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4+3=7

Waiting for CT and NM Bone Scan. 58 years old. What treatment to chose ?

  1. I got CT and NM Bones scan results - no spread 😀
    Seeing urologist in 1 hour to discuss the options. Very nervous, I am thinking about radical prostatectomy like da Vinci. 4+3 is worst then 3+4

    1. Hi . It is great to hear that the scan showed no spread. Hope the meeting with the urologist went well. Yes, the first number in the Gleason score is the primary/more prevalent cancer found, so a 4+3 is higher risk. That said, a Gleason 7, even with the 4 as most prominent, is considered slower growing. A seven, combined with a clean scan, opens up a lot of treatment options. Please feel free to keep us posted on how thing are going and to ask questions. Best, Richard (ProstateCancer.net Team)

  2. Next week, I will have video-visit with dr. Peter Schlegel from Cornell in NY. He was recommended by my physician. My current urologist Dr. Rahuldev Bhalla (from New Jersey) who is "expert" on robotic prostatectomy is recommending surgery - this is his specialty 😀 and business (?).
    I do not like 4+3 vs 3+4 and thinking that cancer can grow after radiation. Surgery is more difficult after radiation. I think that with my age I should do surgery. I will make decision after 2nd opinion next week. On the day when I sow my 1st urologist (dr. Bhalla) I became grandfather to babe boy 😀 😀


    1. I was 3+4, PSA 31, Age 53. Had my prostatectomy 3.5 weeks ago.


      I am self-employed and took a part-time leave to put in about 200 hours of reading and consulting three Chief's of Urology at major Universities. My advice would be:


      1) Get at opinion from 2-3 different Urologists and at least one Radiotherapy Oncologist.
      2) If you elect surgery, make sure it Retzius Sparing Robotic Surgery (RS-RARP, not conventional C-RARP robotic) and make sure the surgeon has at least 1,000 surgeries under their built doing RS-RARP. You will have quicker recovery of continence and erectile function is nerves are spared.
      3) If you elect radiation, realtime MRI guided SBRT is currently the state of the art (aka Viewray MRIdian).



      1. OK, scheduled surgery with dr. Jim Hu from Weill Cornell in NYC on August 10. Very nervous. I got a lot of info from his office. He is very experienced > 4000 and is using
        Retzius Sparing Robotic Surgery.

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