replacement hips. I am now confused as he is the expert Radiologist contradicting a research paper! The consequence is I am now opting for robotic surgery, IF the surgeon agrees I am suitable. I first raised the possibility of prostate cancer with my GP in June 2023 and he initially tried to put me off by suggesting I was over reacting to the Media raising awareness of Prostate cancer. I had to insist on a PSA test. It is now late Nov 2023 so the time from symptoms to treatment is protracted.

@lindamastropietro4429 10 ай бұрын

I hope everything goes well for you.

@Ok-zt4lk 4 ай бұрын

Gleason 3+4=7, TOTAL PSA was 2.9; however, PERCENT FREE PSA was 9.3 ( the initial red flag and why I did a 3Tmp MRI which found several spots). Opted for Focal Laser Ablation (FLA). FLA process was without incident, recovery has been excellent thus far. Timeline was March for MRI, April was the MRI guided biopsy, early June for MRI guided Focal laser ablation outpatient procedure (all done this year 2024). Positive vibes and prayers to all that have this cancer.

@grahamnelson3608 10 ай бұрын

What they missed on the discussion was erectile problems after beam radiation. It is the reverse of prostatectomy. After 6 months mine went to nothing and viagra isn't really helping so far.

@mah1788 10 ай бұрын

Thank you for the video it’s very informative and helpful, It’s still a minefield of witch treatment to go for and very daunting to think of the side effects and the possibility it could come back, it would be interesting to see what you think about cryotherapy as that’s what I’m thinking about having, once again thank you for all the information

@johnreynolds2387 Жыл бұрын

I had a radical prostatectomy carried out by Adam Jones and his team at RBH in July 2020. I was then aged 63. Histology showed Gleason 3 + 4 prostate cancer with a small area of Gleason 5. I recovered quite well and was leak free by day 30 which I think was pretty good. This can be a major issue for many. After a biological reoccurrence with rising PSA I had salvage radiotherapy (33 sessions) January to March 2023. My PSA numbers are below - note the doubling time. On the ED front despite trying all the PED drugs nothing worked. But we live in hope! Undetectable - July 2023 0.033 April 2023 (after radiotherapy Jan-Mar) 0.686 30th December 2022 0.401 18th October 2022 0.173 8th September 2022 0.088 18th May 2022 0.044 10th November 2021 0.040 July 2021 0.035 10th March 2021 0.027 November 2020 0.084 August 2020 (5 weeks post surgery)

@coquirivva 10 ай бұрын

Hello, I am facing almost the same process, surgery in Jan 2021, went to 0, but now it climbed to 0.27 and I will go through radio therapy. Did you do Beam Proton Radio Therapy or Traditional Radio (photons) and what were your side effects after radio therapy? Thanks much, Good Luck and Congrats!

@briang6168 Жыл бұрын

Excellent, clear explaination.

@MM-sf3rl Жыл бұрын

I wonder why they did not talk about ablation therapy, especially with 3+4. This is why men need to educate themselves. Institutions, wonderful institutions, have a standard of care and may not advice beyond that.

@kafka8886 Жыл бұрын

A useful discussion, thanks. I am 3+4 T2 N+0 M+0 and am at the stage of deciding what to do. RT is out as they won't do it due to scoring 18 on IPSS and RT will make urinary issues worse, surgery sounds scary. I'm leaning towards Active Surveillance for the time being. It might be worth clarifying the Hormone part of the HT/RT regime, as I understand it you're not actually getting hormones, you're supressing testosterone production which brings it own set of side effects before you even start on the RT side effects! These can continue long after the RT is finished.

@derekgb3780 Жыл бұрын

Hi - I was 3+3 and under active surveillance which then tipped into 3+4. Went for surgery (robotic laparoscopy) which I didn't find anywhere near as bad as the fear I held about it beforehand. Surgery just over 3 months ago and probably 90% recovered now. All good so far and PSA at 6 weeks and 3 months both

@MM-sf3rl Жыл бұрын

Have you had a genomic test done? This is a good biomarker for how aggressive the cancer may be. Also, the BRCA 1/2 is another good why to check the box that it is not a DNA problem (I think I said that right). Also, did they inform you from your biopsy how much cancer there was in each sample. I also have 3+4 with less than 10% within the sample; low Dicipher test; negative on the BRCA; nothing on the digital exam. There is also ablation therapy if something needs to be done.

@JaniceCharters Жыл бұрын

@@MM-sf3rl how were you able to get the genomic decipher and BRACA tests done. Was this initially offered? There's cryo, nanoknife and hifu that might be suitable

@MM-sf3rl Жыл бұрын

@@JaniceCharters The BRCA was done through my hospital. They send me an envelope; I spit in the tube; results were sent to me via email; a consultation was done through a genetic advisor. This guy was not a doctor. More just explain BRCA 1/2. For the Decipher Test, I asked the doctor who did the biopsy to send samples of the biopsy to Decipher. I also got the bill, which was $4,000. I called them and they said because the insurance would not cover the claim, they dropped the price to $300. What a relief. I asked the gal at Decipher about the next test for my 1 year active surveillance follow up, and she said it will be $300 again. Hope this helps.

@MM-sf3rl Жыл бұрын

@@JaniceCharters I also wanted to mention that there are many tests and depending on cells, kind of cancer found, etc., one test many be more effective than the other. I know I’m not explaining that very well, but I hope you get the idea.

