How to manage prostate cancer with Gleason score 7?

Hello,

Welcome to icliniq.com.

I hope you are doing well. I sincerely apologize for replying a little late, and I am truly sorry that you have been diagnosed with prostate cancer (a malignant growth arising from the prostate gland). I understand how much fear and anxiety can arise as soon as a person hears the word "cancer," and these feelings are completely natural.

However, I would like to reassure you that prostate cancer treatment has advanced significantly over the years. Today, management is far more refined and individualized than it was in the past, especially for early and localized disease.

Considering your age and the presence of cardiac comorbidities, heart-related medical conditions that increase surgical risk, surgical treatment is generally not preferred in your case (attachment removed to protect the identity of the patient). Prostate surgery can be associated with long-term side effects such as urinary incontinence, erectile dysfunction (difficulty achieving or maintaining erections), and wound-related complications. For these reasons, and taking your overall health into account, surgical treatment is not recommended for you.

Moving forward, active surveillance is a well-recognized and widely accepted approach in prostate adenocarcinoma (a common type of prostate cancer arising from glandular cells), particularly when the disease is detected at an early stage, as in your case. I strongly recommend this option for you as an initial management strategy.

Under active surveillance, we closely monitor the disease rather than treating it immediately. This includes regular prostate-specific antigen monitoring (a blood test that reflects prostate activity), assessment of the Gleason score (a grading system that indicates how aggressive the cancer cells are), and annual magnetic resonance imaging (a detailed imaging study of the prostate). If the prostate-specific antigen level rises at any point, or if imaging shows disease progression, we can promptly move to active treatment. At this stage, active surveillance offers excellent disease control with no treatment-related side effects and allows you to maintain your quality of life.

That said, if you prefer a more definitive approach to eliminate the cancer, radiotherapy is also a very good option. Radiation therapy works by targeting and destroying tumor cells within the prostate while avoiding the risks associated with anesthesia and surgery. Compared to surgery, it is safer in patients with cardiac conditions and has fewer long-term complications.

Radiotherapy is generally well tolerated. Some patients may experience mild side effects such as urinary tract irritation (temporary urinary symptoms) or gastrointestinal discomfort (bowel-related upset). These effects are usually short-lived and typically resolve within one to two weeks, after which daily activities return to normal.

Based on your current disease stage and overall health, active surveillance is the most suitable initial option, with availability as an effective backup if intervention becomes necessary. Surgical treatment is not recommended in your situation.

I hope this explanation is clear and helps you feel more confident about your treatment choices. Please remember that you are not alone in this journey. If you have any questions or concerns at any time, we are always available to support you.

Treatment plan: Active surveillance, with radiotherapy if needed.

Follow-up: Every 7 days initially, as advised.

Wishing you reassurance, strength, and good health moving forward.

Thank you.