I am 59. What does my prostate biopsy report indicate?

Question

Hi doctor,

I am a 59-year-old male with a weight of 114 pounds and a height of 5.4 feet. My PSA (prostate-specific antigen) level was 247.5 ng/ml. I also had a TRUS (transrectal ultrasound scan) guided biopsy, and the report is moderately differentiated adenocarcinoma, Gleason grade 4+4 and perineural invasion present.

What does the biopsy report indicate?
What will be the next step?
What medication should I take at the initial stage before any surgery?

I am currently on Tamsulosin and Dutasteride for prostate issues and Gliclazide for diabetes.

Please suggest.

Answer 1

Hi,

Welcome to icliniq.com.

I am sorry to hear about the problem.

The biopsy report indicates that there is prostate cancer. Since the PSA (prostate-specific antigen) level is very high, it suggests that there may be a possibility that the cancer has spread outside the prostate. The next step would be a PSMA PET (prostate-specific membrane antigen positron emission tomography) scan to identify areas in the body affected by prostate cancer.

If this scan is not available, an MRI (magnetic resonance imaging) scan of the abdomen can be performed to check for local involvement or lymph node involvement, along with a bone scan to detect bone metastasis.

The treatment depends on the stage of the disease. If the cancer has spread to the bones, bilateral orchiectomy (removal of the testes) is the standard treatment. If you prefer not to undergo orchiectomy, regular injections (once every three months) can be administered to suppress testicular function.

You should also receive Zoledronic acid injections every three to four weeks to help control bone spread. In addition to these treatments, calcium and iron supplements are necessary. Please consult the urologist for regular follow-up, as the treatment plan may need to be adjusted based on the PSA response and other clinical factors.

I hope this helps you.

Thank you.