Is surgery appropriate for men with Gleason 8-10 disease? PROSTATE CANCER INFOLINK

[Guest guest]

Discussion in this blog. I am interested to hear how people here think these questions should be answered? Another thought is should be surgery be the the treatment of choice for these men or are their other alternatives that might be more effective or a better choice? It might be helpful if you read the entire blog entry.

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Rioja Zuazu et al. have shown that in this group of men, even when the pre-surgical PSA level is < 11 ng/ml and the pathologic stage is pT2, the 5-year survival based on surgery alone is only 40 ± 7 percent. We therefore have three questions:

What is the appropriate adjuvant therapy for men with Gleason 8-10 prostate cancer, pathological stage pT2, and PSA < 11 ng/ml who have been surgically treated, or should they receive expectant management?

Can we differentiate between the 60 percent of men in this group who will have biochemical progression within 5 years and those who won’t, and should they be treated differently?

What is the appropriate adjuvant treatment for men with Gleason score 8-10 and a PSA > 11 ng/ml and those with a Gleason score of 8-10 and a pathological stage of pT3 post surgery?

It is clear that better guidelines need to be put in place for these men. Adjuvant radiation or adjuvant hormone therapy (or both) may not be the best strategy. Should most of these men be placed on clinical trials?

http://prostatecancerinfolink.net/2008/12/02/is-surgery-appropriate-for-men-with-gleason-8-10-disease/

or

http://tinyurl.com/5ok3pq

Kathy