@nydental 11 ай бұрын

Useful imformation but he totally did not discuss SBRT “cyberknife” radio therapy

@PureProstate-n5c 2 ай бұрын

Very nice video, and I like your content.

@johnhirst4673 3 ай бұрын

Excellent video, please do more! I am on active surveillance 3+4 and having regular psa tests. Be useful to get some idea of what level of psa is acceptable.

@BruceHodgkinson 5 ай бұрын

Yes the score is confusing. My score was 4+4 =8 But then they said 4+5=9 . I was stage 4. Had a radical prosectamy. A recent pet scan showed no cancer . I decided no radiation. Psa is climbing. .going to enjoy myself

@equitylease Ай бұрын

74 years old, diagnosed with prostate cancer, Gleason 7, 3+4, prostate 80 grams, psa 50, lab reported extremely avid cancer, pet scan localised no evidence of tissue spread, bone spread and lymph node spread, what would you do?

@peterfardell1408 Жыл бұрын

No mention of holep which removes the core of the prostate with a laser beam. I had this before my hormone/radiotherapy treatment. (PSA was 6 with a 3 plus 4). Had18 months of hormone with 3 months to go. PSA is "below minimum Detectable Level".

@JaniceCharters Жыл бұрын

To my knowledge HoLEP is used to remove tissue causing restrictions in BPH rather than prostate cancer

@stevendaniel8126 Жыл бұрын

Gleason was 3+4 Group two PSA 7 and rising Nodule felt Decided on DaVinci.......

@boblongmore907 10 ай бұрын

How'd it turn out?

@franmellor9843 4 ай бұрын

Excellent content--Thankyou!

@desjennings6839 9 ай бұрын

I had 24 samples taken at a recent Prostate Biopsy. Is 24 an excessive number of samples to take?

@glennscurfield9598 9 ай бұрын

Don't know the definitive answer to that but I had quite a few more than that ,hope everything goes well in the future I had radical prostectamy and Psa has been 0.07 for 4 1/2 year's

@desjennings6839 9 ай бұрын

Thanks very much. I get my biopsy results in three days' time. If I need further treatment, my age, 74, and my Atrial Fibrillation will influence decision-making. My fingers are crossed!

@petersamuels9288 9 ай бұрын

Hi I had my biopsy a month ago and had 39 cores taken (9 positive) PSA 18 Gleason 8 (4+4)

@jimmyReesby 5 ай бұрын

I had 28. One had cancer. It's called the Medical money grab. If you get sick... stick em up!

@go4it129 Ай бұрын

It’s double what I had for my biopsy. (12)

@aozoren 7 ай бұрын

superb explanation

@jimjohngirard Жыл бұрын

Excellent discussion and touched on all the considerations of 3+4=7 Gleason Group 2. I had this diagnosis and was directed to IMRT radiation in 28 treatments. No Hormone. Radiology/Oncologist said I was highly favorable and the treatment was curative. On the 7th of 28 treatments and then 6 month interval PSA testing.

@Jack-2day Жыл бұрын

All the considerations? Again where are they for 3+4=7 (which I have) I have read plenty of other options elsewhere, but this is not the only two available.. Cheers

@maxstyle3286 5 ай бұрын

I am aged 66 . My PSA is 4.1 The MRI prostate w wo contrast RAD showed 4 and the biopsy report from 12 samples showed one RA , biopsy 3+3 and one RMPZ biopsy 4+3 . The bone scan showed no spread . Am i considered as Intermediate Risk Prostate Cancer ? Should i do Radiation therapy with or without hormone therapy ?

@LarryK-jg6iw 2 ай бұрын

I was also a 4+3 (age 74) with no spread outside the prostate, and opted for radical prostatectomy surgery a year and a half ago. After no traceable PSA upon initial post-op follow up, I started manifesting "biochemical recurrence" (BCR) soon thereafter. Although BCR PSA values are miniscule compared to those that generate an initial prostate cancer diagnosis, the treatment option is essentially the same as what you are about to undergo when the safe PSA threshold is exceeded. After all, my prostate is GONE, but I am STILL going to need more treatment. The point is, a 4+3 gleason score of 7 is worse than a 3+4 gleason score of seven. There is some reason to believe that your choice of radiation therapy may be favorable to my choice of surgery because radiation technology has greatly improved in recent years. And if you DO relapse in the next five years or so, the surgery option obviously remains. With all this as preamble, it is my understanding that hormone therapy has been a significantly valuable addition to radiation therapy and would seem advisable for someone with a 4+3 gleason score. Cancer cells feed on testosterone and in addition to radiating them, it also helps to starve them.

@Kalense 5 ай бұрын

An excellent video - but the elephant in the room was somehow missed. You talk about side effects for surgery and radiation, but not for hormone therapy. This is a pity since some of them are both physically and psychologically important and may have a considerable effect on the dynamics of the couple. From the point of view of the oncologist its understandable that they focus more on curing the cancer than on preparing the man for the ways his life may change after the treatment. Understandable, but I feel it's selling the guy a pig in a poke. Or to switch metaphors, when offering advice to a complete novice in chess, telling them that taking the queen is a really good thing to do, without warning them to foresee how that capture might degrade their future prospects, does not help the novice to understand how to play the game.