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Old 12-17-2009, 08:29 PM   #2
medved medved is offline
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Join Date: Jul 2008
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Re: Final got the Path report and it's not good!

Upgrade in the Gleason score post-surgery is very common. Indeed, one of the advantages of surgery is being able to get a more accurate read on the cancer, from a path report. Do you know whether the 7 was a 3+4 or a 4+3? The difference is more significant than you might expect. What did the path report say about spread beyond prostate? Just "positive margins" or did it say something more than that? One somewhat complicated decision in these situations is how quickly to move forward with radiation. Unfortunately, there is no uniform view in the medical community on these issues. There is some evidence that starting radiation sooner yields better results. But, of course, radiation is not free of side effects, so nobody wants it if it is not necessary. I suggest that you address this issue not only with your urologist, but also with a reputable radiation oncologist. In doing so, you need to keep in mind that radiation oncologists make money by doing radiation, so there could be a bias. But it is still worth a consultation, in my view.

Best wishes,

Medved